What Is Spinal Stenosis?
Spinal stenosis is the narrowing of the spinal canal (spaces within the spine) that may exert pressure on the nerve along the spine.
What Causes Spinal Stenosis?
The main cause of spinal stenosis is bone degeneration due to ageing. As we grow older, the vertebrae and intervertebral discs are prone to collapse due to degeneration. The collapsed vertebrae may compress and cause the rupture and inflammation of the intervertebral disc. Chronic inflammation of the small joints also causes the bones to grow spurs that oppress the spinal cord and spinal nerve roots, which leads to spinal stenosis.
Other causes of spinal stenosis include:
- Bone fragments due to fractures
- Scoliosis due to old-age degeneration
- Thickening of the ligaments in of the spine
- Leg pain
- Leg paralysis
- Numbness in the leg
- Weakness in the leg
- Inability to walk
- MRI scan
- X-ray scan
Who Are At Risk?
- Elderly people
- Workers who have long been burdened with heavy work due to work needs
- Those who have long-term bad sitting postures
- Those with family members suffering from spinal stenosis
The treatment of spinal stenosis consists of conservative treatment and surgical treatment. Conservative treatment is more suitable for patients with mild symptoms. Patients with severe symptoms affecting quality of life should consider surgery to solve the root cause of their condition.
- Conservative treatment:
- Medication and physical therapy – taking analgesic, anti-inflammatory or swell-reducing medication combined with physical therapy can reduce the swelling of the spinal nerve roots, thus reducing pain.
- Steroid injection / infiltration – Steroids can reduce inflammation and swelling that cause the spinal nerve roots to be oppressed. However, the steroid injection only reduces pain temporarily and does not solve the root cause of spinal stenosis.
- Radiofrequency modulation – A needle-sized medical device is inserted into the lumbar spine to eliminate the pain at the nerve. This method is more effective than steroid injection / infiltration and provides longer relief.
- Surgical treatment:
- Decompression – This surgery aims to remove the roots of the spinal nerve roots. If the spinal stenosis is caused by bone spurs, spur resection will be done; If it is caused by thickening of the ligamentum flavum, the ligamentum flavum will be removed. The benefit of decompression surgery is that this is a low-risk procedure and the flexibility of the lumbar spine is maintained after surgery. Decompression surgery can be performed via mini-open technique, video-assisted tubular system, or endoscopic technique.
Spinal fusion – This surgery aims to fixate the two vertebral bodies by implanting screws or cages into the spinal joints, replacing the original intervertebral discs and fixing the joints. Recent advances have made percutaneous screw fixation possible as part of the minimally-invasive surgery.