Spinal Stenosis treatment
In people suffering from spinal stenosis, treatment needs to start as soon as possible if the patients are to lead a productive life but before that, it is necessary to understand it is. in spinal stenosis, the channel of the spine becomes narrow. There are three places along the spine where this can occur - the center of the spine, the places where the nerves branch out of the spine and the intra-vertebral space. The narrowing of the spine at one of these places presses down on the spinal cord and nerves that branch out of it and this causes severe pain.
The common causes are osteoarthritis, rheumatoid arthritis, tumors or injuries.
In spinal stenosis, treatment may be non-surgical or surgical.
Non-surgical spinal stenosis treatment
Drugs to relieve pain - The drug, acetaminophen, is given to relieve pain.
Spinal Stenosis treatment
Drugs to reduce swelling - In this type of spinal stenosis treatment, non-steroidal, anti- inflammatory drugs (aspirin, ibuprofen etc) are normally prescribed to reduce swelling of the compressed area. New generation Cox-2 inhibitors have also shown remarkable results
Epidural injections (Corticosteroid injections ) - Sometimes, corticosteroids are administered epidurally. In old cases, where the pain is not relieved by anti-inflammatory and pain relieving drugs, the injections are given on the peripheral (epidural) membrane of the spinal cord. These injections can not cure the disease but they can mitigate the pain in about 50% of spinal stenosis treatment cases using this method. Three injections over a course of several months can be tried.
Although they are not considered diagnostic in and of themselves, generally, if the pain caused by spinal stenosis is relieved by an epidural steroid injection, then the patient can also be expected to have a good result if they later choose surgery.
Movement restrictions - Patients are usually advised to ignore movements that aggravate symptoms of spinal stenosis. Treatment can be walking in elevated position and reclining on a walker or shopping cart instead of walking erect, inclining on the handlebars while cycling or sitting in a chair that can be tilted back.
Exercises and/or physical therapy - Orthopedists recommend the patients undergoing spinal stenosis treatment should involve certain routine exercises in their lifestyle that encourage lumbar flexing and flattening of the lumbar and cervical lordotic (convex at the upper end and concave at the lower end) curve. Intense exercises like stretching and strengthening facilitate strengthening of lumbopelvic muscles, ligaments, and tendons.
Surgical Spinal Stenosis Treatment
The requirement of surgical spinal stenosis treatment is indicated where non-surgical spinal stenosis treatment proves unsuccessful. The non-surgical intervention is presumed to have failed if there is no improvement in the patient's condition after a few months physical therapy.
However, if the patient exhibits the symptoms of cauda equina (the inability to control the bowels or the bladder), surgical spinal stenosis treatment must be resorted to in the first instance itself.
The goal of surgical spinal stenosis treatment is to decrease the pressure being exerted on the spinal cord or associated nerves.
The most common surgical spinal stenosis treatment procedure is called the decompressive lumbar laminectomy. In this procedure, the part of the lamina (roof of the spinal canal) that is responsible for pressing down on the spinal cord is trimmed. If need be, some part of the spinous process (the protruding projectionof the vertebra to which muscles attach) may also require to be trimmed down.
Other surgical spinal stenosis treatment procedures are laminotomy, in which a small portion of the lamina is removed and spinal fusion, in which a piece of bone (usually taken from the patient's pelvic bone) is used to join ('fuse') two adjoining vertebra.