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What is Spinal Stenosis?

spinal stenosis

“What is spinal stenosis?” is one of the most frequently asked questions in any spinal physician’s office. Spinal stenosis is a common back problem, but many affected patients have never heard of it before they are given the diagnosis. Symptoms of spinal stenosis can include intense pain inside the back of the legs and numbing or cramping in various regions of the body. The loss of sensation that spinal stenosis patients experience can be extreme.

Here at Premia Spine we focus on advanced surgical treatments for spinal stenosis and related spinal disorders, including bone spurs, or facet arthrosis, and slipped disc, or spondylolisthesis. We’re excited to share information about these conditions – conditions that affect up to 70 percent of all people at some point in their lives – through our blog. An explanation of spinal stenosis is a good place to start.

“Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal, the space at the center of the vertebrae that houses the spinal nerves. This narrowing puts pressure on the nerves, and on nerves that emanate from the affected vertebrae to other parts of the body. The most commonly affected area is the lower, or lumbar, region of the spine. The neck, or cervical region of the spine, can also exhibit a narrowing; these conditions are called lumbar spinal stenosis and cervical spinal stenosis respectively.

Spinal stenosis can be caused by a variety of factors, including heredity, chronic inflammatory and arthritic conditions, and the normal aging process. In fact, it is most often seen in adults above the ages of 45 years; women are affected by spinal stenosis more frequently than men. The severity is related to the extent of the narrowing and of any attendant spinal problems, such as bone spurs, slipped discs, pinched nerves, spondylolisthesis, or sciatica. A neurosurgeon, orthopedic surgeon or any physician specializing in spinal disorders can diagnose spinal stenosis based on radiographs and X-rays.

Many treatments for spinal stenosis are available, including medications and physical therapy, including exercises for stretching the spine. For patients with moderate to severe spinal stenosis who do not respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option. In spinal decompression procedures the back surgeon reestablishes the proper diameter of the spinal canal at the affected area by removing bony elements that have grown towards the spinal canal and are impinging on the nerves. Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves connecting two or more adjacent vertebrae with screws and rigid rods. Fusion restores stability but eliminates the natural mobility between the vertebrae.

Today a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine. Clinical studies show the TOPS System provides better outcomes than spinal fusion. We encourage patients to consult with a physician who specializes in spinal medicine, and to educate themselves about treatment options.

What is Spondylolisthesis?

Spondylolisthesis

You’ve probably heard the common medical term, “a slipped disc,” but what exactly does that mean? A slipped disc, or more precisely “spondylolisthesis,” is a condition in which one of the vertebrae – the bones in the spinal column – becomes displaced and moves forward or backward in relation to its proper position. This malpositioning can put pressure on the spinal cord and on the nerves that emanate from the spinal column at the position of the slipped disc. The most common cause of spondylolisthesis is degenerative changes in the joints and cartilage of the vertebrae due to aging.. Spondylolisthesis can also result from trauma – a sports injury or an accident, for example.

The most frequent symptom of a lumbar slipped disc is lower back pain. The pain is typically worse after exercise. Decreased range of motion and tightness of the hamstring muscles are also common slipped disc symptoms. The nerve compression may also result in pain, numbness, tingling or weakness in the legs, and in cases of severe compression, loss of bowel or bladder control. Slipped disc can also be associated with spinal stenosis, one of most common spinal problems, characterized by a narrowing of the spinal canal. A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and X-ray imaging. The severity of the slipped disc is graded on a scale based on the degree of slippage from its normal position. After the diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.

Treatments for slipped disc include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and injections. In many patients these treatments are sufficient to alleviate the symptoms of slipped disc. For patients with moderate to severe spondylolisthesis or attendant spinal stenosis who do not respond to conservative therapies, spinal decompression surgery may be recommended. Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. Spinal decompression can have a dramatic affect, relieving pain and other symptoms caused by the slipped disc and spinal stenosis. However, removing portions of the vertebrae reduces the stability of the spinal column. Traditionally spinal fusion back surgery is performed after spinal decompression; screws and rods are implanted to permanently join adjacent vertebrae and restore spinal stability. One drawback is that spinal fusion eliminates the natural independent motion that gives the spine its flexibility. Fusion has also been shown to promote deterioration of adjacent vertebrae.

Now there is an alternative to spinal fusion, the TOPS™ System, developed here at Premia Spine. The TOPS System restores stability while preserving the spine’s full range of motion after decompression and has been clinically shown to provide better outcomes than spinal fusion surgery in trials conducted around the world.

We encourage anyone afflicted with back problems to consult a physician who specializes in spinal disorders, and to learn about all treatment options.

What is sciatica?

sciatica

Everyone has heard of sciatica, but few people know what it actually is – or isn’t. Sciatica is not a spinal condition, or a disease, but a set of symptoms associated with a variety of spinal conditions, characterized by irritation or compression of the sciatic nerve. The longest nerve in the body, the sciatic nerve extends from the base of the spine through the hips and buttocks and down the legs to the tips of the feet. Symptoms of compression or irritation of the sciatic nerve can include radiating pain, numbness, muscle weakness, a tingling sensation along the length of the nerve, and lower back pain.

Several spinal conditions can cause sciatica. A herniated disc or a ruptured disc in the lower back – the lumbar spine – can press against or leak fluid into the spinal canal, putting pressure on the sciatic nerve. Traumatic injuries such as car accidents or falls can cause compression or irritation of the sciatic nerve roots or the nerve itself. A slipped disc, or spondylolisthesis, can also cause sciatica if it impinges on any part of the sciatic nerve. Lumbar spinal stenosis – the narrowing of the spinal canal in the lower back – can also compress or irritate the sciatic nerve.

Conservative, non-surgical treatments typically include physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and low-impact exercises. Alternative methods such as massage therapy, acupuncture, chiropractic adjustments, and acupressure may also be employed. However, surgery for sciatica, such as a discectomy or foraminotomy, may be required for relief of sciatica in the most severe cases of unrelenting and debilitating symptoms. Spinal decompression surgery relieves the pressure, and is often paired with spine fusion surgery to stabilize the spine after decompression. But fusion eliminates the independent mobility of the fused vertebrae. Now there’s an alternative spinal surgery proven to provide better clinical outcomes than fusion, which preserves the patient’s natural range of motion of the individual vertebrae – the TOPS Posterior Arthroplasty procedure. This is one of the exciting advances bringing new hope and treatment options to patients with moderate to severe spinal conditions that do not respond to conservative treatments. We at Premia Spine are on the forefront of developing advanced surgical treatments for spinal disorders. We encourage anyone with lower back pain to investigate all their treatment options.