Aging-related calcification may occur in the facet joints and discs around the spinal cord, and this results in spinal stenosis.
Spinal Stenosis is a completely different entity than disc hernia. Pain does not start with motion, but only after walking for a while and disappears with resting. In advanced spinal stenosis cases, pain may occur even after a short walk. Patient feels great difficulty in his/her feet to bear body weight and there is numbness in the legs. These complaints fade away with resting.
What are the Causes of Spinal Stenosis?
- Spinal stenosis is usually related with aging.
- Damage in the cartilage of vertebrae (arthritis) causes bone growth and this growth narrows the spinal cord and causes mechanical stress on the spinal cord.
- Aging-related vertebrae hernia creates mechanical stress on the spinal cord and spinal stenosis.
- Cysts and tumours of the spinal cord can also cause spinal stenosis.
- Some individuals may have congenital spinal stenosis that exists by birth.
What are the Clinical Findings in Spinal Stenosis?
- Back pain, lumbar pain and/or fatigue
- Leg pain, loss of strength, numbness, tingling (usually increase in severity following long walks)
- Urinary incontinence
- Decrease or even complete disappearance of the pain while sitting or bending forwards.
How is Spinal Stenosis Treated?
Physical treatment, weight loss in overweight patients, using appropriate pain killers may help to control the pain in the initial cases. However, advanced cases may benefit from the following interventions:
- Epidural steroid injections,
- A very small camera can access stenosis area by epiduroscopy and neuroplasty and saline injection may help to widen the narrow sites. Then hyaluronidase injection may help to prevent recurrence of spinal stenosis,
- Radiofrequency applications to facet joints and spinal cord arka kök nerves,
- Surgery is indicated in cases where the patient cannot walk 50 m without resting.
- Some patients may continue to complain from pain after surgical correction of spinal stenosis and stabilisation of spinal canal by implants placed in vertebrae. Spinal cord stimulation is the most effective treatment in such patients.
If the response to spinal cord stimulation is poor, constant delivery of pain killers into the spinal cord can be achieved by placing pain pumps.