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Spinal stenosis occurs when the spinal canal becomes too narrow and the structures of the spinal cord are compressed. Stenosis (narrowing, tightness) of the spinal canal gives symptoms such as pain, which can occur in the lower as well as in the upper back - the location of the pain depends on which part of the spinal canal has narrowed. Spinal stenosis causes many other problems - what are they and what is the treatment for?

Spinal canal stenosisoccurs when the spinal canal becomes too narrow and the structures of the spinal cord are compressed. The spinal cord is located within the spinal canal, which is limited by the vertebrae that build the spine. Under proper conditions, the spinal canal plays a very important role - it protects the delicate tissues of the spinal cord. In he althy people, the core does not fit tightly to the structures of the spinal canal - there are certain free spaces within this canal. Abnormalities occur when these free spaces cease to exist and there is pressure on the spinal cord - this condition is referred to as spinal stenosis (or spinal canal syndrome).

Spinal cord stenosis usually affects patients over the age of 50. According to statistics, about 1 in 200 people over the age of 50 suffer from it. Men and women suffer from spinal canal syndrome with a similar frequency.

Spinal stenosis: causes

Spinal stenosiscan be both congenital and acquired. In the first case, patients may simply be born with a spinal canal that is too narrow. Having such a feature from birth, however, does not mean that the symptoms of the isthmus of the spinal canal already occur in newborns - usually the pathology worsens over time and various ailments begin to appear in patients only after they turn 30 or later.

Much more common causes of spinal stenosis are changes that occur during the patient's life, such as:

  • degenerative changes of the spine, related e.g. to osteoarthritis (their effect may, for example, be the appearance of bone growths within the vertebrae, the so-called osteophytes, which may compress the core tissuescord)
  • spine injuries
  • neoplasms developing within the bones of the spine and in the lumen of the spinal canal
  • Paget's disease
  • discopathy
  • spinal ligament hypertrophy
  • Ankylosing Spondylitis
  • acromegaly
  • surgical procedures performed within the spine (spinal stenosis may be a complication of such operations)

Spinal canal stenosis: symptoms

Symptoms of the isthmus of the spinal canal appear when there is pressure on some part of the spinal cord. The disease is not the same in all patients with spinal stenosis - the clinical picture depends on which section of the spinal cord is compressed. The most common stenosis is in the lumbar and cervical spine. Much rarer, but also possible, is thoracic spinal stenosis.

Spinal stenosis in the lumbar region

In the course of the most common form of the isthmus of the spinal canal, i.e. the one where the narrowing affects the lumbar part of the spine, the following can be observed:

  • back pain in the lumbar region
  • radiating, unilateral or bilateral lower limb pain (pain may appear first in the buttocks, and then radiate along the thigh to the foot - it may resemble ailments occurring in the course of sciatica)
  • sensory disturbances in the lower limbs (patients may experience e.g. tingling)
  • difficulties with walking (pains usually appear while moving, but disappear at rest)

Occasionally, patients with lumbar spinal stenosis may experience symptoms of cauda equina syndrome (such as leg weakness or urination disorders). A characteristic feature of this form of the isthmus of the spinal canal is that the symptoms that appear in its course usually disappear or decrease in intensity after the patient takes a bent body position (e.g. after making a bend).

Cervical spinal stenosis

When spinal stenosis affects the cervical spine, patients may develop:

  • neck, back and neck pains
  • dizziness and headaches
  • shoulder pain
  • paresis of upper limbs
  • sensory disturbance

Spinal stenosis in the cervical thoracic region

In the rarest form of the disease, i.e. stenosis of the thoracic spinal canal, patients may experience mainlyall back pain ailments radiating e.g. to the ribs, and sometimes also radiating towards the lower limbs.

Important

Neoplastic diseases were listed among the causes of the isthmus of the spinal canal. If they are responsible for the stenosis of the spinal canal, it is very important to start cancer treatment as soon as possible - delay in therapy may significantly worsen the prognosis of patients. There are some so-called alarm symptoms, the occurrence of which together with symptoms of spinal stenosis, requires the implementation of urgent diagnostics for the potential presence of a neoplastic disease in a patient. They include, among others sudden unexplained weight loss, chronic fever and low-grade fever, and severe pain at night.

Spinal canal stenosis: diagnosis

The suspicion of spinal stenosis can be made on the basis of the ailments experienced by the patient. In addition to conducting a physical examination (medical interview), the doctor also performs a neurological examination, thanks to which it is possible to make assumptions as to which section of the spinal cord is being compressed.

Spinal canal syndrome is a progressive disease, but it progresses gradually over many years.

The confirmation of the fact that the patient has a narrowing of the spinal canal may be the finding of changes in imaging examinations characteristic for this condition. Spinal X-ray and magnetic resonance imaging are mainly used in the diagnosis of spinal stenosis. However, an X-ray, and its limited value, can be used to determine, for example, the existence of degenerative changes in the spine, but it does not allow to visualize the spinal cord itself. Patients undergo MRI to visualize the nervous tissue.

Spinal canal stenosis: treatment

In the treatment of patients with spinal stenosis, both conservative and surgical procedures are used. In the first case, the following applies:

  • painkillers (mainly from the group of non-steroidal anti-inflammatory drugs - NSAIDs)
  • physiotherapy
  • kinesitherapy
  • glucocorticoid injections
  • so-called nerve blocks
  • acupuncture

Spinal canal stenosis: surgery

Surgical treatment is performed only when spinal stenosis causes severe pain in the patient, impossible to alleviate with pharmacotherapy, and when the disease results in significant limitations of daily activity (e.g. difficulties in walking).Various surgical techniques are used - both the removal of vertebral fragments (by the so-called laminectomy) or the resection of additional bone structures (such as osteophytes). Sometimes the structures of the spinal canal are stabilized with implants.

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Category:

Spine, bones, joints