Spinal Stenosis

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal column causing pressure on the spinal cord. Spinal stenosis most often occurs in the lower back and neck. This condition most commonly occurs as a result of the aging process.

In most cases, spinal stenosis affects people over the age of 50. However, this condition can actually be experienced by everyone of all age groups.

Spinal stenosis is a condition that needs to be treated immediately. This is because spinal stenosis that is not treated quickly and appropriately has the risk of causing a number of serious complications, one of which is paralysis .

Causes of Spinal Stenosis

Spinal stenosis is generally caused by the aging process. As you get older, body tissues undergo a process of change, including in the spine. Spinal tissues, such as ligaments, begin to thicken and the bones become larger, putting pressure on the spinal nerves.

Apart from aging, spinal stenosis can also be caused by the following conditions or diseases:

Abnormal bone growth

Bone spurs ( osteophytes or bone spur ) and Paget 's disease are conditions of abnormal bone growth that can narrow the vertebrae and cause pressure on the spinal cord.

Disc herniation

With age, the walls of the spinal column become weaker. This condition causes the spinal discs to protrude so that they can press on the spinal nerves.

Tumor

Tumors can grow in the spinal cord, in the membranes that line the spinal nerves, or in the space between the nerves and the spinal column. This disease causes the vertebrae to narrow and compress the spinal cord.

Spine injury

Displacement of bones ( spondylolisthesis ), broken bones, cracked bones, to swelling of the tissue in the spine caused by injury , can also cause spinal stenosis.

Risk factors for spinal stenosis

Apart from the causes above, there are a number of factors that can increase a person's risk of suffering from spinal stenosis, namely:

  • Over 50 years old
  • Born with a deformity of the spine
  • Have a history of spinal cord injury
  • Suffering from scoliosis

Symptoms of Spinal Stenosis

Spinal stenosis does not cause any specific symptoms at first. However, over time, spinal stenosis will cause complaints that vary, depending on the part of the bone that is affected.

The following are some parts of the bone that are affected and the symptoms that accompany them:

Neck stenosis (cervical stenosis)

Cervical stenosis is a narrowing of the vertebrae in the neck. Symptoms that can occur are:

  • Numbness or tingling in the hands, arms and legs
  • Weakness in the hands, arms and legs
  • Neck pain
  • Balance disorders
  • Loss of ability to move hands, for example when writing or buttoning clothes

Lumbar stenosis (lumbar stenosis)

Lumbar stenosis is a narrowing of the vertebrae in the lower back. Symptoms of lumbar stenosis can include:

  • Numbness or tingling in the buttocks or legs
  • Weak in the legs
  • Lower back pain ( low back pain )
  • Pain or cramps in the legs when standing too long or when walking down stairs

In severe cases of spinal stenosis, lumbar stenosis can cause other symptoms, namely loss of the ability to hold back urination or bowel movements.

When to see a doctor

Check with your doctor if you experience symptoms of spinal stenosis. Handling needs to be done as early as possible to prevent disease development and complications.

You are also advised to seek medical help immediately if you start to have difficulty walking and cannot hold back your urine or bowel movements.

If you have been diagnosed with spinal stenosis, check with your doctor regularly. In addition to monitoring the results of therapy, routine checks also aim to reduce the risk of complications.

Diagnosis of Spinal Stenosis

The doctor will conduct a question and answer about the patient's symptoms and medical history, followed by a physical examination. Physical examination can measure the patient's ability to move his hands if the patient is suspected of having neck stenosis.

To make a diagnosis, the doctor will also carry out supporting examinations, such as:

  • X-rays , to detect whether there are changes in the spine, such as the occurrence of bone spurs that narrow the vertebrae
  • MRI , to detect damage to the ligaments or spinal discs, as well as detect tumors and pressure on the spinal cord
  • CT myelogram , to see the condition of the spinal nerves in detail and find out whether there are deformities in the spine

Spinal Stenosis Treatment

The treatment given by the doctor will be adjusted to the type of spinal stenosis and the severity of the symptoms experienced by the patient. The goal of treatment is to relieve symptoms, relieve pressure on the spinal cord, and help the patient to carry out normal activities.

Several treatment options that can be given by doctors to treat spinal stenosis are:

Drugs

To relieve the symptoms of spinal stenosis, doctors can give the following medicines:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to relieve pain in the spine
  • Anti-seizure drugs, such as gabapentin and pregabalin , to relieve pain caused by damage to the nerves
  • Tricyclic antidepressant drugs , such as amitriptyline, to relieve chronic pain
  • Opioid pain relievers, such as oxycodone , for short-term pain relief
  • Injectable corticosteroid drugs, such as prednisone , to relieve inflammation and pain

Physiotherapy

After the symptoms subside, physiotherapy can be done to strengthen the back and abdominal muscles, and increase the strength and flexibility of the spine. This physical therapy will restore the function of movement and balance of the body which is reduced due to spinal stenosis.

Operation

Surgical procedures may be performed if other methods are not effective in treating spinal stenosis. Several types of surgical procedures that can be performed are:

  • Laminectomy or decompression surgery, to remove all parts of the vertebrae (lamina) that are pressing on the nerves
  • Laminotomy, to remove part of the vertebrae that is pressing on the nerves
  • Foraminotomy, to widen the hole (foramen) where the nerves exit in the spine by scraping the bone around the hole
  • Spinal fusion, to join two vertebrae if other surgeries don't improve symptoms.

Spinal stenosis surgery can be done manually or combined with robotic spine surgery .

Spinal Stenosis Complications

Untreated severe spinal stenosis can lead to the following complications:

  • Numbness in hands or legs
  • Balance disorders
  • Urinary incontinence
  • Paralysis

Prevention of Spinal Stenosis

Considering that spinal stenosis is generally caused by aging, this condition is difficult to prevent. However, there are several ways you can do to reduce the risk of developing spinal stenosis, namely:

  • Exercise at moderate intensity regularly
  • Quit smoking
  • Eat a healthy, nutritionally complete and balanced diet
  • Maintain body weight to remain ideal
  • Maintain good posture when sitting or standing and position your shoulders perpendicular to your hips
  • Don't lift things that are too heavy
  • Undergo routine doctor checks if you have a history of spinal disease
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