Surgery for Cervical / Lumbar Stenosis
Surgery for Cervical Stenosis
Canal stenosis occurs as a result of ligamentum flavum hypertrophy, prolapsed disc or bony overgrowth facetal – hypertrophy or osteophytes. The goal of surgery is to free the thecal sac and nerve root from the compression of the offending agent.
Surgery is done via the posterior approach which involves placing a cut on the back. It is usually done under general anaesthesia and the patient is put in prone position.
Conventional or open approach involves putting an incision on the back, subperiosteal muscle dissection and approaching the lamina. Lamina is excised with the help of Kerrison punches and burr. Ligamentum flavum is then visualised which is also excised with the help of Kerrison punches. Thecal sac is thus freed from the compression. Laterally exiting nerve roots are visualised and foraminotomy done by removing the osteophytes and the ligamentum flavum.
Lumbar Canal Stenosis
Your spinal cord is a bundle of nerves that runs through a tunnel formed by your vertebrae. The tunnel is called the spinal canal. Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of your back. Stenosis, which means narrowing, can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles.
Spinal stenosis can happen in any part of your spine but is most common in the lower back. This part of your spine is called your lumbar area. Five lumbar vertebrae connect your upper spine to your pelvis.
If you have lumbar spinal stenosis, you may have trouble walking distances or find that you need to lean forward to relieve pressure on your lower back. You may also have pain or numbness in your legs. In more severe cases, you may have difficulty controlling your bowel and bladder.
What causes lumbar spinal stenosis?
The most common cause of spinal stenosis is osteoarthritis, the gradual wear and tear that happens to your joints over time. Spinal stenosis is common because osteoarthritis begins to cause changes in most people’s spines by age 50. That’s why most people who develop symptoms of spinal stenosis are 50 or older. Women have a higher risk of developing spinal stenosis than men.
Besides osteoarthritis, other conditions or circumstances can cause spinal stenosis:
- Congenitally Narrow spinal canal
- Injury to the spine
- Spinal tumour
- Certain bone diseases
- Past surgery of the spine
- Rheumatoid arthritis
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