Spine-spinal canal stenosis (Spinal stenosis) is used to describe the stenosis of the spine-spinal canal and nerve root canals. It occurs due to congenital or later events (developmental, degenerative, traumatic, iatrogenic, etc.) in the spinal stenosis, bone and/or soft tissues. Degenerative spinal-spinal canal stenosis, or more commonly known as spondylosis, is a reflection of aging in the spine and is much more common than other causes that cause stenosis. Although the concept of spinal-spinal canal stenosis has been known for a long time, its modern definition is very new. This concept, which attracted attention with the articles published by Sarpyener in 1945 and Verbiest in 1949, fully entered the literature in the 1950s.
Spine problems that may occur in the aging spineare shown below.
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Osteoporosis
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Low velocity traumatic spine fractures: Osteoporotic fractures
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Spine-spinal canal stenosis
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Deformities-spine curvatures and balance problems
Spine spinal cord The canal surrounds the spinal cord from the foramen magnum to the level of the L1 vertebra, and the cauda equina fibers after the L2 vertebra. The anteroposterior diameter of the canal is 17±5 mm between cervical vertebrae 3-7. The canal, which has an average diameter of 12-14 mm in the thoracic region, expands in the lumbar region and reaches a diameter of 20 ± 5 mm. In cross sections, the boundaries of the channel vary depending on where the section passes. In a section passing through the middle of the spine, the anterior border of the canal is the body of the spine, the lateral borders are the pedicles, and the posterior border is the lamina. In congenital stenosis, pedicles are typically short and stenosis is most common in this region of the canal. In a section passing through the intervertebral disc level, the anterior border of the canal is the annulus fibrosus, the lateral borders are the facet joints and their capsules, and the posterior border is the ligamentum flavum. In degenerative stenosis canals, the narrowest part of the canal is here. The diameter of the spinal canal is particularly narrow In cases with anal, it is also affected by dynamic and postural factors. The intervertebral disc and its constituent annulus fibrosus and nucleus pulposus are structures that contain high amounts of water. The water content in the nucleus pulposus of a young adult is 80%. The nucleus pulposus, surrounded by annulus fibrosus fibers, transmits axial loads to the annulus fibers, converting them into tensile forces, and ensures that some of these forces are absorbed in the flexible fibers of the annulus and some of them are transmitted to the vertebral end plates. When the intervertebral disc ages and loses water, its height decreases and the balance in the distribution of axial loads begins to deteriorate. Accordingly, there is more load on the facet joints and their capsules, and hypertrophy develops in the facet joints and ligaments.
Spine-spinal canal stenosis (Spinal stenosis) begins to be seen after the age of 40 and has a rate of 50% in direct radiographs of people over 50 years of age, and as high as 85% after the age of 65. reaches. Genetic factors, trauma (single, major or recurrent minor), or rheumatoid arthritis may be factors in the development of spondylosis, or degenerative changes may develop with advancing age without any factors. Although the spinal narrow canal of the cervical or lumbar region is similar in mechanism, it will be examined under separate headings due to anatomical differences.
It is necessary to think very carefully before deciding on surgery in the geriatric population. The most appropriate treatment should be chosen in terms of possible complications and consequences. This treatment may be different from adults. What may seem like a very simple problem may arise with major surgery.
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