Spinal stenosis is a narrowing of the spinal canal, which places pressure on the spinal cord. It is a severely debilitating condition whose symptoms often start gradually and grow worse over time. While spinal stenosis can be found in any part of the spine, the lumbar and cervical areas are the most commonly affected. If the stenosis is located on the lower part of the spinal cord it is called lumbar spinal stenosis. Stenosis in the upper part of the spinal cord is called cervical spinal stenosis.
It may occur because of spinal degeneration with aging or because of spinal disc herniation, osteoporosis or a tumor. Spinal stenosis may affect the cervical vertebrae, cervical spine, the lumbar vertebra /lumbar spine or both.
Lumbar spinal stenosis is commonest form of spinal stenosis seen. It results in low back pain as well as pain or abnormal sensations in the legs, thighs, feet or buttocks, or loss of bladder and bowel control.
Though a large number of cases of spinal stenosis can be treated with conservative measures, people having severely disabling pain or having difficulty in walking, are recommended to get spinal surgery. The severely debilitating symptoms like loss of bladder, bowel function, loss of balance, radiating back and hip pain can be fairly corrected through the surgery of spine. Various types of surgeries to correct Stenosis are:
“¢ Laminectomy - removal of the entire bony lamina, a portion of the enlarged facet joints, and the thickened ligaments overlying the spinal cord and nerves.
“¢ Laminotomy - a small portion of the lamina and ligaments, usually on one side. Using this method the natural support of the lamina is left in place, decreasing the chance of postoperative spinal instability.
“¢ Foraminectomy - when the foramen (the area where the nerve roots exit the spinal canal) is removed to increase space over a nerve canal. This surgery can be done alone or along with a laminectomy.
“¢ Foraminotomy - removal of bone around the neural foramen - the space between vertebrae where the nerve root exits the spinal canal. This method is used when disc degeneration has caused the height of the foramen to collapse, resulting in a pinched nerve. It can be performed with a laminectomy or laminotomy.
“¢ Medial Facetectomy - part of the facet (a bony structure in the spinal canal) is removed to increase the space
“¢ Anterior Cervical Discectomy and Fusion - the cervical spine is reached through a small incision in the front of the neck. The intervertebral disc is removed and replaced with a small plug of bone, which in time will fuse the vertebrae.
“¢ Cervical Corpectomy - a portion of the vertebra and adjacent intervertebral discs are removed for decompression of the cervical spinal cord and spinal nerves. A bone graft, and in some cases a metal plate and screws, is used to stabilize the spine.
“¢ Laminoplasty - a posterior approach in which the cervical spine is reached from the back of the neck and involves the surgical reconstruction of the posterior elements of the cervical spine to make more room for the spinal canal.
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