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Spinal Stenosis

Spinal stenosis is a common condition that involves a narrowing in one or more areas of the spine as a result of injury or deterioration to the discs, joints or bones within the spinal canal.

While some patients may be born with spinal stenosis, most cases develop later in life as a result of the degenerative changes that occur in the spine over time. Osteoarthritis is the main cause of spinal stenosis, as it causes the cartilage in the area to deteriorate and eventually results in the bones rubbing against each other and forming growths called bone spurs. These bone spurs may narrow the spinal canal when they form the facet joints. Spinal stenosis can also be caused by a herniated disc, ligament changes or spinal tumors.

Symptoms of Spinal Stenosis

Patients with spinal stenosis may experience cramping, pain and numbness in the legs, back, neck, shoulders or arms, depending on which part of the spine is affected. A loss of sensation, loss of balance and bladder malfunctioning may also occur in some patients. Some patients may not experience any symptoms from this condition. It is only when the narrowed area of the spine compresses the spinal cord or nerves that symptoms arise.

Diagnosing Spinal Stenosis

Spinal stenosis is often difficult to diagnose because its symptoms can come and go and may resemble the symptoms of many other conditions. A diagnosis of spinal stenosis is often achieved after ruling out other conditions after performing imaging exams such as a spinal X-ray, MRI, CT scan, bone scan and others. Your doctor will also ask you several questions about your symptoms and overall health to correctly diagnose your condition and provide an adequate treatment solution.

Treatment

Most cases of spinal stenosis can be effectively treated through conservative methods such as physical therapy, nonsteroidal anti-inflammatory drugs, rest and a back brace. These treatments are usually administered for at least three months for the spine to heal properly and allow for full function. The specific treatment for your individual condition may vary.

For more severe cases of spinal stenosis, surgery may be required to relieve pressure on the spinal cord while also maintaining the integrity of the site. This may be achieved through procedures such as a decompressive laminectomy, laminotomy or fusion that relieve pressure and join the damaged bone back to its normal state.

Spondylolisthesis

Spondylolisthesis involves a displacement of the spinal vertebrae, most often occurring in the lower back. This condition involves one vertebrae moving forward in relation to the ones above and below it, as a result of degeneration, a congenital defect, trauma or other factors.

Patients with spondylolisthesis may experience severe leg and back pain, as well as muscle weakness and tingling. Some patients may not experience any symptoms at all from this condition. Your doctor can diagnose this condition through an X-ray examination of the lower spine, which will help determine the position of the affected vertebrae.

Many cases of spondylolisthesis can be treated through regular observation and rest. Anti-inflammatory medication can often help relieve pain caused by spondylolisthesis, while physical therapy may be administered to help stretch and strengthen the affected area. More severe cases may require surgery to restore the displaced vertebra back to its original location. Surgery is most often needed by patients experiencing pressure on their nerves.

Myelopathy

Myelopathy is a spinal condition most commonly occurring in elderly patients who have difficulty walking or maintaining balance. This condition is most often caused by spinal stenosis, which involves a narrowing of the spinal canal, but may also occur as a result of degeneration, bone spurs and other conditions that place pressure on the nerves.

Symptoms of myelopathy tend to develop gradually and may cause patients to have trouble walking up and down stairs or buttoning their clothing. The lack of clearly defined symptoms often makes myelopathy difficult to diagnose.

Treatment for myelopathy often involves surgery to relieve spinal cord compression or pressure placed on the nerve root. This can help reduce pain and other symptoms caused by the underlying condition. Surgery is not recommended for many older patients who may not be able to handle the stress of such as invasive procedure. Your doctor will discuss the risks of surgery with you in order to determine the best treatment approach for your individual condition.

Spondylolysis

Spondylolysis is a defect in the spine that involves weakness within the vertebrae and the facet joints, which connect all of the vertebrae together. This weakness often results in stress fractures within the vertebrae, or the bones slipping out of place, a condition known as spondylolisthesis. The cause of spondylolysis has been linked to genetic factors as well as repetitive trauma, although the specific cause is still unknown.

Patients with spondylolysis do not usually have any symptoms and may not even be aware that they have this condition. When symptoms do occur, they may include pain in the lower back, which is usually worse with physical activity. Symptoms are most common after the teenage growth spurt, which is usually around age 15 or 16.

Initial treatment for spondylolysis aims to reduce pain and allow any fractures within the spine to heal so that patients can function properly. This is done through anti-inflammatory medications and physical therapy exercises. Avoiding sports and other physical activity during this time is often recommended. Severe cases of spondylolysis may require a brace or back support to stabilize the back, while epidural steroid injections help relieve pain that does not respond to more conservative treatments.

Spinal Fractures

A fracture is a break or crack in a bone, usually caused by a traumatic event such as a car crash, fall, sports injury or violent act. Fractures in the spine affect the vertebrae, and can occur in the upper (cervical), middle (thoracic) or lower (lumbar) back. Patients with osteoporosis, tumors or other conditions prone to weakened bones may be at a higher risk of experiencing a spinal fracture.

After a spinal fracture, patients may experience moderate to severe pain that is usually worse with movement. Because the nerves within the spinal cord may be affected as a result of this injury, patients may also experience numbness, tingling, weakness and bowel/bladder dysfunction. Your doctor can confirm the diagnosis of a fracture through a physical exam and X-ray imaging.

Treatment depends on the type and severity of the fracture, and aims to restore the alignment and stability of the spine. Mild fractures may require bracing, rest and physical therapy for several weeks to promote proper healing. More severe fractures may require surgery to realign the spine and hold the bones in place while they heal. Surgery is also recommended when the spinal cord is injured. Your doctor will decide which type of treatment is best for you after a thorough evaluation of your condition.

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