Posts Tagged spinal stenosis
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
……. Or visit www.SpineHealth.com to SCHEDULE AN APPOINTMENT ONLINE
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
Lumbar Stenosis, Cervical Stenosis, Arthritis, Spinal Stenosis and Effects of Aging on Spine discussion KBNI Houston, Katy, Woodlands, Sugarland, Beaumont, Texas Medical Center TMC
Posted by admin in arthritis, back injury prevention, baytown, beaumont, cervical, cervical spine, cervical stenosis, chiropractor, chiropractor near me, core strengthening exercise, disc degeneration, fracture, houston, katy, low back pain, lumbar, lumbar spine, lumbar stenosis, neck pain, nutritional supplements, pain, spinal stenosis, sugarland, woodlands on June 21, 2014
As the body and spine age, degenerative changes of arthritis and spinal stenosis can affect the spine. When this occurs in the cervical spine (neck) , it is known as cervical stenosis, and when it occurs in the lumbar spine (low back) , it is called lumbar stenosis. Aging typically has an impact on every aspect of daily life, and movement of the spine is no exception. The spine is involved in almost every kind of routine movement: twisting, standing, sitting, walking, and running included. Aging can lower mobility, endurance, strength, and balance, but certain exercises and lifestyle choices help to prolong (and even counteract) some effects of aging, particularly in the case of the spine. The network of muscles, ligaments, and tendons in the torso begins to lose mass as we grow older (as do all muscles in the body), and it becomes more difficult to build muscle mass due to our cells not reproducing as vigorously as they do while we are young. Water loss in tendons (which attach muscles to bones) also makes these tendons stiffer and less capable of managing load-bearing stress. A regimen of core strengthening exercises can prolong torso strength, as well as assist in managing the body’s weight distribution. Regular core strengthening will also help reduce wear on the spinal disks (shock-absorbing pads between our vertebrae) by reducing stress placed upon the spinal column during movement.
The lumbar spine anatomy and the cervical spine anatomy consist of vertebral segments, which are held together by ligaments, which cross over the disc spaces, and over the facet joints (which separate one vertebral level from the next). There is ligament in front of the vertebral body known as the anterior longitudinal ligament. The ligament behind the vertebral body is called the posterior longitudinal ligament. The ligaments around the facet joints are the capsular ligaments. The ligament between the spinous processes is the interspinous ligament, and the ligament between the transverse process is the inter transverse ligament. Of particular importance for the aging spine is the ligamentum flavum, which is a ligament which is found on the inside of the spinal canal, just under the lamina (which is the back roof of the spinal canal). As the spine ages, this ligament can become thickened, and compress upon the nerves of the spinal canal, a condition known as spinal stenosis (cervical stenosis, lumbar stenosis) . When this occurs, patients may experience pain in the neck or low back, or arms or legs. When the spinal stenosis occurs in the neck, it is cervical stenosis. When the spinal stenosis occurs in the low back, it is lumbar stenosis.
Arthritis also affects the aging spine. Arthritis is inflammation of the joints. The spine has many joints, and these can become inflamed, resulting in pain and stiffness. There are two major typed of arthritis, osteoarthritis and rheumatoid arthritis. Osteoarthritis is a result of normal aging or wear and tear upon the spine. Rheumatoid arthritis is a result of an autoimmune disorder. Generally, the goal of arthritis treatment is to improve quality and function of live. When the spine undergoes arthritis, bone spurs can grow inside of the spine and outside of the spine. The facet joints can become thickened and overgrown, and the arthritis can result in bone overgrowth and compression upon nerve roots. The nerve compression from arthritis can affect the spinal nerves in the central canal (where all of the nerves of the spine pass as they traverse the distance from the brain to the rest of the body) and the arthritis can affect the nerves as they leave the spinal canal through the neural foramen, which are openings in the side of the spinal canal located just next to the facet joints.
Our spinal disks, along with our spinal joints, help our spine articulate, but they also gradually wear down and undergo disc degeneration. They can become thinner, causing a loss in height, as well as a rupture (herniated disc )as a result of regular load-bearing stress, sudden impact trauma (such as a fall), or due to increased body mass. Proper hydration, healthy weight management, a varied and nutritious healthy diet, nutritional supplements, and regular rest will all help prolong the effects of aging on the spinal disks, in addition to maintaining bone density at near-optimal levels. High bone density means less incidence of osteoporosis (low bone density), and a much lower probability of bone density-related spinal fractures (osteoporotic compression fractures). Vertebral compression fractures can press upon the nerves of the spine. Smoking can also have an adverse effect on overall spine health.
Our heart muscle gradually loses efficiency, meaning that on a year-by-year average, we are less capable of pumping blood in a given amount of time. This means we get tired more quickly and our muscles take longer to recover from stress. For the spine, this means that the support network of bones, ligaments, and muscles around the spine receive less and less nutrition, especially during periods of load-bearing stress. Regular cardiovascular exercise, proper hydration, and a healthy diet as well as weight management will help maintain heart muscle as we age.
In summary, the aging process can take a severe toll upon the spine. Arthritis in the spine can develop, and along with this, the ligaments can become firm and thickened, resulting in spinal stenosis, lumbar stenosis and cervical stenosis. Proper physical activity, proper nutrition, core strengthening exercises, sciatica exercises, and stretching can help to slow down and even reverse the aging process, as it relates to the spine.
Spine experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have expertise at taking care of patients with aging symptoms of the spine, in particular arthritis, and spinal stenosis including lumbar stenosis and cervical stenosis. In the majority of cases, patients may undergo a treatment course and improve without the need of an operation. When surgery is necessary, Neurosurgeons at the KBNI utilize the most advanced techniques in minimally invasive spine surgery when it is appropriate.
The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, 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 a cervical stenosis or lumbar stenosis, or who have been told they may require a lumbar laminectomy or cervical laminectomy, can contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to schedule an appointment online
Keywords: lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin
Spinal Stenosis or Lumbar Stenosis Causes Low Back Pain and Leg Pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur
Depending on where in the spinal column it manifests, spinal stenosis can be an extremely serious condition. Lumbar (low back) spinal stenosis involves the compression of spinal nerves that run along the spinal column. Spinal nerve compression typically causes decreased mobility accompanied by very sharp lower back pain. This type of spinal nerve compression also produces sciatica, which is normally a radiating or shooting pain down one or both of the legs. Lumbar spinal stenosis is normally less serious, given that the spinal cord is not at risk for compression. Cervical spinal stenosis, however, is potentially far more dangerous. The cervical spinal cord can be compressed, causing nerve damage and, if left untreated, paralysis. When a patient experiences lumbar spinal stenosis, symptoms of pain in the lower extremities typically increases when standing or walking, but improves when sitting. This is because the ligamentum flavum, which is the “yellow” ligament which lies behind the nerves, buckles when standing, but stretches and therefore thins when bending or sitting, thus thinning out and relieving pressure on the nerves in the lumbar spine. The pain which a patient experiences in the legs when standing is different than the pain of “vascular claudication” which is pain in the lower extremities which occurs when a patient is walking. This vascular claudication or leg pain results from increases activity of the muscles of the legs, without adequate blood supply to the muscles, because of narrowing of the arteries feeding the muscles in the leg.
There are several different possible causes for spinal stenosis, and physicians will normally need to conduct imaging tests (CT scans, magnetic resonance imaging MRI , and X-rays) to determine the best course of treatment. Excessive bone growth, herniated (slipped) spinal discs, tumors, overly thick spinal ligaments, and physical trauma can all potentially cause spinal stenosis. Since these problems may need corrective surgery, physicians may require several tests to ensure an accurate diagnosis. In the case of spinal tumors, this will often include a biopsy to determine whether the mass is malignant, as well as if the cancer has spread to other regions of the body.
Surgery to correct lumbar spinal stenosis is typically called a decompressive lumbar laminectomy, which is a surgery of the lumbar spine to remove the back of the spine, the lamina and spinous processes, and remove the ligamentum flavum, to give the nerves more room, and take away pressure on the nerves.
Several medications, such as anti-inflammatories, muscle relaxants, and pain relievers, will often be administered during post-operative care. Physical therapy will also form a cornerstone of a patient’s recovery from spinal stenosis. Physicians typically prescribe a regimen of core strengthening exercises to build up the network of ligaments, muscles, and tendons around the spinal column in order to maximize their ability to assist the spine in bearing the stresses of movement. Increased blood flow and nutrition from aerobic activity will also help in maintaining optimal core strength. Patients should complete their entire physical therapy regimen, as well as adopting long-term core strengthening exercises to lower pain levels and reduce the possibility of subsequent back surgeries.
Spine experts at the Kraus Back and Neck Institute have significant experience treating patients with lumbar spinal stenosis and cervical spinal stenosis. Patients are treated from Houston and the surrounding areas, including Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont and Port Arthur.
“So don’t live in fear and pain.” Come see the experts at the Kraus Back and Neck Institute in Houston, TX.
KRAUS BACK AND NECK INSTITUTE VIDEO, DR GARY KRAUS AND DR MASAKI OISHI
Keywords: spinal stenosis, lumbar stenosis, spinal nerve, physical therapy, core strength, low back pain, leg pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur