Stenosis of the spinal canal of the lumbar spine
Spinal stenosis is a dangerous disease characterized by narrowing (reduction) of the spinal canal. The disease is gradual and can lead to disability without proper treatment. Spinal stenosis is treated by a surgeon.
Causes of the disease
- congenital pathology of the spine (Down syndrome, Knist disease, spondyloepiphyseal dysplasia)
- degenerative and dystrophic changes (osteochondrosis, spondylosis, spondylolisthesis);
- spinal injuries - the main cause of lumbar spinal canal stenosis;
- hyperplasia of the capsule of the arcuate joint, nonunion of the vertebral arches;
- metabolic diseases (fluorosis, acromegaly, pseudogout);
- hematomas, tumors of nervous tissue, infections;
- specific medical procedures.
Risk factors include overweight and physical inactivity.
Depending on the localization, stenosis can be central and local. Central stenosis is a decrease in the size between the arch of the spinous process base and the posterior surface of the vertebra from 12 to 10 mm. Lateral - narrowing of the root canal less than 4 mm.
Symptoms of spinal canal stenosis, severity
Clinical manifestations depend on the form of the disease and the cause that caused it. Common symptoms of spinal canal stenosis include
- fatigue
- impaired sensitivity
- pain
- impaired blood supply to the spinal cord and nerve roots;
- muscle atrophy.
However, these symptoms may indicate not only stenosis, but also be a manifestation of another pathology. Therefore, it is extremely important to seek qualified help and undergo the necessary diagnostics, based on the results of which the doctor will make a diagnosis and prescribe a course of treatment. You can make an appointment with a specialist on our website Dobrobut.com. During the consultation, the doctor will tell you what spinal canal stenosis at the level of l4 l5 or l5 s1 is and why it is dangerous.
Depending on the severity of clinical manifestations, doctors distinguish four degrees of severity of the disease:
- Grade 1 - sharp pain in the calf muscles when walking (intermittent lameness);
- Grade 2 - slight impairment of walking with mild pain syndrome;
- Grade 3 - inability to move without assistance;
- Grade 4 - severe manifestations of lameness with severe pain syndrome.
This is a rapidly progressing pathology, so it is recommended to start treatment as early as possible. Only this approach will help to stop the disease and protect against disability.
We will discuss in what cases conservative therapy is performed and who is indicated for surgery for cervical spinal canal stenosis.
Diagnosis
It is impossible to diagnose stenosis based on pain syndrome, because pain is a manifestation of many pathological conditions. Therefore, after examining the patient and taking anamnesis, the doctor will prescribe additional instrumental studies that will help establish the cause of the disease and prescribe the correct treatment. Such examinations include: MRI and CT of the spine, myelography and functional radiography. In case of degenerative stenosis of the spinal canal, the X-ray shows changes and lumen of the canal.
Important: when examining a patient, a specialist performs a series of tests and tests to determine the extent and level of the lesion.
Absolute and relative stenosis of the spinal canal: treatment
Based on the results of the examination, the specialist will decide what type of treatment is needed.
Conservative treatment:
- analgesics;
- non-steroidal anti-inflammatory drugs;
- epidural injections of glucocorticoids (in some cases);
- physiotherapy;
- massage and physical therapy.
Therapy is aimed at relieving pain and reducing inflammation.
Surgical treatment is prescribed in case of disease progression and lack of effect from conservative therapy. Surgery is indicated in case of increased pain, increased muscle weakness, impaired sensitivity and gradual atrophy.
The following techniques are used as surgical treatment: laminectomy, laminotomy, posterior fixation. After the operation, the patient will have to undergo a long recovery course, which includes massage and exercise therapy.
Prevention
It is possible to prevent the development of absolute and relative stenosis of the spinal canal only if the pathology is not congenital.
Preventive measures:
- regular exercise;
- feasible physical activity;
- rational nutrition, vitamin therapy in spring and autumn;
- correct sleeping position;
- hard mattress.
At the first manifestations of the disease, you should immediately seek professional help. We remind you that spinal canal stenosis is a disease that can cause disability if left untreated. Take care of your health - make an appointment for a consultation now.
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