Spinal stenosis is classified into primary and secondary. Primary stenosis is caused by congenital anomalies, while secondary (acquired) is due to age-related changes, degenerative and infectious processes, injuries, and spinal surgeries.
Two main types of spinal stenosis:
- Cervical stenosis. In this condition, narrowing occurs in the part of the cervical spine.
- Lumbar stenosis. In this case, the narrowing is noted in the lumbar spine.
Causes of spinal stenosis
Symptoms of stenosis develop due to compression of the nerve bundles passing through the spine, as well as circulatory disorders in the cervical or lumbar back. The reasons for compression can be the following:
- Overgrowth of bone tissue, and formation of bone spurs that can grow into the spinal canal.
- Hernias of intervertebral disks. Discs - natural shock absorbers - dry out over time, and soft internal material comes out through cracks on the surface, putting pressure on neighboring tissues.
- The ligaments that connect all the bones of the spine into one system tend to thicken with age and “bulge” into the spinal canal.
- Tumor growth with subsequent compression of surrounding tissues.
- Traumatic spinal injury.
Symptoms of spinal stenosis
Signs of stenosis are caused by compression of sensitive structures that pass through the spinal canal. Symptoms vary depending on the location of the stenosis and the affected nerves.
Spinal stenosis is characterized by the development of the following symptoms:
- Pain in the lower back and legs. The pain is usually bilateral, extending to the buttocks, and thighs and reaching the feet. Sometimes the pain is ascending, starting from the feet and reaching the lower back.
- Numbness of the legs and feet, weakness, and fatigue in the legs at different levels
- Feelings like burning, tingling, and pressure in the legs
- Loss of sensation in the limbs
- Balance problems
- Physical activity causes an exacerbation of the pain syndrome, the development of a convulsive syndrome.
The most characteristic symptom of spinal stenosis is intermittent claudication, which has the following distinguishing features:
- Back pain occurs while walking and radiates down the legs to the front or back of the thigh and lower leg.
- Pain, numbness, and weakness in the legs (legs feel like cotton wool).
- Patients diagnosed with "spinal canal stenosis" note symptoms of dysfunction of the pelvic organs.
- Disorder of urination, and defecation.
- Often, spinal stenosis can be combined with degenerative diseases such as spondylolisthesis and scoliosis.
To establish a diagnosis, the doctor performs a survey, on the basis of which key complaints are determined, conducts an examination, controls neurological reflexes, and determines a neurological deficit. The gold standard of instrumental diagnostics is magnetic resonance imaging and radiography with special functional tests (samples).
To assess the patient's condition before and after treatment, specialized scales are used.
Treatment of spinal stenosis
Most episodes of back pain respond well to conservative treatment. However, it should be noted that spinal stenosis is one of the leading causes of surgical operations in the older age group.
The treatment plan is drawn up by neurosurgeons and depends on many factors: the duration of the disease, the intensity of symptoms, the presence of concomitant pathology, the results of diagnostic imaging (the extent of the lesion). If necessary, specialists of related specialties are involved.
Conservative therapy includes the appointment of drugs, physiotherapy courses (electrophoresis, mud therapy, magneto therapy), as well as physiotherapy exercises.
Drug therapy is represented by the following means:
- Anti-inflammatory drugs are prescribed to reduce local swelling, pain
- Muscle relaxants relax muscles in the lumbosacral region
- Intervertebral regional blockades are aimed at stopping the pain syndrome, they consist in the local administration of an anesthetic drug to achieve the maximum effect.
Drugs that improve blood circulation
With pronounced changes, the ineffectiveness of conservative treatment, the option of surgical treatment is considered. The purpose of the operation is to reduce pain, and slow the progression of the disease. All this is achieved by eliminating pressure on the ultra-sensitive anatomical structures of the spine and creating optimal anatomical relationships.
Surgical treatment methods include:
Surgery for microsurgical decompression of the spinal canal and roots of the spinal cord, with the installation of fixing implants.
The need for the installation of implants and “which ones” is determined by the neurosurgeon after a consultation (examination of the patient, analysis of the results of MRI studies, and radiography).
Forecast and Prevention
Lack of timely treatment can lead to a permanent disability of a person. Possible consequences of spinal stenosis:
- Paralysis and paresis of the lower extremities.
- Violation of the pelvic organs.
- Persistent, intractable pain syndrome.
- Decreased, loss of sensation from the lumbosacral spine and below.
Prevention consists in regular physical activity, balanced nutrition, and weight control. With the development of the first symptoms, it is recommended to immediately seek medical help. Timely treatment is the key to maintaining health.