Tag Archives: Spine Health

Spinal Stenosis: Causes &Treatment (Mayo Clinic)

Mayo Clinic (March 30, 2023) – Spinal stenosis happens when the space inside the backbone is too small. This can put pressure on the spinal cord and the nerves that travel through the spine. Spinal stenosis occurs most often in the neck, called cervical spinal stenosis, and in the lower back, called lumbar spinal stenosis.

Spinal stenosis - Symptoms and causes - Mayo Clinic

The most common cause of spinal stenosis is wear-and-tear changes in the spine related to arthritis. Most people with spinal stenosis are over 50. Younger people may be at higher risk of spinal stenosis if they have scoliosis or other spinal problems.

Symptoms

Spinal stenosis often causes no symptoms. When symptoms do occur, they start slowly and get worse over time. Symptoms depend on which part of the spine is affected.

Spinal stenosis in the neck can cause:

  • Numbness
  • Tingling or weakness in a hand, leg, foot or arm
  • Problems with walking and balance
  • Neck pain
  • Problems with the bowel or bladder

Spinal stenosis in the lower back can cause:

  • Pain or cramping in one or both legs that happens when you stand for a long time or when you walk
  • Back pain

Treatment

Treatment for spinal stenosis depends which part of the spine is affected and the severity of your symptoms.

Nonsurgical treatment can include:

  • Medication.
    For control of pain, your health care professional might prescribe nonsteroidal anti-inflammatory drugs, antidepressants, anti-seizure drugs or opioids.
  • Physical therapy.
    A physical therapist can teach you exercises that can build up your strength and endurance, maintain the flexibility and stability of your spine, and improve your balance.
  • Steroid shots.
    Your nerve roots can become irritated and swollen at the spots where they are being pinched. Injecting a steroid medication into the space around the pinched nerve can reduce the inflammation and relieve some of the pain. Repeated steroid injections can weaken nearby bones, tendons and ligaments, though. That’s why a person often must wait many months before getting another steroid injection.
  • Removal of thickened ligament tissue.
    Sometimes, the ligament at the back of the lumbar spine gets too thick. Needlelike tools inserted through the skin can remove some of the ligament. This can create more space in the spinal canal to reduce pressure on nerve roots.

Surgeries to create more space within the spinal canal may include:

  • Laminectomy.
    This surgery removes the back part, or lamina, of the affected spinal bone. This eases pressure on the nerves by making more space around them. In some cases, that bone may need to be linked to nearby spinal bones with metal hardware and a bone graft.
  • Laminotomy.
    This surgery removes only part of the lamina. The surgeon makes a hole just big enough to relieve pressure in a specific spot.
  • Laminoplasty.
    This surgery is done only on spinal bones in the neck. It makes the space within the spinal canal bigger by creating a hinge on the lamina. Metal hardware bridges the gap in the opened section of the spine.

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LAMINECTOMY

Lumbar laminectomy

Laminectomy is surgery that creates space by removing the lamina — the back part of a vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.

This pressure most commonly is caused by bony overgrowths within the spinal canal, which can occur if you have arthritis in your spine. These overgrowths sometimes are referred to as bone spurs, but they’re a normal side effect of the aging process in some people.

Some patients are able to have a same-day laminectomy, which means they do not need to stay in the hospital following surgery and are able to go home to recover. The procedure is performed using minimally invasive techniques resulting in smaller incisions, lower risk of infection and, for many people, a quicker recovery.

SPINAL FUSION

Spinal Fusion, Lower Back

Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them. Spinal fusion involves techniques designed to mimic the normal healing process of broken bones. During spinal fusion, your surgeon places bone or a bone-like material within the space between two spinal vertebrae. Metal plates, screws and rods may be used to hold the vertebrae together, so they can heal into one solid unit.

Because spinal fusion surgery immobilizes parts of your spine, it changes the way your spine can move. This places additional stress and strain on the vertebrae above and below the fused portion, and may increase the rate at which those areas of your spine degenerate.

Read more at Mayo Clinic

Back Pain: The Symptoms And Causes Of Sciatica

Most sciatica is caused by problems that affect the L4L5, or S1 nerve roots. The nerve may be compressed or irritated, usually because it’s being rubbed by a disc, bone, joint, or ligament. The resulting inflammation makes the tis­sues and the nerves more sensitive and the pain feel worse.

Damage to or pinching of the sciatic nerve, or the nerves that feed into it, can have several causes.

Herniated disc

One of the most common causes of sciatica is a herniated disc in the lower part of the spine. It’s also called a slipped disc, though there’s no slipping going on.

Spinal discs are tucked between the vertebrae, where they act as cushions to keep the bones from touching one another. The discs absorb all the forces placed on the spine from walking, running, sitting, twisting, lifting, and every other activ­ity we do. They also absorb forces from falls, collisions, and other accidents.

Spinal stenosis

The spinal canal protects the spinal cord and the nerves that run up and down the spine. Spinal stenosis is the narrowing of the spinal canal. When this occurs, nerves can be compressed, causing pain. Because the lumbar verte­brae undergo the most consistent stress and support the most weight, lumbar stenosis is the most common type of spinal stenosis.

Spondylolisthesis

The bones of the spine are stacked on top of one another, separated by discs. Spondylolisthesis occurs when one spinal bone slips forward in relation to the bone below it. When the L4 vertebra moves over the L5 vertebra, it can cause a kink in the spinal canal leading to pressure on a nerve root and sciatica.

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