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The spine is one of the most important elements of the human body. When it stops working properly, it can cause tremendous pain. Moreover, it can also affect other parts of the human body, especially the legs. This is why it’s so crucial to address and diagnose all spinal problems in time.
If you feel pain and stiffness in your leg that eases when you sit down, you might suffer from neurogenic claudication.
What Is Neurogenic Claudication?
Neurogenic means that the problem appears in the nervous system. Claudication is a word to describe leg pain or heaviness, especially while walking. This problem can appear when there is a compression of the spinal nerves in the lower part of your spine.
This type of claudication is different from vascular claudication. The second one is caused by reduced blood flow to the leg.
What Are the Symptoms of Neurogenic Claudication?
Some of the most common neurogenic claudication symptoms appear mostly in the back or one or both legs and include:
Those symptoms can be also noticed in the hips or buttocks. People who suffer from neurogenic claudication can also feel that their legs are weak or heavy. Affected people often notice that those symptoms ease while leaning forward or sitting down. This can increase while standing upright and walking.
What Connects Neurogenic Claudication and Lumbar Stenosis
Neurogenic claudication is considered one of the main symptoms of lumbar stenosis. The first former is rather an effect of the problem, rather than its core. Lumbar stenosis is a health condition in which the canals that protect the nerve or the spinal cord narrow in the lower back area. When space is narrower, the nerve cannot travel freely down the spine to other parts of the body, for example, the legs.
There are some factors that can cause this disorder at a young age. However, most people who suffer from lumbar stenosis are 60 years old or higher. Simply put, this disorder affects people as they grow older.
With age, bones and joints thicken. The discs that connect vertebrae can lose their water. Because of that, they no longer play their crucial role which is absorbing shocks between the vertebrae.
When you sit down or lean, you can feel pain relief. It happens because while sitting you can stretch the spine. By doing so, you force the spaces of your spine to open up and take off the pressure from the nerves.
Causes and Risk Factors
The main cause of neurogenic claudication is spinal stenosis, or put more simply, narrowing of the spinal canal in the lower back (lumbar area). Some of the most common causes of spinal stenosis are arthritic changes and wear and tear in the lower spine.
Those changes can lead to bulging discs, overgrowth of bone spurs, and thickening of ligaments. Stenosis may press on the nerve roots that are responsible for feeling and movement of the lower body. This compressing can cause prolonged pain, tingling, and cramping.
The pain intensifies while standing because in this position the spinal canals are naturally narrower. That causes extra pressure on the nerve roots. You can temporarily ease the pain by flexing forward or sitting. Remember that it’s only a temporary solution and is not going to solve your problem. You need professional medical attention.
Neurogenic Claudication Test and Diagnosis
The best way to know if you suffer from neurogenic claudication is by consulting a specialist. You need to have thorough physical exams, connected with detailed interviews. This way a physician can determine where your pain comes from, and what type of pain it is.
Some of the symptoms allow a medical expert to recognize if you suffer from vascular claudication or a neurogenic one. One of the main differences between those two is that in the case of vascular claudication, the pain often eases after resting, while in neurogenic claudication, discomfort is relieved for a while when in a particular position.
To confirm a diagnosis of neurogenic claudication, you might need to participate in a few tests. They can determine the cause of your pain and better prepare you for treatment.
Some of the most common tests that are run when spinal stenosis is suspected are:
Based on your symptoms and effects of testing, a doctor can identify your problem and decide which method of treatment would be the best for you.
Can Neurogenic Claudication Lead to Disability?
As your spine is a very important part of the body, you have to act fast. Otherwise, you risk severe health problems or even disability. According to statistics, neurogenic claudication caused by lumbar spinal stenosis can lead to disability. It is the problem that causes most spinal surgeries among older people, and it is also considered one of the most common causes of disability among this group.
The most effective way to get rid of neurogenic claudication is by surgery. During the treatment, the nerve roots in the lumbar spine are decompressed. It might happen that if the compression that was affecting the spine caused a herniated disc, a microdiscectomy procedure might be necessary. In other cases, a process of laminectomy is very often necessary, when the part of a bone is removed.
Spinal implants can make the surgery less traumatic. A spinal implant is a very useful device that can reduce back pain. When you suffer from any disorder in your spinal column, you might benefit from it. The device can be surgically placed in between your vertebrae and you can manage it remotely once you feel the pain. You are going to send low-level electrical impulses to the spinal cord.
Thanks to this, you can stimulate your spine and reduce pain. This solution is ideal for anyone for whom the nonsurgical method of reducing pain doesn’t work. Spinal implants can be a great solution for people who suffer from neurogenic claudication and are looking for a long-lasting solution for their problem and pain.
Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a generalized term used to describe ongoing pain after back surgery. After going through a spinal surgical procedure, of course both you and your surgeon desire your complete painlessness. But, even with the best spinal surgeon and the best indications for your spinal surgery success, there is always a small chance that back pain may continue after surgery and recovery (studies report continued back pain after 5% of all spinal surgeries ).
What causes Failed Back Surgery Syndrome? There are many reasons why a back surgery might not result in a completely pain-free existence, partially owing to the fact that spine surgery is only able to accomplish stabilizing a painful joint and decompressing a pinched nerve. If your back condition involves more than these two pain-causing situations, your spine surgeon will need to continue your care and explore additional solutions to your back pain condition.
Back surgery is reported to be 95% successful at changing anatomy that causes pain and correcting the physical results of a back injury. But it’s also important to realize that back surgeryisn’t a cure-all for every type of back pain-causing condition. Since the spine is a very complex part of your anatomy, with many vertebrae, nerves, and cushioning between your discs, it can be a complex process to get to the root of what’s truly causing you pain.
Your back surgeon will thoroughly assess your back pain condition, and use top technology to diagnose your back pain causes, but it’s important for you to have realistic expectations of what back surgery can and cannot accomplish for you. If you experience Failed Back Surgery Syndrome, your skilled physician will then conduct additional tests and map out a plan of action to remedy as much of your back pain as possible. All valuable things take time, so don’t set yourself up for possible disappointment by expecting a quick fix to any back pain. It may take an extra procedure or extra treatment after your back surgery to get you feeling much better.
If you do have great success after your back surgery, then you’re in that fortunate 95% of back pain patients whose symptoms lessen and whose lifestyle will very soon be active and more comfortable again.
Spinal stenosis, an unnatural narrowing (or stenosis) of the spinal canal, is an all too common cause of back pain and restricted mobility, which results from pressure the narrowing column places on spinal nerves. For those who don’t respond to more conservative treatments, surgery may be recommended to correct spinal stenosis, and it’s important for such patients to prepare for the procedure properly. The preparations starts by ascertaining that back surgery is indeed called for.
Pain in your leg that is greater than the pain in your back caused by a pinched nerve (as measured by standard pain scales), is one indication that surgery is appropriate for a given case of spinal stenosis. Leg pain that does not decrease and interferes with your quality of life, and radiological scans confirming that the pain is likely due to nerve compression, are also indications that surgery may be beneficial.
Much of the advice on preparing for any back surgery applies to a spinal stenosis operation, as well. As in other back surgeries, you should stop smoking and, if overweight, shed excess pounds. Get your blood pressure down. Walk, or engage in other moderate activity that gets your muscles moving. This is important to speed your recovery process.
Check the medications you’re taking and discuss them with your physicians to ensure the medications will not interfere with your surgery or recovery. For example, blood thinners can interfere with blood clotting. Among women, birth control pills and hormone replacement therapy can also interfere with surgery.
Traditionally, spinal fusion back surgery has been performed in conjunction with spinal stenosis surgery to stabilize the spine at the site of the operation. A drawback of spinal fusion is that the procedure eliminates the independent motion of the fused vertebrae, and is also physically demanding. Now there is an alternative to spinal fusion following spinal stenosis surgery. The TOPSTM (Total Posterior Solution) System can be used instead of spinal fusion, and has better outcomes. Investigating whether this alternative procedure makes sense for you could be one of the best ways to prepare for your surgery for spinal stenosis.
In recent blogs we’ve addressed preparations for back surgery – specifically surgery for spinal stenosis, and spinal fusion operations. Yet the recovery process is just as important as the back surgery itself to your long-term health, so it’s important prepare for postoperative routines and realities well before the surgery is performed.
Among the first questions patients often ask about the spinal fusion back surgery recovery process is how soon they will be able to get out of bed following the operation. Patients typically get out of bed the day after their surgery – with the help of attendants, who will assist you in sitting up, getting your legs over the side of the bed, standing up and walking. You’ll be glad you spent time getting in shape before your operation. The preparation pays off at times like this, as being in good health will help throughout your healing and recovery, as the body responds to the trauma of surgery and works to repair itself.
Movement is indeed critical to proper healing, and since you’ll spend a good deal of time in bed in the first days after the spinal fusion operation, its important to learn how to move correctly in bed. You’ll be shown the best way to turn over, sit up, and move in ways that will promote proper healing, strengthen muscles and minimize pain.
Your caregivers will have plenty of useful tips for helping ensure a smooth, steady recovery from spinal fusion. For example, using slip on shoes, eliminating the need to bend over and tie laces; having pajamas with button tops, so you don’t have to lift arms and pull the PJs over your head; and drinking liquids from a squeeze bottle so there’s no need to bend the neck as when drinking from a cup, are among simple tips that will help you recover more quickly and with less discomfort.
Today many candidates for spinal fusion surgery can opt for the TOPSTM (Total Posterior Solution) System instead. The TOPS implant has been shown to have better clinical outcomes and fewer post-surgical complications than spinal fusion. And unlike spine fusion procedures, the TOPS device preserves the full range of each vertebra’s motion. Patients concerned about how soon they can get out of bed following spine fusion back surgery should make sure they’re familiar with all their surgical options, as the choices they make can also affect their recovery.
In our last blog we began addressing the topic of preparing for spinal fusion back surgery. We touched upon tests that may be performed, and the need to prepare physically through a conditioning regimen so your body is ready for the rigors of surgery. Here are additional points anyone considering spinal fusion should remember:
One potential complication of spinal fusion surgery is excessive bleeding. Several commonly used medications can increase bleeding, including aspirin, ibuprofen and other NSAIDs, as can anticoagulants such as warfarin. You will need to discontinue use of any such medications. Should your physician or surgeon be concerned about the risk of excessive blood loss during your spinal fusion operation, you may bank your own blood, called an autologous blood donation, before the surgery.
Be sure to discuss all the medications you are taking with your physicians, and they will advise you when (and if) you should stop taking them. Some medications could cause adverse affects in combination with the anesthetics or other medications used during the operation, and anti-inflammatory medication such as cortisone and chemotherapy can compromise the body’s ability to heal.
Failure of the bone graft to heal, called pseudarthrosis, is one of spinal fusion’s most problematic post-surgical complications. Smoking is associated with this complication, and nicotine has been shown to compromise the ability of bone cells to grow. It is imperative that smokers stop smoking prior to the surgery, and not smoke before their recovery is complete.
Before resigning yourself to spinal fusion surgery, remember that spinal problems often respond to more conservative treatments, such as physical therapy and healthy lifestyle changes. Alternative surgical procedures may also be available. For example, many candidates for spinal fusion can choose the TOPSTM(Total Posterior Solution) System instead. The TOPS System not only preserves all the natural flexion of individual vertebrae, unlike spinal fusion, but it has also been shown to have better outcomes in clinical trials around the world. Indeed, investigating alternative options is another productive way to prepare for a spinal fusion operation.
Epidural injections of steroids have often been the treatment of choice for patients with a pinched nerve in the back whose symptoms did not respond to simple exercise, physical therapy, or other more conservative approaches. Steroid injections have also been offered to patients with spinal stenosis whose back pain was unrelieved by less invasive therapy. But the results of a new research study hint that injections of steroids for back pain may be less beneficial than believed. The study is small, but it still bears consideration, as the findings are statistically valid and underscore why healing is as much an art as a science.
The study of the efficacy of steroid injections for back pain examined more than 270 patients, aged 53 to 75 years old, culled from the ranks of a larger study of individuals with spinal health problems. The research subjects were followed for four years. Sixty-nine of these patients had epidural injections and 207 did not, but otherwise the patients’ symptoms were primarily the same in terms of severity, as measured by well-established scales used to measure pain in the leg and lower back. Using these scales, researchers found less improvement among those who had epidural injections than among patients who did not have injections.
Several caveats must be offered when considering the results of this research. First, as the authors readily acknowledge, factors that the researchers didn’t account for and couldn’t control may have affected or skewed the results. Nonetheless, we are seeing fresh thinking and new techniques improving outcomes for many spinal patients. For example, patients who elected to have spinal decompression surgery to relieve symptoms of pinched nerves typically opted for a spinal fusion back surgery in tandem, in order to stabilize the spine. Today, a growing number are opting for TOPSTM – the Total Posterior Solution – System, instead of spinal fusion. The TOPS system, unlike spinal fusion, preserves complete independent motion of the individual vertebrae. This is one more way that fresh thinking, and new technologies and procedures are transforming the care and treatment of back problems.
Lumbar spinal stenosis, a common medical problem, denotes an unnatural narrowing of the spinal canal, the center of the spinal column housing the spinal nerves that relay sensorial information to the brain and control the movements of our muscles. The term stenosis comes from Latin, and means a narrowing. When a portion of the spinal canal narrows unnaturally, it can put pressure on the spinal nerves, and these pinched nerves in turn can cause pain and limit mobility.
The good news is that a variety of treatment options are available that have been proven effective in helping individuals recover from or ameliorate the symptoms of spinal stenosis. Conservative, non-invasive therapies include simple lifestyle changes, medications, physical therapy, and injections of anti-inflammatory agents. For patients with spinal stenosis, there’s no way of knowing which of these approaches will be most successful, so physicians may simply prescribe one of these treatments as a first step, and monitor the results to see how the patient responds. If the first method selected doesn’t achieve the results of helping the patient recover from spinal stenosis, the next option may be tried, and so on.
For patients with moderate to severe spinal stenosis who do not respond to conservative treatments, surgery may be recommended. In this form of spinal decompression surgery, the surgeon trims away excess bone in the narrowed center of the affected vertebra, relieving pressure on the compressed nerve or nerves. Historically, a spinal fusion back surgery operation has been performed in conjunction with surgery to relieve spinal stenosis, in order to stabilize the region of the spine where the operation was performed. Today there’s an important, and better alternative to spinal fusion. The TOPS (Total Posterior Spine) System procedure provides better clinical outcomes than spinal fusion surgery. The TOPS solution has the added benefit of preserving the spine’s full range of motion, unlike spinal fusion, which permanently fuses adjacent vertebrae. TOPS also offers a much quicker recovery from surgical treatment for spinal stenosis than spinal fusion. If you’re a candidate for spinal stenosis surgery, make sure you understand all the advanced surgical solutions available today, and what impact each will have on your recovery from this condition.
In our previous blog we discussed the tremendous stresses borne by the lumbar, or lower portion of the spine comprising the five lowest vertebrae. In fact, lumbar back pain is a significant health issue, affecting about 70 to 85 percent of Americans at some point in their lives, according the National Institutes of Health (NIH). Among the most common causes of lumbar spinal problems is the degeneration of bones and tissue in the spine that occur as a normal part of aging. But one doesn’t have to be older to have lumbar spinal problems. Back pain is the most frequent cause of activity limitation in people under the age of 45, according to the NIH. Trauma or injury, poor posture and biomechanics, genetics, obesity and poor muscle tone can all result in lumbar spinal problems that cause pain, limit mobility, and have other serious health consequences. These conditions include spinal stenosis, bulging disc, herniated disc, slipped disc, radiculopathy and spondylolisthesis.
A variety of treatment options are available for individuals affected by conditions causing lumbar back pain. Individuals with moderate to severe cases of these conditions who do not respond to conservative treatment options such as medication, physical therapy and lifestyle changes, may opt for a surgical solution. Frequently this involves cutting away portions of a lumbar vertebra that is impinging, or putting pressure on a nerve emanating from the spinal column. Such spinal decompression surgery can have a dramatic impact on relieving pain and restoring mobility. However, removing bony elements also weakens and destabilizes the spine, so historically a procedure known as lumbar fusion, or lumbar spinal fusion has been performed in conjunction with spinal decompression back surgery of the lower spine. In this procedure the vertebra from which tissue was removed is fused to an adjacent vertebra. This stabilizes and strengthens the spine, but lumbar fusion eliminates the natural flexion and independent motion of the fused vertebrae. Today lumbar decompression surgery patients have an alternative to lumbar fusion: the TOPS™ (Total Posterior Spine) System. TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. If you are considering surgery for a lumbar spinal problem, ask your physician about all your surgical options.
Imagine if the branches of a tree were just as big at the top as they are at the bottom, and that sometimes, heavy loads were placed on the ends of the very highest branches. Think of the stress that would put on the lower portion of the tree trunk. Well, that’s analogous to the situation we humans experience with our spinal columns. Our spinal column is like the trunk of a tree, but we’re just as big at the top of our trunks as at the bottom. The stress this puts on our lower backs – also called the lumbar region of the spine – is exacerbated by the cumulative affect of a lifetime of lifting and twisting in combination with degenerative changes of the spine that occur as a result of aging. So it’s not surprising that the majority of back problems that bring patients to spinal specialists are centered in the lower, or lumbar region of the spine.
These stresses, along with our genetic makeup, disease or injury, can result in a host of spinal disorders such as bulging or herniated discs, slipped disc and spinal stenosis. These disorders, in turn, can result in unnatural pressure being put on nerves that emanate from the spinal column, potentially causing pain, restricted mobility, and other symptoms of pinched nerves. We talked about the problem of pinched spinal nerve and spinal decompression in general in a previous blog. As we noted, spinal decompression is a means of easing pressure on impinged spinal nerves, and can be performed either non-surgically or surgically. Lumbar spinal decompression simply refers to decompression procedures performed on the lower portion of the spine.
The surgical solution for a lumbar pinched nerve involves removing tissue from vertebrae in the lumbar region that impinge, or put pressure on a nerve. This is called lumbar spinal decompression surgery. Historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. This provides an important more treatment option for individuals with moderate to severe symptoms of pinched nerves who do not respond to non-surgical lumbar decompression procedures.
It may sound like something only a deep sea diver needs to be concerned about, but spinal decompression is an important topic for many people suffering from debilitating back pain. Spinal decompression refers to the process of relieving pressure on one or more pinched, or impinged nerves in the spinal column. The pressure on such nerves can cause pain, restrict mobility, and result in a host of other physical problems that can manifest in almost any part of the body. A host of spinal conditions, including spinal stenosis, disc degeneration, bulging, herniated or slipped discs, and facet syndrome can put pressure on nerves emanating from the spinal column.
Spinal decompression can be performed both surgically and non surgically. Non-surgical spinal decompression utilizes mechanical, computer controlled traction devices to reduce the pressure placed on nerves in specific portions of the spine. Inversion therapy, in which patients hang upside down, is another from of non-surgical spinal decompression.
For patients who do not respond to non-invasive methods, spinal decompression surgery can achieve dramatic improvements. In this surgical procedure, portions of the bone or tissue of the spine that impinge of a nerve are cut away, relieving the pressure. Historically, a spinal fusion procedure was performed in conjunction with spinal decompression surgery, in order to stabilize the spine at the point where the decompression procedure was performed. But spinal fusion, in which two vertebrae are fused to enhance spinal stability, eliminates the independent motion of the fused vertebrae, and may accelerate degeneration of adjacent vertebrae. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.
If you’re a patient whose pinched spinal nerve is not responding to non-invasive decompression methods, make sure you discuss all your surgical options with your physicians.