Stenosis of the spinal canal represents a chronic process of penetration into the spaces that occupy the spinal cord and the nerve roots of the cartilaginous,
soft-tissue and bone structures. Stenosis does not include narrowing of the canal,
caused by disc hernias.
Stenosis of the spinal canal is characterized by common manifestations and is diagnosed by magnetic resonance imaging and computed tomography, as well as spondylography (radiography of the spinal canal).
Stenosis of the spinal canal is distinguishedidiopathic, that is, congenital, acquired and combined. The disease leads to compression of roots and spinal cord with manifestations of neurologic symptoms. The most common stenosis is the lumbar region. Its causes may be traumatic
lesions, tumors, thickening of the yellow ligament, growth of osteophytes, protrusion
disks, arthrosis of the facet joints, stenosis of the vertebral arteries.
Congenital stenosis is caused by individualfeatures of the spine, acquired in its basis has a variety of reasons, such as Bechterew's disease, the formation of post-operative scars and adhesions, Forestier's disease and others. Pathophysiological mechanisms are ischemia, stenosis
vertebral arteries, aseptic inflammation and increased epidural
Pressure that results from chronic compression
neurovascular systems of the spinal canal. As a result,
irregularity of blood flow to nerve structures of the spinal canal. Decrease
the level of incoming blood leads to ischemia of nerve roots and horse tail.
With the strengthening of biochemical processes, the need for oxygen increases,
so the pain occurs, as a rule, when walking. Increased
epidural pressure is the cause of the inflammatory process.
Often, acquired stenosis occurs onthe last stage of osteochondrosis, when there are compensatory processes aimed at stabilizing the vertebral-motor segment. There is arthrosis of the intervertebral joints and the growth of bone tissue in the form of osteophytes. Symptoms of the disease are painful sensations arising from irritation of the nerve roots. With the development of the disease, delivery to the spinal cord of nutrients and oxygen is reduced. As a result, during physical activity there is weakness and pain in the limbs and spine. Manifestations of stenosis are a violation of the sensitivity of the legs, hypertrophy of the muscles, syndrome of intermittent claudication, lumbulgia. To identify the causes of the disease, computed tomography is combined with a myelogram, based on the analysis of the results of which a diagnosis is made - stenosis of the spinal canal. Treatment can be prompt and conservative.
Therapy includes the use of anti-inflammatory,vascular and antialgic drugs. Drug treatment is combined with massage, physiotherapy, epidural introduction of steroids (diprospan, kenalog). In many cases, glucocorticoid hormones are used in combination with anesthetics. Surgical methods of treatment include the installation of stabilization and interstitial fixation systems, decompressive laminectomy. Laminectomy
consists in the resection of structures leading to compression of the nerve roots and
horse tail. Significantly improve the results of laminectomy system
stabilization. The application of interstitial dynamic fixation reduces the load on the posterior support columns and expands the area of the spinal canal. As a consequence, the lumbalgic syndrome is reduced.
Stenosis of the spinal canal is a rather serious pathology of the spine, with which one should not joke. When the first signs appear, you should contact a specialist.
