The spine in the human body performs several functions. It is an important component of the musculoskeletal system, protects the spinal cord and participates in body movements. Any changes in its structure are reflected in the quality of human life. Among diseases caused by deformation of the supporting system, spinal stenosis of the lumbar region deserves special attention. Basically, the development of this ailment is associated with the natural aging of the body. But there may be other reasons. What kind? We will talk about this in this article. You will also find out what symptoms accompany the pathology and why its treatment should not be neglected.
Disease definition
The spinal canal plays an important role in the human body - protects the spinal cord. Together with the head, it makes up the central nervous system, which regulates the functioning of the whole organism. Therefore, the preservation of the anatomical structure of the spinal canal is the key to the full functioning of the spinal cord. Any violations in this system result in irreversible consequences.
Stenosis of the spinal canal of the lumbar is a pathological process that is characterized by a narrowing of its diameter. A decrease in clearance leads to compression of the roots of the spinal cord. The first mention of this ailment is associated with Antoine Portap. In 1803, the doctor described the disease in detail, and determined its causes. In the column “Symptoms” he noted leg paralysis and muscle atrophy.
Stenosis is a fairly common pathology, which is mainly found in elderly people. If you look at the statistics, this diagnosis is confirmed in 21% of patients after 60 years. Only 30% of them have clinical symptoms of the disease.
Causes of stenosis
To know the main causes of the disease, it is necessary to understand the anatomy of the supporting system, and more precisely, its lumbar part.
The spinal canal is formed by bodies and arches. They are interconnected by bundles. The spinal cord passes inside the canal. The entire space of the cavity is filled with fluid and fatty tissue. Such a peculiar layer allows you to make up for the minor narrowing of the channel, which are possible with ordinary human activity. If the diameter of the lumen is reduced even more, compression of the nerve processes or the brain itself occurs. As a result of this pathological process, various symptoms of a neurological nature appear.
The cause of the disease can be tumors, protrusion of the disc, intervertebral hernia, trauma, arthrosis of the joints. This form of the disease is called "secondary stenosis of the spinal canal of the lumbar region," since narrowing of the lumen is a consequence of other pathologies. The development of the primary (idiopathic) variant of the disease is due to congenital malformations. Its symptoms appear even at a young age. Congenital malformations result from abnormal intrauterine development.
One of the dangerous consequences of the disease is a violation of the transport of nutrients to the spinal cord. As a result, pressure increases in the spinal canal, which leads to vascular compression. As a result, they can no longer transmit the required volume of blood at high speed. Against the background of all changes in the body, a person begins to experience pain in the back and limbs.
How to recognize a disease?
Stenosis of the spinal canal of the lumbar is a fairly common pathology. The human body is subject to the natural processes of aging, which are usually manifested by degenerative changes. Stenosis begins with discomfort in the lumbar region. Exacerbation periods give way to relative peace. Increased pain can trigger any external factor (awkward movement, physical activity). The intensity of discomfort increases gradually. This is possible because the deformation of the channel does not occur in one day, it takes time. It is almost impossible to notice compression at the initial stage of development. Nerve tissue is very elastic. When pressed, it stretches inward along with the bone tissue. Painful discomfort occurs when the tissues are at the limit of extensibility.
With stenosis, the roots of the spinal cord undergo constant traumatic pressure. They are always in a state of edema. Pain in the lower back is usually accompanied by severe burning, because the blood supply to the nervous tissue is still impaired. She is constantly deficient in oxygen.
Sometimes, against the background of a load or an awkward movement, a sharp compression of the nerve occurs, as a result, it stops its work. This can be seen by a change in the patient’s gait and a weakening of motor function. It becomes difficult for a person to stand or sit. Only at this stage he goes to the doctor and hears a diagnosis of “lumbar spinal canal stenosis”. Symptoms can progress and lead to irreversible consequences if treatment is not started in time.
Classification of stenosis
As a result of degenerative disorders at the level of bone tissue, the diameter of the spinal canal is narrowed. Given these changes, the following forms of the disease are distinguished:
- Absolute stenosis involves a decrease in the lumen of the channel to 5-10 mm. Pathology is characterized by a vivid clinical picture. Treatment requires surgical intervention, but conservative methods are possible.
- Relative stenosis of the spinal canal of the lumbar involves a narrowing of the lumen to 10-12 mm. This form of the disease is detected by chance, is well treatable.
- With lateral stenosis , a narrowing of the spinal canal to 3 mm is observed. This is the extreme stage of the disease, involving mandatory surgical intervention.
Medical examination for stenosis
Adequate and timely therapy is the key to a quick recovery. The sooner the doctor prescribes treatment, the more chances to defeat the disease. To consult on this issue, you must visit a neurosurgeon or neurologist. Stenosis of the spinal canal of the lumbosacral spine is their specialization. The diagnosis of the disease is based on clinical symptoms, data from a neurological examination (changes in reflexes, limb sensitivity) and the results of an additional examination. Since pain in the lumbar can be due to many reasons, radiography and spondylography can not be done. Sometimes an additional MRI is required. Based on the results of the examination, a specialist can determine the presence of a disease, its cause, as well as select adequate therapy.
Treatment principles
As with any other chronic disease, first of all, the doctor prescribes conservative therapy. The course usually takes no more than 30 days. Timely access to a doctor can cure stenosis of the spinal canal of the lumbar in 1-2 months and not resort to surgical intervention. Running cases require lifelong supportive care. The standard course of treatment includes medication and physiotherapy. Its main goal is to eradicate the cause of the disease, as well as reduce symptoms.
Treatment with pills and ointments
Drug therapy is indicated for patients without pronounced neurological disorders, when the only complaints are pain in the sacrum and legs. The treatment of spinal canal stenosis in the lumbar is to take the following drugs:
- Nonsteroidal anti-inflammatory drugs (Ibuprofen, Diclofenac, Xefocam). They reduce pain, swelling in the nerve root, eliminate inflammation.
- Muscle relaxants ("Midokalm", "Tizanidine"). Such medications are designed to relieve muscle tension.
- Vitamins of group B (Milgamma, Neurovitan).
- Vascular agents (Pentoxifylline, Curantil). Their main action is aimed at improving blood flow.
- Decongested drugs ("Diacarb").
With severe pain discomfort, an epidural or sacral blockade, as well as local anesthetics, show an excellent effect. Often, such drugs are taken in combination.
Physiotherapy
If the general condition of the patient does not worsen, he is sent for a consultation with a rehabilitation doctor. This specialist is developing physical therapy programs . Exercises for stenosis of the spinal canal of the lumbar are selected individually, taking into account the patient's condition and the severity of the disease. The main task of physiotherapy exercises is to teach you to control the manifestations of the disease, to increase the strength and flexibility of the supporting apparatus. Below are a few exercise options recommended for stenosis.
- Lying on your back, bend your legs and spread shoulder width apart. It is necessary to take a deep breath, count to five, and then exhale strongly raise the chest. Such a complex should be repeated 8-10 times.
- Exercise is recommended to start with breathing exercises. Lying on your back, you need to raise and press your knees to your chest, to stay in this position for several minutes. After that, the legs can be gently released. Repeat at least 10 times.
- Lying on your back, spread your arms in different directions. The legs must be bent at the knees, and then gently turn left and right. In this case, the back should remain motionless.
Such simple exercises can alleviate the condition of patients with a diagnosis of "stenosis of the spinal canal of the lumbar region." Therapeutic exercises also help to improve blood circulation in the affected parts of the body. At the initial stage, the exercise therapy complex should be performed under the supervision of a medical instructor. After mastering the correct technique, classes can be continued at home.
Help traditional medicine
In the arsenal of folk healers, there are many tools for the treatment of stenosis. Among them, compresses from honey are especially popular. It is necessary to grease the lumbar region with a sweet delicacy, cover with a towel and put mustard plasters on top. You can also make a compress from the infusion of elderberry, chamomile and thyme flowers. To do this, in the resulting decoction of medicinal plants, it is necessary to moisten the cotton cloth, and then attach to the affected area and wrap the warmth with a scarf for the night.
It is important to understand that with the help of traditional healers it is impossible to cure stenosis of the spinal canal of the lumbar. Surgery or drug therapy will help to cope with this ailment. Any prescriptions for doctors give a short-term effect. Sooner or later, you still have to see a doctor.
When is surgery necessary?
Surgical treatment of stenosis should be considered separately. Surgical intervention is indicated if conservative therapy has not brought the desired result, or if the disease is in an advanced stage. The main goal of the procedure is to free the nerve roots from compression. Currently, several surgical options have been developed that can eliminate spinal stenosis of the lumbar spine. The operation can be performed both open-type and endoscopically. Among all the practices practiced, the most effective are the following:
- Decompression laminectomy. The operation involves cutting sections that compress the nerve root. Resection can affect the arch of the vertebra, the yellow ligament, the spinous process. In 68% of cases, the intervention gives a positive result.
- Stabilizing operations. They are usually recommended in addition to decompression laminectomy to enhance support function of the spine.
The result of any surgery is very difficult to predict. On the other hand, often the only way to cure stenosis of the spinal canal of the lumbar is surgery. Feedback on the methods used in most cases is positive. Negative opinions of patients are usually associated with a difficult recovery period. About it in more detail below.
Rehabilitation after surgery
After surgery, all the strength of the patient should be aimed at restoring health. A rehabilitologist can help him in this. An important component of the recovery period is the ability to control pain. For these purposes, a specialist can offer several ways: thermal procedures, the use of ice, ultrasound, electrical stimulation. To improve physical performance, the patient is also prescribed a course of exercise therapy. Exercises are selected individually, taking into account the patient's condition. As soon as the patient learns to independently control the pain syndrome, the recovery period can be considered completed.
Possible complications
Reducing the diameter of the spinal canal is dangerous for its effect on the spinal cord. In this case, the clinical picture of the disease changes dramatically, neurological symptoms occur. Their manifestations depend on the severity of the pathological process (paresis of the limbs, violation of the sensitivity of the pelvic organs).
Conclusion
Now you know why spinal stenosis should not be ignored. The types, symptoms and treatment of the disease are also described in this article. This pathology is characterized by a complex course, so you can not do without the help of a qualified specialist. The treatment of already formed stenosis is a long and difficult process. To prevent its occurrence, it is enough to regularly undergo a medical examination and adhere to an active lifestyle. Be healthy!