Posts Tagged spinal canal
Recovering from Spinal Stenosis, Lumbar Stenosis, Cervical Stenosis review by KBNI serving Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland
Recovering from Spinal Stenosis, Lumbar Stenosis, Cervical Stenosis
Spinal stenosis results from the reduction (narrowing) of the open spaces within the spinal column. Due to the fact that spinal nerves run most of the length of the spine through our spinal canal, a narrowing at any point can increase the pressure on spinal nerves during everyday movement. As one might expect, this narrowing may produce extreme back pain via compression of the spinal nerves. Other symptoms of spinal stenosis include numbness in the legs or arms, weakness in the legs or arms, and problems with bladder or bowel function.
Generally, age-related degeneration is responsible for the onset of spinal stenosis in most patients. As we age, repeated movement of the articulated facet joints of the spinal column breaks down the cartilage on the ends of our facet joints (the joints that link our vertebrae together). Our spinal discs (the shock-absorbing pads between our vertebrae) also become thinner, harder, and less capable of bearing the shocks of everyday movement. This natural degeneration reduces the spaces between the vertebrae, increasing the likelihood of compressed spinal nerves. In some patients, the reduction in open space may be severe enough to threaten the integrity of the spinal cord. Younger people may also develop spinal stenosis, but most of these patients’ spinal columns have been compromised by a disease that affects muscle and bone tissue.
Treatment and recovery options for spinal stenosis patients vary depending on the severity of the narrowing as well as its location. In most cases, the narrowing occurs either in the neck or the lower back. Imaging tests (x-rays, magnetic resonance imaging MRI) will likely be used to pinpoint the spinal nerves that are at risk, as well as to ascertain that the patient’s back pain and other symptoms are the result of an actual narrowing of the spinal canal, as opposed to other natural aging processes. Magnetic resonance imaging (MRI) is particularly useful here due to the fact that it allows physicians to view soft tissue (like spinal nerves) in great detail. Computerized tomography (CT) myelograms may also be used, as these procedures combine multiple x-rays into one complete view of the size and shape of the spinal canal.
For treatment, physicians will likely recommend non-steroidal anti-inflammatory drugs (NSAIDs) to mediate back pain. Corticosteroid injections may also be used to prevent inflammation around compromised spinal disks or compressed spinal nerves. Houston spine pain treatments for more severe spinal stenosis will likely require surgery to increase space within the spinal canal and relieve pressure on the spinal cord or spinal nerves. Back surgery neurosurgery is typically only recommended, however, if conservative treatments like pain medication and physical therapy have failed to adequately address the problem.
When spinal stenosis is present in the lumbar spine (lumbar stenosis), patients may experience pain in the lower extremities, which is worse when standing, and improved when sitting. In rare cases, there may be a loss of bowel or bladder control. When the stenosis is rapid in onset, as may be caused by a severe traumatic disc herniation, or by a fracture, then loss of bowel or bladder control may be more common. When the spinal stenosis is more gradual in onset, as is the case with degenerative changes, then loss of bowel or bladder control is much less common.
When spinal stenosis is present in the cervical spine (cervical stenosis), the spinal cord may be compressed. This may not only lead to pain, but it may lead to paralysis, due to compression of the spinal cord. Pressure on the spinal cord may also create a condition known as myelopathy, in which there is a partial injury to the spinal cord, leading to progressive loss of control of the lower extremities, and possibly a loss of control of bowel and bladder function. The patient may also experience shocks traveling from the neck down the spine, which is known as a L’Hermitte sign. When myelopathy is present, due to cervical spinal stenosis and spinal cord compression in the cervical spine, the MRI scan of the cervical spinal cord will frequently show a high intensity signal, or a bright spot, in the cervical spinal cord. This represents a spinal injury, and may be incomplete, in which case the patient will have function of the lower extremities, or may be a complete spinal cord injury, in where the is no movement below the injury in the spinal cord.
Depending upon the nature of the stenosis, surgery may be performed to relieve the spinal stenosis. When surgery is undertaken to relieve lumbar stenosis, the procedure typically performed is known as a lumbar laminectomy, in which the lamina, or back of the lumbar spine, is removed. This generally has a good chance of success, at decompressing nerves in the lumbar spine often helps their improvement. When surgery is undertaken to relieve cervical spinal stenosis, a cervical laminectomy may be performed from a posterior approach, or an anterior fusion may be needed as well. Unlike lumbar laminectomy which generally had a good result, with improved lower extremity function, laminectomy to decompress the cervical spinal cord is generally not as successful. Removing the mechanical pressure placed on the cervical spinal cord generally helps to reduce the risk of further neurological deterioration, but it is difficult to predict whether there will be any improvement in neurological function. Patients may also experience brisk reflexes in the lower extremities, and may have, upon examination, a positive Babinski sign (flaring of the toes upon rubbing of the soles of the feet). It is important for the patient to know when to seek medical consultation, in order to prevent worsening neurological deterioration. A neurosurgeon or spine surgeon may need to perform neurosurgery in order to try to preserve function. A neurosurgeon is a surgeon who performs neurosurgery upon the brain and spine. A neurosurgeon typically has significant training in spine surgery. A spine surgeon may have had the neurosurgery training of a neurosurgeon, or they may be an orthopedic surgeon who has had fellowship training in spine surgery.
Physicians at the Kraus Back and Neck Institute have significant experience treating cervical spinal stenosis and lumbar spinal stenosis. They are well versed in the full spectrum of treatments, and know when to advise conservative measures, and when to recommend surgical intervention upon the spine.
The Kraus Back and Neck Institute (KBNI) in Houston TX cares for patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Patients suffering from neck pain or lower back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at
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Keywords: spinal stenosis, cervical stenosis, cervical laminectomy, lumbar stenosis, lumbar laminectomy, back pain, spinal canal, spinal nerves, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC), Dallas, Fort Worth, San Antonio, Austin