La spinal stenosis is a pathology of the back which is characterized by narrowing of the spinal canal, causing potential compression of the spinal cord in some cases.
But what are the causes of this stenosis? how to recognize it? what about his surgery and convalescence ? Answers in this article.
Brief anatomical reminder
La spine, commonly called " spine » constitutes the framework of the back extending from the base of the skull to the pelvis. Made up of 33 bones called " vertebrae » Tiered from top to bottom: cervical, dorsal, lumbar and sacrococcygeal vertebrae, this part of the body plays a role in maintaining and moving the trunk.
Its role is also neurological and represented by the protection of the spinal canal containing the spinal cord which terminates at the terminal part of the vertebral column giving rise to a set of nerves grouped into ponytail bearing the same name. The ponytail is mainly responsible for the innervation of the lower limb as well as the perineum.
Le intervertebral disc is the gelatinous part between each vertebrate. Histologically speaking, the disc is formed of a central part called " pulpy nucleus » and a peripheral part which corresponds to a fibrous ring made of collagen and cartilage. The role of the disc is to allow the damping and the distribution of pressures on the whole of the rachis.
What is spinal stenosis?
Spinal stenosis is defined as a decrease in the diameter of the spinal canal ou Spinal canal containing the spinal cord. When the narrowing becomes severe, it can irritate the spinal cord as well as its nerve roots.
This pathology is likely to concern all parts of the spine, but more particularly the cervical level giving what is called a narrow cervical canal and the lumbar level giving a lumbar spinal stenosis (or narrow lumbar canal).
As mentioned above, spinal stenosis is related to partial or total narrowing of the spinal canal. Indeed, this phenomenon can have several origins: congenital, traumatic or tumoral.
Generally, the pathologies most frequently involved in spinal stenosis are:
Congenital cause :
In rare cases, some individuals are born with an abnormally reduced diameter spinal canal. In some the narrowing is asymptomatic and may not be responsible for any serious symptoms, but in others it may be the cause of a number of more or less serious consequences.
This is the case of vertebral osteoarthritis, essentially linked to the normal aging process.
It can be responsible for the reduction of the diameter of the spinal canal when it is voluminous but also in the event of a complicated hernia.
Which corresponds to an advancement of a vertebra relative to another underlying vertebra.
Trauma or cancers
Any trauma or cancer can obstruct the spinal canal, causing potential spinal stenosis as a result.
What are the symptoms ?
The manifestation of spinal stenosis varies from one individual to another, and the symptoms vary depending on whether it is a cervical shrinkage or an lumbar stenosis.
When it comes to a cervical stenosis can we have :
- Turnkey neck pain or neck pain
- Radiating pain in the arms and hands
- Neurological signs at advanced stages such as tingling, numbness, paralysis...
- A asthenia felt throughout the body, in rare cases.
When it comes to lumbar stenosis, can we have :
- Turnkey low back pain or lower back pain in the Lumbar spine whose intensity can be diminished by sitting or bending the lumbar spine.
- Radiating pains in the whole of the lower limb, starting from the buttocks towards the two legs.
- feelings ofnumbness or tingling at the level of the lower limb
- A feeling weak throughout the body, in rare cases.
- Achievement of sexual function et urinary under cauda equina syndrome.
What about treatment?
Being a risky pathology, its treatment must always be the subject of a consultation with a health professional, because he will be able to recommend the treatment that will best suit your case, respecting well-defined conditions and indications.
The therapeutic components included in the management of spinal stenosis are essentially:
- The pharmaceuticals : paracetamol, NSAIDs, morphine, corticosteroids, infiltrations, etc.
- La physiotherapy (physiotherapy) : for a good improvement of the functional prognosis
- Le wearing a corset : in case of severe spinal stenosis
- Le relative rest
- Le surgical treatment
When indicated, surgery for spinal stenosis (cervical or lumbar) is based on more or less complex surgical techniques, the most frequently used of which are:
- La Laminoplasty
- La discectomy
- La corpectomy
- La flavectomy
Recovery from spinal stenosis surgery
In general, in the event of hospitalization scheduled for surgery, patients only stay one to two days following the operation.
Wearing a cervical collar is generally not recommended by doctors in case of laminoplasty. However, wearing a neck brace flexible is desirable in some patients, in particular to better support the spine during the first days following the procedure.
Regarding the duration of hospitalization, this can range from 24 to 48 hours, in the absence of postoperative complications. The patient is allowed to get out of bed and start walking from the first day after the procedure.
The first bandage is redone 24 h after the operation, then repeat every other day until the wound is completely healed.
At the end of 6 weeks of the intervention, the patient must make his first postoperative consultation then a second one after 3 months of the intervention. The consultation of the 3rd month will be based on the clinical and radiological control serving to evaluate the evolution of the intervention. If the pain persists, the doctor may recommend additional follow-up time.
45 days after the operation, the patient can contact a physiotherapist to benefit from the sessions physiotherapy can be based on gentle massages of the muscles or alternatively Stretching. However, the physio should be gradual and gentle for faster and more effective recovery. However, other sporting activities should be resumed in the long term (from the first months) provided that any sudden physical effort or the carrying of heavy loads is avoided.
In the event of the appearance of new symptoms or usual symptoms such as shooting pains, numbness, muscle weakness or paralysis, you should never hesitate to report them to your surgeon or doctor.
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