Spinal stenosis is one of the most common spinal diseases found in the elderly. Spinal stenosis is described as a narrowing of the spaces within the spine mostly generated by the degenerative discs. This limited spaces can put pressure on the nerves that supply the spine. Presented signs and symptoms are pain or cramping in one or both legs, Numbness or tingling, muscle weakness and fatigue especially at affected area such as lower back and neck. However, Some patients with spinal stenosis may not have symptoms. Being aware of warning sings and seeking immediate medical attention when these signs are indicated are highly recommended in order to get spinal stenosis diagnosed and treated appropriately.
Spinal stenosis (or narrowing) is a common condition that occurs when the small spinal canal containing the nerve roots and spinal cord becomes compressed. It is mostly caused by the deterioration of spinal discs, osteoarthritis and the formation of bone spurs which can result in the compression of spinal cord or nerves. The main manifestation includes pain or numbness in the back, radiating to the hip or the leg (s). It is mostly found in patients age over 45 with the increased risks of degenerative changes.
Presented signs and symptoms might vary. Medical attention should be immediately provided if any of these symptoms is showed up:
Apart from the degenerative disc which is the most common factor of spinal stenosis, other causes may include:
Most patients often need medical attention when their daily life and activities are largely interfered. To diagnose spinal stenosis, full physical examination and detailed medical history taking e.g. signs and symptoms will be examined. Additional imaging tests such as X-ray, CT scan (computerized tomography) and MRI scan (Magnetic Resonance Imaging) might be used to precisely pinpoint the affected areas. After the diagnosis is completely done, the treatment can be planned accordingly. Non-surgical treatments include pain killer medicines, rehabilitation programs and pain intervention. In severe cases, if patients are good candidates, surgery is highly suggested.
The selected treatment option entirely depends on symptoms, disease severity and individual health-related conditions of each patient.
Surgery is highly considered if the patient is an appropriate candidate or other non-operative treatments failed. The surgical objective is to relieve the pressure on spinal cord or nerve roots by generating more spaces of the spinal canal. Surgery mainly aims to decompress the area of stenosis which is the most definitive way to resolve symptoms of spinal stenosis.
Surgical procedures to treat spinal stenosis include open surgery and minimally invasive surgery. Recently, minimally invasive surgery is an increasing used technique. This approach removes bone or lamina (the back part of the affected vertebra) in a way that reduces the damage to nearby healthy tissue. It can reduce potential risks of operative complications and inflammation. This results in less pain with a faster recovery time and shorter hospital stay.
Although spinal stenosis cannot be entirely prevented, lifestyle modification greatly strives to reduce the risks to develop the disease. To lower risks of spinal stenosis, health-related recommendations are
Neurological surgeon and spine surgeon.
Spine Academy, Bangkok Hospital.
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