Understanding the problem
The spinal column contains open spaces that create passageways for the spinal cord and the spinal nerves. Spinal stenosis is a narrowing of (or an intrusion into) these openings. This can cause a compression of the nerves. Spinal stenosis most commonly affects the cervical and lumbar regions of the spine. The spinal nerves can become compressed against the vertebral bone. This can interfere with nerve function. It can cause pain in the spine or in other parts of the body.
Understanding who suffers
Approximately 250,000-500,000 US residents have symptoms of spinal stenosis. This represents about 1 per 1000 persons older than 65 years and about 5 of every 1000 persons older than 50 years. About 70 million Americans are older than 50 years, and this number is estimated to grow by 18 million in the next decade alone, suggesting that the prevalence of spinal stenosis will increase.
Potential Signs and Symptoms
Patients with lumbar spinal stenosis may feel pain, weakness, or numbness in the legs, calves or buttocks. In the lumbar spine, symptoms often increase when walking short distances and decrease when the patient sits, bends forward or lies down.
Cervical spinal stenosis may cause similar symptoms in the shoulders, arms, and legs; hand clumsiness, gait and balance disturbances can also occur.
In some patients the pain starts in the legs and moves upward to the buttocks; in other patients the pain begins higher in the body and moves downward.
This is referred to as a sensory march. The pain may radiate like sciatica or may be a cramping pain. In severe cases, the pain can be constant. Severe cases of stenosis can also cause bladder and bowel problems, but this rarely occurs. Also paraplegia or significant loss of function also rarely, if ever, occurs
Examinations Usually Required
The selection of an initial screening examination in patients who are suspected of having spinal stenosis depends on the age of the patient.
Standard radiographs have been the recommended initial imaging study of choice:
MRI is the imaging modality of choice for lumbar spinal stenosis.
CT scanning provides excellent central canal visualization (fluid-filled space that runs through the length of the entire spinal cord) , lateral recess visualization (where narrowing reduces the available space within the exit doorway (foramen) of the spinal canal), and neuroforaminal visualization (to show any reduction of the size of the opening in the spinal column through which the spinal nerve exits).
Proposing Treatment and Why AIMIS
Treatment options for spinal stenosis initially may include anti-inflammatory medications, muscle relaxants and medications to relieve pain. Steroid injections may also be recommended along with physical therapy.
If these methods are not effective, surgery may be needed to eliminate pressure on the nerves.
AIMIS performs a large number of procedures for this disease area including:
- Minimally Invasive Cervical & Lumbar Spinal Surgery
- Nerve Decompression
- ALIF or Anterior Lumbar Interbody Fusion
- Anterior Cervical Corpectomy
- PLIF or Posterior Lumbar Interbody Fusion
- TLIF or Transforaminal Lumbar Interbody Fusion
To see our surgical technologies please click here
To see our surgical procedures please click here
Reputable and Prestigious Surgeons
AIMIS’ skilled team of neurosurgeons, orthopaedic surgeons and ancillary professionals has one of the leading experiences in the world for treating spinal stenosis. Our full team are consulted with each case to find the most suitable experienced doctor for the patient’s exact issue, to ensure the maximum potential outcome of treatment.
Getting More Information Before Moving Forward
You may have questions like:
- Can I get more information before I commit to this?
- Can I get a second opinion from you before I commit to this?
- How can I find out the cost before I have any obligation?
What AIMIS Can do:
AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.
AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.
AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.
Further information on the problem:
Spinal stenosis most commonly affects the cervical and lumbar regions of the spine.
Each vertebra has a large opening at the rear called the spinal canal. In the cervical and thoracic regions of the spine, the spinal cord travels through this space. In the lumbar region of the spine, this opening contains a bundle of nerve roots. Openings called foramina branch away from the spinal canal. These spaces provide pathways for the nerve roots that travel from the spine to other parts of the body.
In a spine with stenosis, one or more of these openings are narrowed. The spinal nerves can become compressed against the vertebral bone. This can interfere with nerve function. It can cause pain in the spine or in other parts of the body.
Stenosis can be due to various reasons:
- Commonly cause by an excess growth of bone around the spinal nerves. This excess bone growth often results from osteoarthritis.
- Stenosis can also result from a dislocation or a fracture of the vertebral bone. Stenosis can be caused by soft tissue intruding into the spine’s open spaces.
- Herniated discs, tumors, and thickened spinal ligaments can press against the spinal nerves.
- Cases where a person is born with a small spinal canal that does not provide enough room for the spinal nerves.
Further Information on Increased Risk Groups
Lumbar spinal stenosis (LSS) remains the leading preoperative diagnosis for adults older than 65 years who undergo spine surgery. The incidence of lateral nerve entrapment is reportedly 8-11%. Some studies implicate lateral recess stenosis as the pain generator for 60% of patients with symptomatology of failed back surgery syndrome.
As many as 35% of persons who are asymptomatic and aged 20-39 years demonstrate disc bulging. CT scanning and MRI studies in patients who are asymptomatic and younger than 40 years demonstrate a 4-28% occurrence of spinal stenosis. Most persons older than 60 years have spinal stenosis to some degree. Because most patients with mild spinal stenosis are asymptomatic, the absolute frequency can only be estimated.
Further examination that maybe required or requested
Typically, plain x-rays are done first. They are helpful in looking for infection, tumors, and identifying problems with alignment of the spine. They can show narrowed disc space, fractures, bone spurs (osteophytes), or osteoarthritis (spondylosis).
A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show a bulging disc or a herniated disc.
Additional test that may be requested could include:
- Bone scan: to help detect spinal problems such as osteoarthritis, fractures, or infections.
- CT myelogram: to provide detailed anatomic picture of your spine, especially of the nerves and the surrounding bone. The doctor will look for areas of compression, or pressure, on the nerves. CT scans done in conjunction with myelography are particularly helpful diagnosing lumbar spinal stenosis.
Why AIMIS for this Surgery
AIMIS strives for excellence in delivering the best surgical outcomes, via the extensive expertise of its prestige surgeons, its technologies, its highly trained staff and superior facilities to provide an individualized and compassionate experience in a comfortable environment. All patients are treated with the individual care they deserve in an effort to provide the best chance of successful treatment.
Other Services Provided by AIMIS
In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you’ll know the best flights to take, where you’ll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become “”part of our family”” and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.