SPINAL STENOSIS IN INDIA

Spinal Stenosis in India

Your spine, or backbone, protects your spinal cord and allows you to stand and bend. Spinal stenosis causes narrowing in your spine. The narrowing can occur at the center of your spine, in the canals branching off your spine and/or between the vertebrae, the bones of the spine. The narrowing puts pressure on your nerves and spinal cord and can cause pain.

Spinal stenosis occurs mostly in people older than 50. Younger people with a spine injury or a narrow spinal canal are also at risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include pain in your neck or back, numbness, weakness or pain in your arms or legs, and foot problems. Treatments include medications, physical therapy, braces and surgery.

What Is Lumbar Spinal Stenosis?

The lumbar spine is made up of five vertebral bodies in the lower back. Nerves coming off the spinal cord travel though the spinal canal and exit the canal through small openings on the sides of the vertebral called foramen. Lumbar stenosis (spinal stenosis) is a condition whereby either the spinal canal (central stenosis) or vertebral foramen (foraminal stenosis) becomes narrowed. If the narrowing is substantial, it causes compression of the nerves, which causes the painful symptoms of lumbar spinal stenosis.

What Causes Lumbar Spinal Stenosis?

The most common cause of lumbar spinal stenosis is degenerative arthritis. As with other joints in the body arthritis commonly occurs in the spine as part of the normal ageing process. This can lead to loss of the cartilage between the bones at the joints, formation of bone spurs (osteophytes), loss of the normal height of the discs between the vertebrae of the spine (degenerative disc disease), and overgrowth (hypertrophy) of the ligamentous structures. Each of these processes reduces the normal space available for the nerves and can directly press on nerve tissues to cause lumbar spinal stenosis.

Lumbar spinal stenosis can also be caused by other conditions that decrease the space of the spinal canal or vertebral foramen.

These can include: –

• Tumor
• Infection
• Various metabolic bone disorders, such as paget’s disease of bone

These causes are much less common than degenerative arthritis.

Spinal Stenosis Symptoms in India

Many people have evidence of spinal stenosis on X-rays, but have no signs or symptoms. When symptoms do occur, they often start gradually and worsen over time. The most common parts of the spine affected by spinal stenosis are the neck and lower back. Symptoms vary, depending on the location of the stenosis.

Spinal stenosis in the neck in India

• • Numbness or weakness : – Spinal stenosis in your upper (cervical) spine can cause numbness, weakness or tingling in a leg, foot, arm or hand. You may drop things more often or have a tendency to fall.

• • Neck or shoulder pain : – This may occur if the nerves in your neck are compressed. However, cervical spinal stenosis often causes no pain. And neck pain can be caused by problems other than spinal stenosis.
• Loss of bowel or bladder control : – In severe cases of cervical spinal stenosis, nerves to the bladder or bowel may be affected, leading to incontinence.

Spinal stenosis in the lower back in India

Compressed nerves in your lower (lumbar) spine can cause pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down.

This Can Cause

• Pain
• Numbness
• Tingling
• Weakness or cramping in the legs and feet, particularly progressively with walking and being relieved with resting

These symptoms are sometimes referred to as pseudoclaudication as they mimic the symptoms of inadequate circulation to the legs that is referred to as claudication.

Risk Factors

Spinal stenosis risk factors include : –

• • Age : – Most people with spinal stenosis are over 50 years old.
• Inherited conditions : – Some birth defects result in a spinal canal that’s smaller than usual. This increases the risk of spinal stenosis.

Complications in India

Spinal stenosis complications vary, depending on which nerves are compressed.

Cervical stenosis complications in India

• • Incontinence : – In severe cases of cervical spinal stenosis, you may lose the ability to control your bowels or bladder.
• Weakness or paralysis : – Cervical spinal stenosis often causes severe weakness and sometimes paralysis.

Lumbar stenosis complications in India

Cauda equina syndrome is a rare but serious complication, in which the bundle of nerve roots at the lower end of the spinal cord is compressed. This can cause numbness and paralysis, and emergency surgery may be necessary to relieve the pressure.

What Is The Treatment For Lumbar Spinal Stenosis?

In most cases the treatment for lumbar spinal stenosis begins with conservative (non-operative) treatment. This can include medications to reduce inflammation, even short courses of oral cortisone medication, and pain medications. There are also several medications directed specifically at nerve pain that are helpful in lumbar spinal stenosis, including gabapentin (Neurontin) and pregabalin (Lyrica). Physical therapy can help in some cases. Cortisone (steroid) injections in the lumbar spine can also reduce the symptoms by decreasing inflammation and swelling around the nerve tissue. These can be repeated up to three times per year