Thursday, June 27, 2013

Stenosis of the Spine - Spinal Stenosis, A Huge Spinal Problem


The spine is perhaps one of the most important groups of bones in the body, considering that it houses and protects the spinal cord, which is essential for any person to live a normal life. Any injury that may happen to the spine can have serious repercussions, such as severe back pain, which may extend from the neck, lower back, and down to the legs, weakness and a tingling sensation both often occurring in the lower extremities, permanent paralysis, and even death. One often serious problem with the spine and the spinal cord is the stenosis of the spine.

Spinal stenosis is basically the narrowing of the spinal canal, resulting in the impingement of various nerve roots and even the spinal cord, by bony spurs from fractures or other soft tissues, such as in the case of a herniated disc. Though spinal stenosis may occur anywhere in the spine, the lumbar or lower back area is the most vulnerable to spinal stenosis, which is known as lumbar spinal stenosis.

In general, spinal stenosis occurs due to a number of factors, though it is commonly caused by degenerative arthritis. Similar to the arthritis of other joints in the body, degenerative arthritis manifests as we grow older. This can lead to the loss of cartilage in the joints, formation of bone spurs, occurrence of degenerative disc disease, which is the deterioration of the spinal discs, and overgrowth of the ligamentous structures. Each of these can cause the narrowing of the spinal canal, which in turn can cause the impingement of the nerves. Other less common factors that can cause spinal stenosis are tumors, infections, and various metabolic bone disorders.

Lower back pain and weakness, numbness, pain, and loss of sensation of the lower extremities can often be experienced with spinal stenosis. In many cases, the severity of pain increases while standing or walking and diminishes when at rest, leaning forward, or lying down. Awkward positions like bending backwards can make the situation even worse. Over time, especially when caused by degenerative arthritis, spinal stenosis worsens, considering that degenerative arthritis is a progressive disease. When left untreated, the nerve impingement can lead to the Caude Equina Syndrome, which is exhibited by weakness or loss of function of the legs, as well as loss of bowel and bladder control, and loss of sexual function.

When it comes to spinal stenosis treatment, there are many readily available medications, exercises, and procedures that can improve or fix the situation. In most cases, physicians would recommend the use of various conservative treatments, such as medications for the reduction of inflammation, short courses of oral cortisone medication, and various pain medications. Some medications that are primarily used for nerve pain can also help with spinal stenosis, such as gabapentin and pregabalin. Steroid injections may even be injected directly into the affected area to reduce inflammation and swelling around the nerve tissue.

For a more drastic measure, spinal stenosis surgery may be recommended by the physician, especially when conservative treatments do not provide any relief. Basically, common surgical procedures done for spinal stenosis are laminectomy, laminotomy, and foraminotomy, which focus on removing the cause of the nerve impingement. In some cases, spinal and lumbar fusion may also be done together with the above mentioned procedures. However, many patients and physicians treat surgery as a last resort because of the many complications that may arise during and after the surgery and the long recovery period.

One of the most popular treatments for the stenosis of the spine is natural or home remedies, such as stretching exercises, physical therapy, and the use of the spinal decompression machine. Through various stretching and back strengthening movements, nerve impingement can be relieved. Spinal decompression therapy with a decompression machine can also help improve the situation by using traction on the affected area.

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