Stenosis of the lumbar spine: causes and treatment
The spine in the human body performs several functions. It is an important link in the musculoskeletal system, it protects the spinal cord and participates in the movements of the trunk. Any changes in its structure affect the quality of life of a person. Among the diseases caused by deformation of the supporting system, special attention is deserved by stenosis of the lumbar spinal canal. In general, the development of this disease is associated with the natural aging of the body. But there may be other reasons. What kind? We'll talk about this in this article. You will also find out which symptoms are accompanied by pathology and why one should not neglect her treatment.
Definition of the disease
The spinal canal plays an important role in the human body - it protects the spinal cord. Together with the head he makes 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 operation of the spinal cord. Any violations in this system result in irreversible consequences.
Stenosis of the lumbar spine is a pathological process that is characterized by a narrowing of its diameter. Reducing the lumen leads to squeezing the roots of the spinal cord. The first mention of this disease is associated with Antoine Portap. In 1803, the doctor described the disease in detail, determined its causes. In the column: "Symptoms" he noted paralysis of the legs and muscle atrophy.
Stenosis is a fairly common pathology, which mainly occurs in older 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.
Reasons for stenosis
To know the main causes of the disease, you need to understand the anatomy of the support system, or rather, its lumbar part.
The spinal canal is formed by bodies and arches. They are connected together by ligaments. Inside the canal passes the spinal cord. The entire space of the cavity is filled with fluid and fatty tissue. This peculiar layer allows us to fill in the small channel narrowings that are possible in the ordinary course of human activity. If the diameter of the lumen is reduced even more, there is compression of the nerve processes or the brain itself. As a result of this pathological process, various symptoms of a neurological nature appear.
In the role of the cause of an ailment, tumors, disc protrusions, intervertebral hernias, traumas, joint arthrosis can act. This form of the disease is called "secondary stenosis of the spinal canal of the lumbar region," because the narrowing of the lumen is a consequence of other pathologies. The development of the primary( idiopathic) variant of the disease is caused by congenital malformations. His symptoms appear at a young age. Congenital anomalies arise from improper intrauterine development.
One of the dangerous consequences of the disease is the disruption of the transport of nutrients to the spinal cord. As a result, the pressure in the spinal canal increases, which leads to the squeezing of the vessels. As a consequence, they can no longer transmit the required volume of blood at a high rate. Against the backdrop of all changes in the body, a person begins to experience pain in the back and limbs.
How to recognize the disease?
Stenosis of the lumbar spine is a fairly common pathology. The human body is prone to natural aging processes, which are usually manifested by degenerative changes. Stenosis begins with discomfort in the lumbar region. The periods of exacerbation are replaced by relative calm. 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, this requires time. It is almost impossible to detect 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.
When stenosed, spine cord roots undergo permanent traumatic pressure. They are always in a state of swelling. Pain in the lower back is usually accompanied by a burning sensation, because blood supply to the nervous tissue is still disturbed. She is constantly in short supply of oxygen.
Sometimes, against the background of a load or an awkward movement, the nerve is severely squeezed, as a result, it stops working. This can be seen from the change in the gait of the patient and the weakening of the motor function. It becomes difficult for a person to stand or sit. Only at this stage he turns to the doctor and hears the diagnosis of "stenosis of the spinal canal of the lumbar region".Symptoms can progress and lead to irreversible consequences if the treatment is not started on time.
Classification of stenosis
As a result of degenerative disorders at the level of bone tissue, the diameter of the spinal canal is narrowing. Taking into account such changes, the following forms of the disease are distinguished:
- Absolute stenosis suggests a decrease in the lumen of the canal up to 5-10 mm. Pathology is characterized by a vivid clinical picture. Treatment requires surgery, but conservative methods may be used.
- Relative stenosis of the lumbar spinal canal implies a narrowing of the lumen to 10-12 mm. This form of the disease is detected by chance, it is easy to treat.
- With lateral stenosis , narrowing of the spinal canal up to 3 mm is observed. This is the last stage of the disease, implying mandatory surgical intervention.
Medical examination for stenosis
Adequate and timely therapy is the key to a quick recovery. The earlier a doctor prescribes treatment, the more likely it is that he will conquer the disease. For consultation on this issue, you need to 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, neurological examination( changes in reflexes, sensitivity of the limbs), and results of additional examination. Since pain in the lumbar region can be due to a variety of reasons, without carrying out radiography and spondylography can not do. Sometimes an additional MRI is required. Based on the results of the examination, a specialist can determine the presence of the disease, its cause, and also to select an adequate therapy.
Principles of treatment
As with any other chronic disease, the doctor first of all appoints conservative therapy. The course usually takes no more than 30 days. Timely access to a doctor can cure stenosis of the lumbar spinal canal for 1-2 months and do not resort to surgical intervention. Launched cases require maintenance therapy throughout life. The standard course of treatment includes taking medications and physiotherapy. Its main goal is to eradicate the cause of the disease, and also to reduce symptoms.
Treatment with tablets and ointments
Drug therapy is indicated to patients without severe neurological disorders, when the only complaints are pain in the area of the sacrum and legs. Treatment of stenosis of the spinal canal in the lumbar part is the admission of the following drugs:
- Non-steroidal anti-inflammatory drugs( Ibuprofen, Diclofenac, Xsefokam).They reduce pain syndrome, swelling in the nerve root, eliminate inflammation.
- Muscle relaxants( "Midokalm", "Tizanidine").Such medications are designed to relieve muscle tension.
- Group B vitamins( "Milgamma", "Neurovitan").
- Vascular tools( Pentoxifylline, Kurantil).Their main effect is aimed at improving blood flow.
- Antipyretic drugs( Diakarb).
For severe pain discomfort, epidural or sacral blockades, as well as local anesthetics, have an excellent effect. Often such drugs are taken in the complex.
If the general condition of the patient does not worsen, he is referred to a doctor-rehabilitologist for advice. This specialist is engaged in the development of curative physical education programs. Exercises for stenosis of the lumbar spinal canal are selected individually, taking into account the patient's condition and the severity of the disease. The main task of exercise therapy is to teach you how to control the manifestation of a disease, to increase the strength and flexibility of the support apparatus. Below are several options for exercises recommended for stenosis.
- Lying on your back, bend your legs and spread your shoulders wide. You need to take a deep breath, count to five, and then exhale heavily to lift the chest. Such a complex should be repeated 8-10 times.
- It is recommended to begin the exercise with respiratory gymnastics. Lying on your back, you need to raise and press your knees to your chest, stay in this position for a few minutes. After that, the legs can be released smoothly. Repeat at least 10 times.
- Lying on the back, hands spread in different directions. The legs must be bent at the knees, and then smoothly turn left and right. In this case, the back must remain stationary.
Such simple exercises make it possible to alleviate the condition of patients diagnosed with "stenosis of the lumbar spine".Therapeutic exercises also help improve blood circulation in the affected parts of the body. At the initial stage, the exercise complex should be performed under the supervision of a doctor-instructor. After mastering the correct technique, lessons can be continued at home.
Traditional medicine help
In the arsenal of folk healers there are many tools for the treatment of stenosis. Among them, compresses made of honey are very popular. It is necessary to lubricate the waist 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, you need to moisten the cotton cloth, and then attach it to the affected area and wrap it up warm with a scarf for the night.
It is important to understand that with the help of folk healers it is impossible to cure stenosis of the lumbar spinal canal. The operation or medication will help to cope with this ailment. Any prescription of the healers gives a short-term effect. Sooner or later you will still have to see a doctor.
When is surgery necessary?
Treatment of stenosis by a surgical procedure should be considered separately. Surgical intervention is indicated if conservative therapy does not bring the desired result, or the disease is in a neglected stage. The main purpose of the procedure is to release the nerve roots from compression. Currently, several options for surgical intervention have been developed, which allow to eliminate stenosis of the lumbar spinal canal. The operation can be performed both in an open type and endoscopically. Among all practiced methods the most effective are the following:
- Decompression laminectomy. The operation involves cutting down the areas that compress the nerve root. Resection can affect the arc of the vertebra, yellow ligament, spinous process. In 68% of cases, the intervention gives a positive result.
- Stabilizing operations. Usually they are recommended in addition to decompression laminectomy for strengthening the supporting function of the spine.
The result of any surgical intervention is very difficult to predict. On the other hand, often the only option to cure stenosis of the lumbar spinal canal is surgery. Reviews about the methods used in most cases are positive. Negative opinions of patients, as a rule, are associated with a difficult recovery period. It is described in more detail below.
Rehabilitation after operation
After surgical intervention, all the forces of the patient should be aimed at restoring health. In this he can help a doctor-rehabilitologist. An important component of the recovery period is the ability to control pain syndrome. For these purposes, the specialist can offer several methods: thermal procedures, the use of ice, ultrasound, electrostimulation. To improve physical performance, the patient is also assigned a course of exercise therapy. Exercises are selected individually, taking into account the condition of the patient. As soon as the patient learns to control the pain syndrome alone, the recovery period can be considered complete.
Possible complications of
The reduction in the diameter of the spinal canal is dangerous due to its effect on the spinal cord. At the same time, the clinical picture of the disease changes dramatically, neurological symptoms appear. Their manifestations depend on the severity of the pathological process( paresis of the limbs, a violation of the sensitivity of the pelvic organs).
Now you know why you should not ignore the stenosis of the spinal canal. Types, symptoms and treatment of the disease are also described in this article. This pathology is characterized by a complex course, therefore, without the help of a qualified specialist, it is indispensable. Treatment of the already formed stenosis is a long and difficult process. To prevent its occurrence, it is enough to undergo regular medical examinations and adhere to an active lifestyle. Be healthy!