Sunday, January 6, 2008

Spinal Stenosis

Spinal Stenosis

A condition due to narrowing of the spinal cord causing nerve pinching which leads to persistent pain in the buttocks, limping, lack of feeling in the lower extremities, and decreased physical activity.

The Silent Epidemic

Physical Therapy
Physical therapy can often help relieve symptoms by restoring flexibility and strengthening back and abdominal muscles. This program may include:
Heat/cold therapy
Water therapy
Dynamic lumbar stabilization program
Electrical stimulation
Assessment of musculoskeletal imbalances
Stretching exercises
Posture and body mechanics training
In the earlier stages of spinal stenosis, pain-relieving and anti-inflammatory medications such as ibuprofen and acetaminophen can relieve mild symptoms.
Pain-blocking Injections
Inflammation of the spinal nerves and nerves roots can often be reduced through steroid or cortisone injections next to the spine, at the site of back pain. However, pain-blocking injections offer temporary relief and may need to be administered more than once a year, depending on the patient's needs.
Decompressive Surgery
Surgeons can alleviate abnormal pressure by decompressing the spinal canal, removing bone and ligaments around the narrowing. Decompressive surgery is usually recommended for patients with severe symptoms which haven't been relieved by other treatments.
In a procedure called a laminectomy, an incision is made in the patient's back to access the spinal canal. The canal is O-shaped, formed by the vertebrae in front and tissue (lamina) at the rear. Physicians surgically remove the lamina, changing the canal from an O to an open-ended U shape, which creates room in the canal and restores nomal blood flow to the nerves. The patient's back muscles cover and protect the open area of the canal.
Laminoplasty is a variation on cervical laminectomy (in the neck) used in some patients; it preserves movement (no lost range of motion from fusion), and does not require as much bone removal as a laminectomy.
Some patients may be candidates for a minimally invasive approach to spinal surgery.

Wear and tear on discs and joints can cause spinal instability as well as stenosis. In such cases, it may be necessary to brace the spine by fusing the backbones. Metal rods, hooks, wires, and screws are all strong, safe and effective fusion methods. Other patients may benefit from stabilization with bone implants specially designed for grafting. Both methods effectively brace the spine and lessen pain.

source :
Article: Multislice CT fluoroscopy-assisted cervical transforaminal injection of steroids: technical note
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