Spinal Stenosis/Narrow Channel
What is spinal stenosis?
The vertebrae, anterior discs, connect to each other with posterior joints and ligaments form a holistic bone structure. The spinal cord and nerves run through the canal formed by this structure. Normally, the width of this canal is 13-14mm or more . The narrowing of this canal for any reason and as a result of compression on the nerves it contains is called spinal stenosis.
normal disc
Spinal cord
spinal canal
corrupted disk
thickened ligament
bone growth
In whom and how does spinal stenosis appear?
Although it can be seen in the neck region, it is more common in the lumbar region in patients over 50 years of age. It can also be seen at young ages in those with various hormonal, metabolic diseases and congenital spinal anomalies.
Rarely, this canal may be congenitally narrow. However, what we see more frequently is canal stenosis that occurs with aging. The deterioration and thickening of the joints in the posterior region of the spine and the thickening of the ligament called the ligamentum flavum between the vertebrae narrows the spinal canal. In addition, deterioration of the anterior discs and their overflow to the canal may cause additional stenosis. If this deterioration continues, slippage or even scoliosis-like bending between the vertebrae may develop.
How is spinal stenosis diagnosed and what kind of complaints does it cause?
The most important complaint of patients with stenosis is pain radiating to the lower back and legs (neurogenic claudication), which increases with activation. The pain is accompanied by numbness and tingling in the legs and feet. These complaints disappear when the patient rests. In order to reduce these complaints, patients usually stand and walk by leaning forward. Many patients experience leg cramps and weakness. However, it should be kept in mind that stenosis in the lumbar region may not always cause complaints.
In cases where it is untreated and advanced, reflex, motor and sensory disorders and even urinary and fecal incontinence problems may occur.
How is spinal stenosis diagnosed?
The definitive diagnosis of the disease is made by radiological examination. MRI gives very valuable information on this subject. Tomography and myelography also provide valuable information about the location and extent of the disease.
What is the treatment for spinal stenosis?
The definitive treatment of narrow canal is surgery. However, in the early and non-intense periods, resting, reducing waist movements with a corset, medication and physical therapy may be beneficial.
Surgical treatment is required in cases that do not respond to medical treatment, where the complaints are severe, and especially where the canal diameter is 9mm or less.
The aim of surgical treatment is to remove the pressure on the spinal cord and nerves. For this, the bones, joints and thickened ligaments that make up the posterior part of the spinal canal are removed. Distorted discs are removed from the front and these sections are supported by metal cages. With screws placed at the back, the integrity and balance of the spine is maintained.