The vertebrae are connected to each other by the discs in the front and the joints and ligaments in the back, creating a holistic bone structure. The spinal cord and nerves course through the channel formed by this structure. Normally the width of this channel is 13-14mm or more. The situation where this canal narrows for any reason and as a result puts pressure on the nerves it contains is called spinal stenosis.
In whom and how does spinal stenosis appear?
Neck Although it can be seen in the waist area, it is more commonly seen in the waist area in patients over 50 years of age. It can also be seen at a young age in people with various hormonal and metabolic diseases and congenital spine anomalies.
Rarely, this canal may be congenitally narrow. However, what we see more frequently is canal stenosis that occurs with aging. The deterioration and thickening of the joints in the back region of the spine and the thickening of the ligament called ligamentum flavum between the vertebrae narrow the spinal canal. In addition, the deterioration of the discs in the front and their protrusion into the canal may cause additional stenosis. If this deterioration continues, slipping between the vertebrae or even bending like scoliosis may develop.
How is spinal stenosis understood and what kind of complaints does it cause?
One of the most important problems for patients with stenosis is spinal stenosis. The complaint is pain that increases with activation and spreads to the waist and legs (neurogenic claudication). The pain is accompanied by numbness and tingling in the legs and feet. These complaints disappear when the patient rests. To reduce these complaints, patients generally lean forward and walk. Many patients may experience leg cramps and weakness. However, it should not be forgotten that stenosis in the lumbar region may not always cause complaints.
In cases where it is untreated and advanced, reflex, motor and sensory disorders and even urinary and fecal incontinence problems may occur.
How is spinal stenosis diagnosed?
The definitive diagnosis of the disease is made by radiological examination. MRI provides very valuable information on this subject. Tomography and myelography also provide valuable information about the location and extent of the disease.
What is the treatment of spinal stenosis?
The definitive treatment of the stenosis is surgery. However, it is early and the complaints are intense. During periods when there is no pain, rest, reducing waist movements with a corset, medication and physical therapy may be required.
Surgical treatment is required in cases that do not respond to medical treatment, complaints are severe, especially when the canal diameter is 9 mm or less.
The aim of surgical treatment is to relieve the pressure on the spinal cord and nerves. For this, the bones, joints and thickened ligaments that form the back part of the spinal canal are removed. Damaged discs in the front are removed and these sections are supported with metal cages. The integrity and balance of the spine is maintained with screws placed on the back.
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