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Category: Spinal Stenosis

Carl Spivak, MD - Executive Spine SurgeryNewsSpinal Stenosis
symptoms of spinal stenosis
By Staff Writer Spinal Stenosis

5 Important Symptoms of Spinal Stenosis to Watch

Do you suffer from intense pain in your back?

If so, you’re not alone. The American Chiropractic Association reported most sick days at work occur due to back pain and that it serves as the single leading cause for disability in the United States.

Symptoms of spinal stenosis greatly contribute to this statistic. 

What is Spinal Stenosis?

Spinal stenosis refers to narrowing of the spinal cord. Causes of this narrowing include:

  • arthritis
  • bone spurs
  • degenerative spondylolisthesis
  • a herniated disc
  • scoliosis
  • tumors
  • an injury to the back

As this narrowing occurs, it causes the ligaments to thicken and the bones of the vertebrae to overgrow. The spine can narrow in one portion or in multiple portions.

Narrowing can occur in the spaces between vertebrae, the space in the middle of the spine, and or the part of the spine where the nerve plexuses branch outward. Cervical stenosis happens up in the neck while lumbar stenosis occurs down in the lower back.

This common cause of back pain should not get ignored. You should know what stenosis symptoms to watch for as it can lead to nerve damage, resulting in serious problems.

5 Important Symptoms of Spinal Stenosis

Pain serves as an alarm from your body to signal possible danger to your health. Back pain can come from all sorts of causes. When you experience back pain, you should look for other symptoms that can help you find the cause.

If spinal stenosis is causing your back pain, then you need to see a professional. Read on to learn 5 important symptoms of this debilitating condition.

1. Numbness and Tingling

Sometimes you may experience a harmless bout of numbness and tingling when you sit with your legs crossed for too long, and it goes away within minutes. However, if you continuously experience this sensation for no apparent reason, then it may signal something more serious.

Anytime you experience numbness and tingling for a prolonged period of time, you should pay attention. It signals trouble with your nerves.

As spinal stenosis narrows the spinal cord, it presses on the nerve. Nerves constantly send impulses to help you feel and move and an interruption to these impulses creates that pins and needles sensation or a complete loss of sensation. When spinal stenosis causes this numbness and tingling, you may feel it in your arm, hand, foot, and/or leg, depending on the area affected.

2. Weakness

Nerves allow for voluntary muscle movement by allowing you to feel the area and therefore manipulate it through electrical communication. Sort of the way you move Mario with a Nintendo controller.

As the narrowing damages nerves and blocks the impulse, they will not work properly. If you damage your controller wires, you may find that Mario only moves limitedly or not at all.  In the same sense, blocking nerve communication means that you lose control of the area that particular nerve regulates. 

As a stenosis symptom, you will experience this weakness in the same areas that you feel the numbness and tingling. You should seek help at the first sign of weakness.

One common form of weakness from this condition comes in the form of foot drop. This means that the weakness in the foot or leg muscles makes the foot slap the floor as the person walks. Early treatment may reverse this symptom, but letting it go may lead to permanent nerve damage and loss of function in that area of your body.

3. Difficulty Standing or Walking

Weakness leads to loss of function.

Cervical stenosis can lead to shakey hands or clumsiness. This can make it difficult to write, drive, and do other important daily activities.

Lumbar stenosis can eventually make walking and standing painful and difficult, as it weakens the legs and feet. This also affects the person’s balance, causing falls.

4. Chronic Headaches

Cervicogenic headaches begin in the neck and spine, resulting from the pressed nerves. This type of headache closely resembles migraine pain. It feels steady and does not throb.

It may start as an intermittent pain in the head. Over time, the pain occurs more frequently.

It often starts at the base of the neck or between the shoulder blades and spreads throughout one side of the head. Sometimes the person may also feel forehead and brow pain as well.

5. Bladder or Bowel Incontinence 

As spinal stenosis progresses, the scope of muscle weakness grows. Cauda equine syndrome refers to a seriously progressed version of this condition. 

As the bony protrusions and swollen ligaments continue to compress the spine, the damage can start to affect the entire lower region of the body. This leads to the inability to control the bladder and/or bowels.

Not only can this create embarrassing situations, but it alerts you to a serious compression of the spinal cord. At this point, you need to get to an emergency room. Letting it go any further can result in permanent paralysis of the legs.

Treatment Options

To treat spinal stenosis symptoms, you may use pain relievers, anti-inflammatory medications, steroid injections, and special exercises. However, only spinal surgery fixes spinal stenosis at its source.

Device Implants

For a person not quite ready for a more serious procedure, a surgeon may provide the patient pain relief by implanting a device into the spine. This can help reduce pain by limiting the forward and backward movement to reduce spinal compression.

Minimally Invasive Laminectomy

This procedure allows surgeons to remove the lamina, a part of the vertebrae that protect the spinal cord, to relieve pressure. It can also involve fusing the spine, to create a single bone.

If possible, this provides patients with the best treatment option. It offers a long-term solution and does not require an extensive recovery time like the traditional, more invasive open spinal surgery.

Seek Professional Help for Your Back Pain

If you experience symptoms of spinal stenosis, then you should see a medical professional for diagnosis and treatment. Do not ignore your symptoms because they will not disappear on their own. Early detection of this condition can prevent permanent disability.

Living with pain greatly affects the quality of life. We want to help! Take your life back by booking an appointment with us today.

 

By Staff Writer Spinal Stenosis

10 Facts You Need to Know About Spinal Stenosis Surgery

Spinal Stenosis SurgeryYou can never be too careful about your health. Living with chronic and often debilitating pain is, unfortunately, a reality for many patients, and can sap life of all its joy.

Spinal ailments are some of the major causes of chronic pain, and are caused by a variety of conditions.

Spinal stenosis is a fairly rare condition in which the spinal canal can start to narrow, exerting pressure on the spinal cord and nerves. This causes numbness, tingling, and often pain in the arms, legs, torso or back. It often requires spinal stenosis surgery.

Spinal stenosis most commonly occurs in those above 50 years of age and can be categorized into two main types—Lumbar Stenosis and Cervical Stenosis.

Lumbar Stenosis- This affliction targets the spinal nerve roots in the lower part of the back, often producing symptoms of sciatica—tingling, weakness or numbness that radiates from the lower back and spreads to the hips and legs.

Cervical Stenosis- Rarer than lumbar stenosis, cervical stenosis is characterized by pain in the neck and is often more dangerous than lumbar stenosis. Compression of the spinal cord can lead to serious problems—often even paralysis.

The treatment involved in spinal stenosis can be fraught with dangers, and must be ventured into only with a qualified and experienced medical professional. Cervical spine surgery recovery can take three months to a year.

Neurological surgery and spine surgery are extremely invasive and critical procedures, as the target area is the spinal cord. A minor slip by the physician can cause extreme complications, including patient paralysis.

Here are 10 important things to keep in mind if you are contemplating corrective surgery to treat spinal stenosis:

  1. Spinal stenosis surgery is often seen as the last resort in treatment.

Physicians don’t often recommend spinal stenosis surgery unless all other options have been exhausted.

Your doctor will most likely try to treat spinal stenosis with other, non-invasive options like exercise, physical therapy and perhaps, a back or neck brace, before resorting to surgery.

Some considerations physicians keep in mind when recommending stenosis of the spine surgery are:

  • If the patient has been suffering pain from a long time
  • Whether stenosis has caused numbness or loss of sensation in the limbs
  • Loss of control over bowel movement
  • Loss of strength and control in the arms and legs.
  1. Spinal stenosis can often be treated non-surgically.

Exercise, physiotherapy and physical constrictions can often clear up mild cases of stenosis, without requiring surgery.

Doctors may prescribe one of more of the following, non-invasive modes of treatment.

  • Medication to alleviate pain
  • Exercises to correct spinal narrowing
  • Medicines to reduce swelling
  • Physical therapy with a qualified physiotherapist
  • Limits on physical activity
  • A brace or similar constrictive instrument for the back.

Spinal cord stimulation is also a mildly invasive, but very effective form of treatment that can help in alleviating spinal stenosis symptoms.

  1. Prepping for surgery.

Spinal stenosis surgery often requires specialized blood tests, ECG, urinalysis, cardiovascular, pulmonary, and other tests to determine the patient’s health condition.

In addition, patients may be asked to follow a special diet before surgery, refrain from smoking and the use of anticoagulants such as Coumadin and Aspirin, as these can interfere with the natural process of blood coagulation.

  1. Reasons you could need spinal stenosis surgery.

Surgery should  be considered only  if you :

  • Have exhausted all other treatment options.
  • Suffer from chronic and extreme pain.
  • Have low motor strength or loss of sensation in your arms and legs.
  • Have little to no control over bowel movements.
  1. Surgery Techniques.

Spinal stenosis surgery is done to free up areas for your spinal cord and the nerve roots. This is called decompression.

The two main surgery techniques that are often employed in spine surgery are:

  • Decompression– tissue pressing against a nerve structure is removed, making more room for the spinal canal.
  • Stabilization– limits motion between the vertebrae.
  1. Open Spine Surgery or Minimally Invasive Spine Surgery?

Surgery usually performed by means of a deep incision in the back is called open spine surgery;  the minimally invasive procedure is performed via several, smaller incisions requiring the use of a microscope, endoscope, and a tiny camera.

Minimally invasive surgery is by far the safer option; however, severe cases of spinal stenosis may require open spine surgery.

  1. Risks associated with surgery.

The potential risks associated with spinal stenosis surgery are:

  • Injury to spinal cord/nerves
  • Infection
  • Anesthesia risks
  • Pseudoarthrosis (this is where the bony fusion doesn’t heal as well as it should)
  • Bone graft site pain
  • Instrument breakage or failure.
  1. Surgery Outcomes.

Spinal Stenosis surgery yields good results: 80-90% of patients report alleviation of pain levels. However, it doesn’t cure the condition instantly.

Patients may require pain medication for 2-4 weeks and additional time before returning to normal physical activity.

  1. Recovery Period.

The recovery period for spinal stenosis surgery is usually three to six months, but it can last up to a year.

Your doctor will probably instruct you on carefully sitting, standing and moving, to avoid any strain on the spine.

The body needs time to heal after surgery, so it is advisable to avoid heavy lifting, sports or physical exertion during the recovery period.

Pain alleviation techniques and exercises can help here. However, be sure to consult your doctor before starting any sort of physical exercise, therapy or medication.

  1. Alternative treatments.

Non-conventional treatments for spinal stenosis include chiropractic adjustments and acupuncture. These can be undergone in conjunction with regular treatment methods.

Another proven way of treating stenosis is SPS (Spinal Cord Stimulation). Most patients having undergone the procedure report a 50 to 70 percent alleviation in pain, and studies suggest that SPS may affect the emotional perception of pain, as well.

Living with chronic pain can be punishing, and is never pleasant. Surgery is one of the ways out; however, other, non-invasive treatments can be just as effective.

Being aware of the risks, outcomes, and realities of stenosis surgery is an important part of the treatment and learning process. Never accede to a surgery unequipped with knowledge and research into the condition, its treatment, and the physician’s credentials.

To be forewarned is to be forearmed. Happy recovery!

 

 

 

By Staff Writer Lower back pain, Pain, Relief, Sciatica, Spinal fusion, Spinal Stenosis, Treatment Options for Back Pain

My lower back is in pain all the time and my doctor did an x-ray of my lower back and it came back fine, what else could be wrong?

Low back pain is a common complaint in America.  It may arise as result of injury but ususally there is no specific cause.  There are many potential causes of low back pain.   The pain may originate from many different structures including your spine bones, disks, facet joints, muscles, ligaments,chest and abdomen, etc.  Please see What Causes Back Pain?  for more information.

X-ray is not a sufficient workup for back pain, most people need at least an MRI scan to properly evaluate their back.  Sometimes they need special diagnostic injections called pain mapping.  This may include diagnostic transforaminal nerve blocks, medial branch blocks and discogram.

Unless a serious cause of back pain is found most doctors recommend to start with conservative treatment, such as rest, physical therapy to improve core muscle strength and flexibility, non steroidal anti-inflammatory medications, pain medicine and steroid injections. Patients who do not improve may benefit from surgery.  Please see When Should I Consider Back Surgery?

Depending on the cause of the pain patients may benefit from disk surgery (What is Sciatica?), lumbar laminectomy (Overview of Spinal Stenosis), lumbar fusion (Spinal Fusion and alternate Options) or vertebroplasty or kyphoplasty (Kyphoplasty – what is it?).

For more information please Schedule an Appointment. Good Luck!

By Staff Writer Lower back pain, Sciatica, Spinal Stenosis, Spondylosis, Treatment Options for Back Pain

Does everyone eventually get some form of spondylosis?

Spondylosis is degenerative arthritis of the spine.  Most, if not all, people develop evidence of spondylosis on X-rays, CT or MRI, since it is normal wear and tear changes of the spine.   Fortunately many people do not develop significant pain or other symptoms from it.  For more information click on Back arthritis or Sciatica.  Good Luck!

By Staff Writer Discectomy, endoscopic spine surgery, laser surgery, Lower back pain, Pain, Relief, Sciatica, Spinal Stenosis, Treatment Options for Back Pain

I have a large disc protrusion compressing my L5 nerve and causing spinal stenosis. Do I need surgery?

Disc protrusion is when the disk slips out of it’s normal position in between the spinal vertebrae and extends into the spinal canal.   Other commonly used names are bulging disk, slipped disk or herniated disk, etc.  Spinal stenosis is tightness or loss of volume of the spinal canal.

Right L4-5 disk protrusion initially is treated with conservative treatment which may include rest, physical therapy, medications and steroid injections.  Surgery is considered when a patient fails conservative treatment and/or has severe pain, numbness, weakness or neurological dysfunction (such as urinary incontinence).

Today most disk surgery can be done by using extremely minimally invasive surgical techniques called endoscopic spine surgery or laser spine surgery.  This revolutionary same day surgery is done through a tiny tube the size of a pen which is placed into the spine under X-ray guidance.  The disk is found and visualized through the high definition video camera found inside the spine endoscope.   The disk is then removed with tiny little instruments taking pressure off of the nerve.  This usual provides quick relief of pain and suffering.  Often patients feel much better right after surgery.

For more information on sciatica and lumbar disk herniations click on the following link Sciatica.  Good Luck!

By Staff Writer endoscopic spine surgery, laser surgery, Pain, Spinal Stenosis, Surgery

I’m 63 and now when I walk for a short distance the back of my right leg starts burning to the point I can hardly walk. What is this?

Leg pain from walking is called claudication.  Neurogenic claudication is leg pain from nerve compression in the spine.  This is called stenosis and results from thickened ligaments, bone spurs and disk herniations.  Some people are at increased risk of spinal stenosis because they were born with a smaller spinal canal then normal.   This is called congenital spinal stenosis.  Spinal stenosis and neurogenic claudication presents with back pain and diffuse leg pain and numbness from walking which is relieved by using a shopping cart or sitting down.  Some people describe it “like walking on a cloud”.  Vascular claudication is leg pain from narrowed arteries in your legs.  It is brought on by walking and is relieved by sitting or standing still.  People usually have absent pulses, skin and hair changes in there feet.

You probably have spinal stenosis compressing your spinal nerves and decreasing blood supply to the nerves.  If the nerves can not get enough blood and oxygen they “suffocate” developing pain and numbness in the legs.  Stopping and sitting down or bending forwards decreases pressure on the nerve, improving blood supply and decreasing pain.

Many people benefit from rest, physical therapy, anti-inflammatories, nerve medicine (such as neurontin), steroid injections and surgery.  Please click on Sciatica for more information on lumbar spinal stenosis.  Please contact Executive Spine Surgery for a consultation on spinal stenosis.   Good Luck!

By Staff Writer endoscopic spine surgery, laser surgery, Pain, Relief, Sciatica, Spinal Stenosis, Spondylosis, Treatment Options for Back Pain

What can be done? Can it be fixed easily? What are Schmorls nodes? What is an annular bulge?

These are 3 separate problems:

1. Schmorl’s nodes – Schmorl’s nodes are disk herniations into the vertebral body.  The disk squeezes out of the disk space into the bone.  This is usually not usually painful or treated.

2. L5-S1 degenerated, bulging and protruded disk – Over time disks wear out from injury, aging, wear and tear, genetics, work and sports.  Your L5-S1 disk is degenerating, wearing out and likely collapsing and bulging into the spinal canal pinching the L5 and S1 nerve root.  A protruded disk is larger then bulging disk.  This may be the source of the pain and is often fixed with discectomy or spinal fusion.  Click link to read more on sciatica and disk herniations I have a pain in my left butt that goes all the way down my leg. What could that be?

3. Spinal stenosis – is narrowing of the spinal canal.  The measurement varies but is in the range of 11 mm.  More important than the measured size of the canal is the appearance and the amount of nerve compression seen on MRI.  Spinal stenosis may be treated with pain injections or surgery.  Minimally invasive treatment options include MILD procedure and METRx tubular laminectomy.  JOIMAX is currently working on new endoscopic treatment for spinal stenosis.

I would recommend seeing a spine surgeon to determine the best treatment for your back.   Good Luck!

By Staff Writer Pain, Sciatica, Spinal Stenosis, Spondylosis, Surgery

Can stress fractures cause other medical problems like degenerative disc disease, stenosis, bone spurs?

Stress fractures of the pars interarticularis (the bone that hooks the upper vertebrae to the lower vertebrae preventing them from slipping apart) are called spndylolysis.  Lysis means split or in this case break or fracture.  Spondylolysis commonly happens in childhood during the growth spurt.  It may also break from physically demanding sports like football or gymnastics.  Sometimes these fractures may heal with rest and bracing, or they may stay the same or progress resulting in slippage of the spine called spondylolithesis.  Spondylolithesis is when the upper vertebrae slips forward on the lower vertebrae.  This may cause back pain from abnormal alignment and instability (increased spine movements).  Spondylolithesis may also cause leg pain from bone, ligament and/or scar tissue pinching the nerves going to the legs.  This tightness is called spinal stenosis.   The pars fracture and spondylolithesis (slip) may stress the disks, facet joints, ligaments and muscles leading to degenerative disk disease and bone spurs.

Today there are many surgical options for spondylolysis (pars fracture) and spondylolithesis (slip) including endoscopic foraminotomy (opening up the tightness around the nerves), endoscopic rhizotomy (cutting the facet pain nerves like a “root canal” for the spine) and endoscopic fusion (placement of screws, rods and bone to stabilize the spine strengthen the spine and prevent abnormal spine movements called instability).  For more information please contact Executive Spine Surgery.  Good Luck!

By Staff Writer Sciatica, Spinal Stenosis, Treatment Options for Back Pain

One inch incision for Stenosis, Degenerative Disc Disease, Sciatica, etc.

Spine surgery done through an inch or smaller incision is called minimally invasive surgery.  This may be done by a neurosurgeon who specializes in minimally invasive surgery.  The procedure involves placing sequentially larger tubes in the back to dilate and separate the skin, muscle and soft tissues to get access to the spine.   Click to Read More on treatment options.  Good Luck!

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