Absolute spinal stenosis: what is it, treatment

Absolute spinal stenosis is a pathological process in which there is a critical narrowing of the space of the spinal cord. The spinal canal resulting in absolute contraction in a certain area may be reduced to ten or less millimeters. This condition in most cases ends with the fact that the nervous tissue of the spinal cord begin to experience compression. Threat manifest neurological symptoms – disorders of the internal organs, pain, serious violations of sensitivity and mobility.

Another point is the poor circulation of the spinal cord. Due to the shortage of oxygen and nutrients it begins to starve and die almost instantly the nerve cells. Happens ischemic stroke of the spinal cord. As a result, the patient may remain for a lifetime confined to a wheelchair. And if the stenosis is localized in the chest area and above, the probability of cardiac arrest or breathing difficulties.

To treat absolute stenosis conservative methods don't work. If such a diagnosis was made, urgent surgical intervention is necessary.

Specialist usually carries out the removal of part of the vertebra or intervertebral disc exerting pressure on the nervous tissue. This surgery also often causes complications, but if it is not carried out, the probability of the worst outcome.

Absolute stenosis

The spinal canal protects one of the most important organs of the human body – the spinal cord. Thanks to his normal function of internal organs, nerve impulses are transmitted to muscles, upper and lower limbs. The spinal cord is protected not only gross bony vertebral bodies, there are several other shells, including dural pouch, arachnoid sheath. In addition, it is protected by cerebrospinal fluid, or CSF.

As you can see, evolution has directed much effort to such a huge bundle of nerve tissue like the spinal cord, was well protected and did not experience any external influences. But due to the negative factors of different types may occur such a dangerous condition as stenosis, or narrowing, of the spinal canal.

Stenosis usually develops due to osteoarthritis, degenerative disc disease or herniation, bone spurs on the vertebrae. Another risk factor – the traumatic impact. Because the greatest risk are people with degenerative changes of the spine, it is not surprising that the age factor plays a big role. Also, the stenosis can occur as a consequence of tumors inside the spinal canal – the cyst or tumor.

• See also: secondary stenosis

Patients of retirement age are more liable to become victims of such diseases as stenosis. A pathological condition of this type can be divided into two types – relative and absolute stenosis. Narrowing is considered absolute if the spinal canal when it is reduced to 10 or less millimeters. If the space is more broad, but narrowed compared to the norm is a relative stenosis. The relative form of narrowing is often asymptomatic and is found incidentally during diagnosis of other diseases. Quite another matter – an absolute contraction.

Symptoms

The clinical picture of absolute stenosis varies depending on what part of the spine the narrowing is localized, for any reason, formed and how they are progressing. In most cases the patient faces the compression of the spinal cord, ischemic stroke and its tissues as a consequence of the disability. Sometimes, however, a strong compression of the spinal cord does not occur even at absolute stenosis, and the forecast is more reassuring.

Narrowing of the cervical

If there has been an absolute narrowing of the spinal canal in the neck, weaken sharply, until the paralysis of the upper limb. If sensitivity persists, in principle, there is at least partial paralysis. He was accompanied by paraesthesia – numbness, the feeling of "running ants" in the arms and shoulder girdle.

In addition, in cases of severe spinal cord compression may develop the following symptoms:

• Shortness of breath, until his failing;
• Paralyzes all of the body belowneck;
• Disappears below the sensitivity of the cervical.

This localization of the stenosis is most dangerous for the patient. In many cases the worst possible outcome.

Stenosis of thoracic region

Symptoms of absolute stenosis at the level of the thoracic spine was to a lesser extent. Let the spinal canal here and the most narrow, it is more protected. Because of the frame edges, it is almost real, and therefore less likely to result in movements to expose the spinal cord compression. In addition, stenosis of rarely develops in this region because of degenerative changes occur here infrequently.

Symptoms of stenosis of thoracic region includes:

• Pain, radiating to the heart and abdominal area;
• The paresthesia of the chest, abdomen, arms;
• Full or partial loss of mobility and sensitivity below the affected area;
• Dysfunction of the genital organs, rectum and bladder.

Stenosis in the lumbar region

In most cases, the spinal cord is under pressure here. Because the lower back can withstand heavy loads and more than any other spine moves.

The clinical picture includes:

• Paroxysmal or persistent pain, gives in the gluteal and femoral region;
• A lumbago back;
• Complicated or impossible to walk, limp;
• Weakness and numbness of the lower extremities;
• Partial or complete paralysis below the affected area;
• Disorders of the sexual organs, rectum and bladder.

Complications

The more narrow the spinal canal becomes, the worse the condition of blood vessels and nerves that pass in it. Compressed vessels and nerves impairs nutrition of tissues, and innervation. Begins the inflammatory process. Due to lack of supply of nutrients, there is a risk of ischemic stroke of the spinal cord that often leads to lifelong disability. In this case, the nerve cells can start to die EN masse, and the person loses the ability to move normally and feel limbs.

• Recommended reading: lateral spinal stenosis

The spinal cord is the body which is stronger than all other senses lack of oxygen and blood. It is necessary to block their access, just a moment, and tissues almost immediately begin to die. The result is paralysis of the lower limbs, or if the stenosis is localized in the thoracic region and above, is fatal due to the inability to breathe.

Surgery

It makes no sense to talk about conservative treatment of absolute stenosis. Once it is diagnosed, doctors prescribe surgery. No time to procrastinate, because it can lead to death of nerve cells, and as a result, the patient for life will be in a wheelchair.

Depending on the clinical picture and possibilities of clinics can offer different methods of surgical intervention with absolute stenosis:

• Laminectomy. The removal of the exposed element of the vertebral arch. The spinal canal immediately released. This operation is appropriate in traumatic stress. This effect has been used for about a hundred years, is familiar to surgeons and is rarely a cause for further complications;
• A discectomy. The removal of the intervertebral disc is subjected in whole or in part. If the cause of stenosis in the hernia, remove the can and just left for its limits cartilage nucleus pulposus.

In both cases, after removal of the source of compression in the structure of the spine is inserted into the implant. It is necessary to lock the spine into a physiological position to give the patient to move normally, and the main thing – to prevent the new compression. Currently doctors are used to this end is usually either titanium alloys or plastic.

Before the surgery reception at the attending physician, shall the necessary tests. Of course, if there is still time. Ideally before surgery you need to conduct a re-diagnosis, and to investigate the state of the cardiovascular system. Unfortunately, sometimes these precautions have to be neglected to save the patient's normal life and mobility. Or even life in General.

In some cases it can cause a recurrence of the narrowing of the spinal canal. This can happen because the body will sarastic the injured tissue scarring, or forms excess bone growths.Then again may appoint surgery. The specialist will take into account that this is not the first operation, and will take all measures to new complications followed.