Spinal Stenosis

Spinal stenosis is a condition characterized by narrowing of the spine that results in pressure on the spinal nerves. Spinal stenosis usually occurs in the lower back or neck. Most people with spinal stenosis are 50 years or older.

Causes of spinal stenosis
Aging is the most common cause of spinal stenosis. As we get older, the process of tissue modification occurs throughout the body. Spinal tissue, such as ligaments, begins to thicken and bones expand, putting pressure on the nerves. In addition, several other conditions can cause spinal stenosis, including:

Spinal injury. Spinal segments can be dislocated or broken by accident, including traffic accidents.
Tumors Tumors can appear in the spinal cord, in the membrane lining the spinal cord or in the space between nerves and spine.
Paget's disease, which is a disease characterized by abnormal bone growth.
Scoliosis, which is a deformation of the spine.
Spinal abnormalities from birth.

Symptoms of spinal stenosis

Symptoms of spinal stenosis are distinguished based on the location of the stenosis and the part of the nerve that is infected.

Neck stenosis (cervical stenosis), narrowing that occurs in the cervical spine. Symptoms that may appear include:

Weakness and numbness or tingling in the hands, arms, legs or soles of the feet.
Neck hurts.
The balance is changed and running.
Changes in bowel or bladder function if the condition of stenosis is severe enough.

Lumbar stenosis (lumbar stenosis), which is a narrowing that occurs in the lower back of the spine. Symptoms that may appear include:

Weakness and numbness or tingling in the legs and feet.
Low back pain (low back pain).
Pain or cramps in one or both legs when standing for a long time or when walking.

Occasionally, symptoms of spinal stenosis cannot be felt by the patient and are only known after imaging tests, such as CT or MRI scans.

Diagnosis of spinal stenosis

In the first step of diagnosing vertebral stenosis, the doctor will ask questions about the signs and symptoms and discuss the patient's medical history.

Then the doctor will do a physical examination, especially tests of motor nerves and sensory strength.

The doctor will do other tests, such as imaging tests, to help determine the cause of the symptoms and signs that appear. Imaging tests include:

X-ray image. X-rays in the spine may show changes, such as narrowing of the gap in the spinal canal.
MRI This test can detect damage that occurs in ligaments and bone pads, the presence of tumors, as well as detection of parts of the spinal cord that are under pressure.
CT myelogram. Computed tomography produces detailed cross-sectional images of the patient's body and from different angles. CT myelogram is done after dye injection (contrast). Dyes will indicate the condition of the spinal nerves and can see bone deformity and formation or the appearance of tumors in the spine.

Treatment of spinal stenosis

Treatment of spinal stenosis is adjusted to the location and severity of symptoms and signs of stenosis that appear. There are several forms of treatment for spinal spinosis, including:

Medicine. As a first step in the treatment of vertebral stenosis, the doctor will provide medication to relieve pain. These medicines include:

Pain relievers temporarily reduce pain and spinal discomfort.

Anticonvulsant, anticonvulsant, or anticonvulsant drugs such as gabapentin or pregabalin can reduce pain caused by nerve disorders.

Antidepressants, such as amitriptyline, can reduce persistent pain.

Opioids to reduce pain Opioids must be used with caution because if used long term, they will be addictive.

Physiotherapy. To reduce pain, people with spinal stenosis tend to reduce their daily activities. However, it can weaken muscles and increase pain. Physiotherapy is useful for:

Increase stamina and strength of the body.

Maintain spinal flexibility and stability.

Improve body balance.

Corticosteroid injections. This treatment aims to reduce inflammation of the pinched nerve and relieve pain. However, repeated corticosteroid injections can weaken bones and connective tissue around the injection area. Therefore, this injection should not be done too often.

Surgery Surgical procedures are performed if other treatment methods are ineffective. Spinal stenosis surgery aims to relieve pressure on the spinal cord permanently by creating space in the spinal canal. Some types of surgical procedures to treat spinal stenosis include:
Laminectomy (decompression). Surgical procedure to remove a portion of the vertebral column (lamina) from vertebrae that are pressing on nerves.
Laminotomy. Unlike laminectomy, which removes all lamina from bone segments, laminotomy only removes a portion of the lamina.
Foraminotomy. Surgical procedure to expand the vertebral column on the way out of the spinal cord.

Complications of spinal stenosis
Although rare, severe untreated spinal stenosis can cause permanent complications, including: