Degenerative Lumbar Spine (spinal canal stenosis) SCS
Spinal canal stenosis is a age related condition. Normally patients over 50 years of age suffer from this problem. Due to age related wear and tear , spinal joints (facet joints) increase in size with hypertrophy of ligaments (Ligamentum flavum). This generates pressure over nerves (roots of cauda equina).
Main symptoms of Spinal canal stenosis (SCS)
- Lower back pain and/or leg pain
- Claudication pain in legs: Sciatica pain – pain in one or both legs, tired feeling down the legs after standing or walking for specific period of time, weakness in legs
- Tingling and numbness in legs after walking or standing for a specific period of time.
- Tight hamstring muscles (the muscles in the back of the thigh) and decreased flexibility in lower back
- Difficulty or pain while arching the back backwards
As this is a slow growing condition, nerves tolerate pressure. Normally patients experience walking and standing limitation. Surgery is needed when the pain is disabling. Also it is recommended for patients who develop progressive neurologic deterioration. With the micro decompression surgery, pain can be alleviated and patients can be cured (decompression: removing the pressure on the nerves). Micro decompression procedure, can improve walking and standing distances, relieves Claudication pain and improves parasthesia. With about 90% to 95% of success rate, this surgery can permanently cure the pain and improves the functional capability of the patients.
Spinal fusion surgery
Spinal fusion means we stick one vertebra with another one by doing specialized surgery!! Due to age or trauma, spinal joints become weak, cause compression over spinal nerves. At times they develop spinal instability. Spinal joints become so loose that they are not able to support body weight. Spinal fusion is a preferred method to stabilize these weak joints.
Spondylolisthesis is a spinal condition wherein one vertebra slides over another vertebra. In simple terms it is called displacement of vertebra. The displaced vertebra/vertebrae press on the nerves coming out from the sides and thus cause recurrent back pain and leg pain with pin pricking sensation in the lower limbs. (Tingling and numbness in legs)
This condition can occur due to general aging process in which bones, joints and ligaments in the spine become weak with reduced ability to hold the spinal column in alignment. The degenerative Spondylolisthesis is more common in people above 50 years of age while people above 65 years of age run greater risk of such condition.
Degenerative Spondylolisthesis generally occurs at one of two levels of the lumbar spine - at L4-L5 level of the lower spine (which is the most common location) and at L3-L4 level. It is relatively rare at other levels of the spine.
Main symptoms of Degenerative Spondylolisthesis:
The symptoms are more or less same as spinal canal stenosis.
Surgery is rarely needed and it may be considered if the pain is disabling. Also it is recommended for patients who develop progressive neurologic deterioration. This involves micro decompression and stabilization procedure. It means removal of pressure from nerves and implantation of specialized spinal implants to provide support to weak joints. Stabilization procedure involves spinal fusion or motion retaining spinal stabilization.