Stenosis of the lumbar and cervical spinal canal

Stenosis of the cervical spinal canal

Stenosis of the spinal canal of the cervical spine (stenosis of the spinal canal) is a chronic pathological process in the cervical spine, which consists in reduction of the lumen of the spinal canal by various structures (tumor, disc herniation, osteophytes, fracture, etc.) due to the patient's having a vertebral disease post.

This condition is more often diagnosed at the age of 55-60 years, equally, both in women and men.

Without timely and comprehensive treatment, the patient acquires disability and loses ability to work.

Classification

For causative factors, the stenosis of the cervical spinal canal is divided into 3 groups:

• Congenital stenosis - develops in the presence of congenital diseases of the spine;
• Acquired (degenerative) stenosis - develops in the case of acquired, as a rule, destructive degenerative diseases of the spine;
• Mixed (combined) stenosis is a combination of several causative factors in the development of the disease.

According to anatomical signs, there are two types of cervical stenosis:

1. Central stenosis - a decrease in the channel in the volume (shortening the distance from the back to the front, or the lateral surface, on the arch of the cervical vertebra);
2. Lateral stenosis (lateral) - a decrease in the volume of the radicular canal (the exit points of the roots of the spinal cord).

Causes

There are several causal and predisposing factors that increase the risk of spinal canal stenosis in the cervical spine:

The mechanism of the development of the symptoms of stenosis of the spinal canal is quite simple and understandable.

The decrease in the volume of the cavity in which the spinal cord passes, as well as the vessels and nerves of the spine, leads to the development of clinical manifestations characteristic of the cervical spine.

The first complaints arise in a certain position of the neck (slopes, turns, etc.). In the process of aggravation of the condition, the compression of the vertebral structures increases, the innervation is more difficult, the blood flow through the vessels is disturbed.

In the case of severe stenosis, there is an increase in CSF pressure (cerebrospinal fluid), which causes a definite clinical picture and can lead as complications to a number of inflammatory stagnant processes.

Symptoms of stenosis of the cervical spinal canal

Symptoms of narrowing of the spinal canal in the cervical region:

• Pain in the neck - can be either unilateral or bilateral, initially occur with a certain position of the neck, with the progression of the process becomes practically constant, can be irradiated (rendered) to the scapula, occiput, shoulders, hands and others;
• Headaches of varying severity, more often localized in the occiput and temporal regions;
• Disturbance of sensitivity (paresthesia, a feeling of "crawling crawling") of the skin of the neck, hands, head;
• Weakness and discomfort in the hands;
• Dizziness, worse with sharp turns and inclinations of the head, down to fainting;
• The increased tone of the muscular framework of the neck, upper limbs;
• Violation of the pelvic organs (urination disorders, incontinence of urine and feces, alternating constipation and diarrhea, impotence, violation of sexual desire);
• Paresis or paralysis of the legs, hands or complete immobility of the patient;
• "Wadded feet
• Violation of the function of respiration (frequent, superficial, difficult).

Diagnostics

To diagnose the arisen stenosis of the cervical spine, the patient is first of all questioned, complaints at the time of going to the doctor, the course of the disease, as well as predisposing factors, previous diseases and others.

The doctor pays attention to the forced position of the body, in which the patient feels better, palpating to identify pain points on the affected spine.

After this, mandatory additional instrumental methods of examination are appointed:

1. Radiography of the spine (in two projections - anteroposterior and lateral). The main and most popular method of diagnosis. It allows to determine bone growths, violation of vertebral integrity, their adhesion, indirect signs of changes in joints, tumors and other neoplasms, their location, structure and size.
2. CT of the spine (computed tomography). With the help of layered computer images, this method allows you to accurately determine the causal factor of stenosis, including microscopic changes.
3. MRI of the spine (magnetic resonance imaging). The most accurate method of diagnosing the spinal column, however, it is quite expensive and has a number of contraindications, therefore, not all patients with suspected stenosis of the spinal cord channel. Allows you to view snapshots of the finest sections of the spinal tissues, on which it is possible to detect changes not only in bones, but also in cartilage, joints, vessels and nerves.
4. Myelogram. Allows you to determine the pathology and structure of the spinal cord, as well as the state of cerebrospinal fluid and passability through the channel with the help of a contrast medium and an X-ray.

Treatment of stenosis of the cervical spinal canal

Stenosis of the spinal canal requires an integrated approach to treatment. This includes conservative (medicines and physiotherapy) and operational methods.

Conservative treatment of cervical stenosis

This appointment of medicines and the course of procedures of physiotherapy (the duration of treatment is selected individually, according to the individual characteristics of the patient):

Surgical treatment of stenosis

The operation on the spine is performed in the case when conservative treatment does not have the proper effect, or developmental complications grossly violate the life and work capacity of the patient. Methods of surgically helping a patient with spinal stenosis have been developed quite a lot, but often perform one of three operations, the effectiveness of which is maximum:

• Laminectomy is decompressive. The structure is removed, which resulted in the narrowing of the channel. These can be osteophytes, spinous processes of the vertebrae, arches, intervertebral discs, hernial protrusions, yellow ligament, tumor, etc.
• Stabilizing systems. A special case of laminectomy, in which additional fixing elements are attached to the spine.
• Intermittent fixation of the vertebrae. After the removal of the fragment, narrowing the passage of the spinal cord and nerve roots, it may be necessary to install the implant.

Complications

Complications of stenosis of the cervical spine can occur quite often:

1. Paresis and paralysis (both reversible and non-reversible);
2. Violation of the function of pelvic organs (incontinence of feces and urine, violation of sexual functions, etc.);
3. Complete immobility of the body;
4. Stroke;
5. Death.

Prevention

Preventive procedures that prevent the development of cervical stenosis:

• Fighting hypodynamia (warm-up for the neck and during the day);
• Exercise therapy;
• Compliance with proper posture, especially during work at the table and computer;
• Compliance with the principles of proper nutrition;
• Timely request for medical help.

A source: http://spinomed.ru/bolezni/stenoz-pozvonochnogo-kanala/sheyniy

Treatment of spinal stenosis

Stenosis of the spinal canal is the narrowing of the lumen of the spinal canal. Depending on the stage of the disease, the lumen size is reduced from 15 mm (in the norm) to 12-4 mm.

The disease can occur along the entire length of the spinal column, but often there is stenosis of the cervical spine and lumbar spine. A common cause of the disease is degenerative changes in the cartilaginous tissue.

This makes it difficult to circulate the intervertebral fluid and pinch the roots of the spinal nerves and blood vessels.

Treatment of this condition can be carried out with the help of folk remedies that improve blood circulation and reduce pain.

It is recommended to combine the means for internal use with external rubbers and ointments.

In addition, it is necessary to regularly do medical gymnastics and give up heavy physical labor.

What is spinal stenosis?

Stenosis in medical practice means constriction. Stenosis of the spinal canal is a decrease in the lumen of the spinal canal of the spine. This narrowing occurs gradually and is caused by various causes.

Most often, the patient develops a degenerative stenosis of the vertebral canal, which develops due to degenerative changes in the cartilaginous tissue of the intervertebral discs.

The stenosis of the vertebral canal of the cervical and lumbar spine often develops.

Symptoms of stenosis are manifested in the patient due to the squeezing of the roots of the nerves leaving the spine and the blood vessels that nourish these nerves.

Also, there is a violation of the cerebrospinal fluid.

Causes of the disease

Allocate an innate and acquired form of the disease.

Congenital stenosis of the spinal canal is due to congenital features of the anatomical structure of the spine.

Acquired stenosis occurs in humans against a background of various adverse factors and pathological processes in the body or age-related changes.

the cause of stenosis of the spine is degenerative changes in the cartilaginous tissue of the intervertebral discs. With age, dehydration of the cartilage occurs (a decrease in the water content in it).

Because of this, the tissue loses its damping properties, which leads to cartilage damage, the appearance of cracks, tears. At the beginning of this process, the outer part of the intervertebral disc (fibrous ring) suffers.

Often these lesions do not show any symptoms, and diagnostics and treatment are not carried out. In the places of rupture of the disc, connective scar tissue is formed, with the help of which the healing of lesions occurs.

However, this tissue is not capable of fully replacing cartilaginous tissue, so the strength of the intervertebral disc is lost, it is more susceptible to further trauma.

The inner part of the intervertebral disc is called "pulpous nucleus".

In this part, there is also a process of dehydration, which leads to a decrease in the height of the disc and loss of damping properties. This leads to an increase in the load on the joints connecting the posterior parts of the vertebrae to the facet joints. The pressure inside the joint increases, this leads to their degenerative change.

This leads to a reduction in pain and stabilization of the disc. However, sometimes such osteophytes can lead to narrowing of the spinal canal and squeezing the roots of the spinal nerves and the spinal cord itself.

Thus, stenosis of the spinal column occurs.

To less common causes of the disease include the following factors:

• intervertebral hernia;
• benign or malignant tumor of the spinal cord;
• swelling of the spinal cord.

Classification of stenosis

Normally, the vertebral canal is oval in shape. Its sagittal (anteroposterior) size is 15-25 mm, transverse - 26-30 mm.

With stenosis of the spinal canal, its sagittal size decreases.

Depending on the stage of the disease, the relative, absolute and lateral stenosis are identified.

1. Relative stenosis. The channel size is reduced to 10-12 mm. Complaints in this case in most cases are absent, and to identify such a disease can be accidental. However, if there is no treatment, the patient's condition worsens, and the symptoms grow.
2. Absolute stenosis. With this form of the disease, the size of the spinal canal decreases to 4-10 mm. In this case, the patient exhibits characteristic neurological symptoms of the disease.
3. Lateral stenosis. The size of the spinal canal decreases to 3 mm. The patient suffers from severe pain and characteristic neurologic symptoms.

Depending on the location of stenosis:

• lumbar spine - develops most often;
• cervical spine is the second most common;
• thoracic department - occurs relatively rarely.

Symptoms of Stenosis

Stenosis of the lumbar region is manifested by pain in the lower back. Painful sensations increase during exercise and walking.

Pain disappears when the patient sits or lies. Often the pain manifests in the legs while walking. Painful sensations increase during the movement and do not pass even after stopping.

You can ease the pain by leaning forward.

Sometimes with stenosis of the lumbar spine pain can occur in the hips or gluteal muscles. In this case it is important to conduct differential diagnosis with diseases or degenerative changes of the hip joint.

In more severe cases, note numbness in the legs, muscle weakness, tingling sensation. In this case, the inclination of the trunk forward also alleviates the symptoms.

Stenosis of the cervical spine is manifested by pain in the neck with irradiation in the hands. Also, the patient may have weakness in the muscles of the hands, paresis, tingling.

Diagnosis of stenosis

Stenosis of the spinal canal is diagnosed on the basis of patient complaints and research results:

• magnetic resonance imaging;
• computed tomography;
• X-ray examination of the lumbar or cervical spine.

Treatment of stenosis

Traditional treatment involves an operation to eliminate spinal defects. Traditional medicine has in its arsenal of drugs that can reduce pain without surgery.

Also, traditional medicine can be used during rehabilitation after the operation.

Treatment of stenosis also includes therapeutic exercise and massage, which improve the blood circulation and nutrition of the damaged spine, strengthen the back muscles and relieve pain.

Physiotherapy

Therapeutic exercise is an important stage in the treatment of relative stenosis of the spinal column.

Exercises will help the patient feel better, improve posture, strengthen the back muscles, maintain the flexibility of the spine and reduce pain.

Therapeutic exercise is also useful for the cardiovascular system and serves as a preventive maintenance of vascular diseases.

Exercises for stenosis of the lumbar spine

1. Exercise number 1. The patient should lie on his back. Legs are shoulder width apart and are bent at the knees, feet on the floor. With an exhalation the patient should raise his chest above the floor, count to five and slowly lower it. Repeat the exercise ten times.
2. Exercise number 2. The patient should lie on his back, hands are divorced in the sides. With an exhalation it is necessary to press the knees bent at the knees to the chest, count to ten and slowly lower it. Exercise is repeated ten times.
3. Exercise number 3. The patient should lie on his back, hands are divorced in the sides. It is necessary to turn slightly bent at the knees of the legs alternately in the right and left side. At this time, the head should turn in the opposite direction. The duration of the exercise is 5 minutes.

The complex of exercises should be done 3-4 times a week. Such ancillary treatment lasts 3 months, as a result of which it is possible to achieve improvement in the patient's condition.

Treatment with folk remedies

Folk remedies serve to alleviate the symptoms of the disease, improve blood circulation and nutrition of the damaged intervertebral disc.

Popular treatment of folk methods of back pain is the application of compress. Healing compresses are left for 15-20 minutes, after which the back is washed with warm water.

• Honey and mustard plasters, The back of the patient is smeared with honey in the stenosis area, the top is covered with a gauze or tissue napkin and put mustard plasters and cover with cellophane.
• Honey can also be used for massage. It must be gently rubbed into the back of the patient. The procedure is recommended to be carried out daily.
• Horseradish, radish and sour cream. An equal amount of horseradish and radish rubbed on a fine grater and mixed with sour cream to get a uniform thick mass.
• Frankincense and apple cider vinegar. In 50 ml of apple cider vinegar, 50 g of incense is dissolved. The drug is applied to the wool tissue and applied to the back in the stenosis area.
• Garlic and lemon. Mix in equal volume lemon juice and chopped garlic. Soak gauze or cotton cloth in this mixture and put on a sore spot. The drug is used for cold compress.
• Herbal decoction for compress. Mix in equal volume the color of chamomile, the herb of St. John's wort and thyme. For 500 ml of boiling water take 5 tbsp. l. collection, insist in a thermos for half an hour, after which it is filtered. In warm infusion, moisten the cotton cloth, apply on the affected area of ​​the back and wrap with cellophane. This compress can be left overnight.
• Vodka. It is useful to rub your back for the night with vodka.

A source: http://nmed.org/lechenie-stenoza-pozvonochnogo-kanala.html

Stenosis of the spinal canal

The spinal canal performs a very important function in the human body. Inside it is the spinal cord, for the delicate tissue of which the canal of the vertebrae is an excellent defense.

The spinal cord, together with the head, forms the central nervous system, which regulates all functions in the body.

Therefore, maintaining the integrity and normal anatomical structure of the spinal canal is the key to the normal function of the spinal cord.

Stenosis of the spinal canal is a chronic and, as a rule, progressive pathological process, which is characterized by a narrowing of the central canal of the spine.

Also here is the narrowing of the intervertebral foramen, from which the nerve roots of the spinal cord exit.

Reduced space can be due to bone, cartilaginous growths in osteoarthritis, spondylarthrosis, spondylosis (degenerative stenosis of the spinal canal) or various soft tissue structures (tumors).

If you look at the statistics, this diagnosis is established in 21% of people over 60, with only 30% of they have complaints and clinical symptoms of the disease, that is, not always stenosis of the spine is manifested in patient.

The frequent detection of this pathology in recent years has been facilitated by the introduction of MRI and CT in clinical practice.

In most cases, the narrowing of the spinal canal is diagnosed accidentally when examined for another reason. Most often, constriction is observed in the lumbar region.

Inside the canal of the spine is the spinal cord, which is compressed by stenosis

Causes

Depending on the causes of development, the stenosis of the spinal canal can be congenital (primary) or acquired (secondary).

Causes of congenital narrowing of the central canal of the spine:

• abnormalities of vertebral development, for example, shortening of their arches;
• anomalies in the development of the cartilaginous tissue of the spinal column (achondroplasia).

The causes of acquired narrowing of the canal:

• degenerative diseases of the spine (osteochondrosis, spondylosis, spondylarthrosis, spondylolisthesis), this narrowing is also called discogenic, which shows a link with the pathology of the intervertebral discs;
• trauma and post-traumatic deformities of the spine;
• ossification of the intervertebral hernia;
• pathological changes in the yellow ligament of the spine (hypertrophic proliferation, ossification);
• ankylosing spondylitis;
• spondylolisthesis;
• diseases that are accompanied by a metabolic disorder and the accumulation of various metabolic products in the tissues of the spine;
• Paget's disease;
• traumatic hematomas;
• tumor lesions (primary and metastatic);
• iatrogenic effect (complication of surgical intervention on vertebrae);
• infectious diseases.

Stenosis of the canal of the spine in the lumbosacral spine

Depending on the cause, the symptomatology of the disease will differ, as well as its treatment. Therefore, it is necessary to find out why the canal of the spine narrowed in a particular patient.

Classification

The diagnosis of stenosis can be made if, during the examination, it is established that the distance from the posterior surface of the vertebral body to the base of the spinous process is less than 12 mm.

In this case, 10-12 mm is a relative stenosis, and less than 10 mm is an absolute stenosis. These measurements are relevant for the central type of constriction, when the lumen of the central canal of the spine suffers.

There is also a lateral type of stenosis, when the intervertebral opening narrows, through which the nerve roots of the spinal cord exit. In this case, stenosis is established when the hole is reduced to 4 mm or less.

You can also find the term sagittal stenosis, which denotes a narrowing of the channel in the same plane.

Symptoms of spinal stenosis

Symptoms of the disease differ depending on the localization of the narrowing (which department of the spine suffers), its degree, cause and rate of increase.

Stenosis of the cervical spine

When the roots of the spinal cord are compressed, patients complain of pain in the neck, in the occipital region of the head, in the muscles of the shoulder girdle. There may be a decrease in the strength of affected muscle groups, sensitive disorders (tingling, numbness in the neck, shoulders).

When compressing the cervical spinal cord, serious and life-threatening symptoms occur:

• impaired breathing or complete stop;
• the development of paralysis of the entire body below the level of defeat;
• complete absence of any kind of sensitivity below defeat.

Chronic neck pain can be a sign of stenosis

Stenosis of thoracic spine

Symptoms of stenosis of the spine in the thoracic region are less pronounced, and this despite the fact that the diameter of the canal here is the smallest. The fact is that the thoracic spine is inactive. In this regard, he least suffers from degenerative and dystrophic changes.

Symptoms of narrowing of the thoracic spine can include:

• pain in the area of ​​damage;
• pain in the heart, internal organs of the abdominal cavity;
• a violation of the sensitivity of the skin of the chest and abdomen;
• when the spinal cord is compressed, there is paralysis and lack of sensitivity below the area of ​​damage, disruption of the pelvic organs.

Stenosis of the lumbar spine

This localization of the narrowing of the vertebral canal occurs most often. Symptoms are caused by compression of the nerve roots of the lumbosacral segment of the spinal cord or the brain tissue itself.

The following symptoms are observed:

• acute or chronic pain syndrome (lumbalgia or lumbago), with pain starting in the waist and descending along the lower surface of the foot to the foot;
• a person can limp;
• there is rapid fatigue when walking;
• decrease in the muscular strength of the lower extremities or their paresis (paralysis);
• muscle atrophy of the legs;
• violation of the sensitivity of the perineum and legs;
• disruption of the anal sphincter and bladder;
• erectile dysfunction in men.

Diagnostic Methods

The arrows indicate the narrowing of the spinal canal on the MRI

Suspected stenosis of the canal of the spinal cord can be, leaving the patient's characteristic complaints, but there are several more pathologies that manifest similar symptoms. Therefore, for an accurate diagnosis, some additional survey methods are needed.

Diagnosis of stenosis of the canal of the spinal cord includes:

1. Radiography of the spine.
2. Computer and magnetic resonance imaging.
3. Myelography is a method of research with the help of a contrast medium, which allows you to evaluate the anatomical state of the spinal cord.

The above methods allow not only to establish the presence of stenosis of the spinal canal, but also its the cause, as well as the results obtained, will be used to compose a set of stenosis treatment the spine.

Complications

Narrowing the canal of the spinal column is dangerous, first of all, by its possible impact on the spinal cord.

This causes various neurological symptoms, the manifestation of which depends on the level of pathology and the degree of compression of the spinal cord.

Damage can be both reversible and final (lower paraparesis, impaired sensitivity and function of pelvic organs).

Principles of treatment

Treatment of spinal stenosis is not an easy task and, as a rule, is not without surgery.

Conservative treatment of spinal stenosis

If the patient has no symptoms of compression of the spinal cord, and additional methods of examination confirm this, you can try conservative therapy.

The methods of conservative therapy include the appointment of medications that eliminate the main symptom of the disease - pain.

These are non-narcotic and narcotic analgesics, non-steroidal anti-inflammatory drugs, diuretics, muscle relaxants. Such medications are prescribed either inward or in the form of external agents.

In severe pain syndrome, blockades with local anesthetics and glucocorticoids are used.

Therapeutic exercises in this case should be carried out with extreme caution. Complex LFK must choose a specialist or an instructor. The first exercises should be performed under the strict supervision of a doctor, and only after you have mastered their correct technique, you can continue to study at home.

As additional methods can be appointed physiotherapy, massage, acupuncture. It must be said that conservative treatment is only symptomatic.

It does not eliminate the underlying cause of stenosis.

Therefore, can not get rid of the disease, but, nevertheless, a full course of therapy leads to significant relief of the condition in 32-45% of patients with stenosis of the spinal canal.

Surgical treatment of stenosis is the only chance for recovery

Surgical treatment of spinal stenosis

The operation is prescribed with ineffectiveness of conservative therapy, with progression of constriction, with compression of the spinal cord or a high risk of such, and also at the request of the patient himself.

There are several types of operations that are performed on the spine to eliminate stenosis (the type of operation depends on the cause and type of stenosis). Most often, decompression laminectomy, installation of spinal stabilizing systems, installation of systems for interstitial fixation.

Surgery on the spine is a very big risk, as there is a possibility of serious postoperative complications. But sometimes only surgical treatment can save a person from disability.

A source: http://MoyaSpina.ru/bolezni/stenoz-pozvonochnogo-kanala

Stenosis of the cervical spinal canal: causes, symptoms, diagnosis and treatment

Diseases of the spinal column have a negative effect on the entire human body.

Stenosis of the cervical spinal canal can provoke not only problems with control over the upper body, but even a stroke or death.

Therefore, treat the presented pathology immediately after you feel its first signs.

What is the disease?

Stenosis of the cervical spinal canal is a decrease in the volume of its lumen, which can be congenital or acquired. There is such a disease quite often. However, it is typical for people who have already crossed the 60-year mark.

At a young age, pathology is extremely rare. If it does, it is often provoked by innate factors. The narrowing of the canal in which the spinal cord is located is a dangerous phenomenon, therefore it is necessary to treat it.

Classification of the disease

Thus, stenosis of the cervical spinal canal can be:

1. Acquired. In this case, its development was influenced by external factors.
2. Congenital. Pathology is genetically laid down or started to develop due to an inadequately correct intrauterine fetal formation.
3. Combined. There are already two groups of factors that influence: external and internal.

By clinical degree, the pathology can be classified as follows:

• Acquired non-degenerative.
• Constitutional (here we mean the anatomical features of the body).
• Degenerative.
• Caused by an anomaly or dysplasia of the spine.

According to the area of ​​the lesion, the stenosis of the cervical spine can be absolute (if the channel has an area of ​​more than 75 mm2) and relative (if this figure falls below 75 mm square).

Causes of pathology development

This disease usually provokes such factors:

• Compression fracture or other types of spinal injuries.
• Congenital irregular structure of vertebrae, provoked by a woman's diseases during pregnancy.
• Inflammatory processes in the spine.
• Bechterew's disease.
• Intervertebral formation: a hernia, a malignant or benign tumor, metastases in the spine.
• Spondyloarthrosis, which promotes deformity of the spinal column.
• Osteochondrosis of cervical department.
• Bony growths and osteophytes.

Symptomatology of pathology

Stenosis of the spinal canal of the cervical spine is a complex and dangerous disease characterized by such signs:

1. Pain in the neck. They can be one-sided or localized on both sides. There is discomfort initially only after a long stay in an uncomfortable position. However, during the progression of the pathology, the pain becomes aching and almost constant.
2. Headache in the temporal and occipital region. It has a different degree of intensity.
3. Loss of sensitivity of the skin, neck, head and even upper limbs.
4. Dizziness, which has the ability to intensify during a sharp turn of the head.
5. Weakness in the hands, a feeling of discomfort.
6. Disturbance of respiratory functions.
7. Increasing muscle tone in the arms and neck, although weakness does not go away anywhere.

Features of pathology diagnostics

Relative or absolute stenosis of the cervical spinal canal can be determined using the following methods:

• Palpation of the affected area by the doctor, external examination of the patient, as well as fixing his complaints. The doctor must collect a complete history in order to exclude a hereditary predisposition or confirm it.
• Radiography. It is done in 2 projections: lateral and anteroposterior. This method of diagnosis is the most important and informative. It allows to determine the presence and size of bone growths, the degree of vertebral integrity, the presence of tumors or hernias, their size, structure and location.
• CT scan. Due to this research the doctor has the opportunity to determine the factor that triggered the onset of the disease. The procedure allows you to see even the most microscopic changes in the spine.
• MRI. This procedure is also considered very informative, but it is not always carried out because of its high cost. In addition, the patient in the case of its implementation receives a strong radiation, so this study has a lot of contraindications.
• Myelogram. To carry out this study, a special contrast agent is introduced into the spine, with which it is possible to examine its structure well. In addition, the state of the cerebrospinal fluid and its quantity are determined.

Conservative treatment of pathology

If you have stenosis of the cervical spinal canal, treatment should be started immediately. It starts with taking medications. Among them you can choose the following:

• Depending on the intensity of pain, the patient is prescribed certain dosages of non-steroidal anti-inflammatory drugs: "Piroxicam "Ibuprofen "Dicloberte".
• To reduce puffiness, eliminate pain syndrome and squeeze vertebral structures, injections of hormonal preparations or glucocorticosteroids can be used: Prednisolone, Diprospan.
• To reduce the volume of cerebrospinal fluid, diuretics are used: magnesia or "Lasix".

Naturally, drug therapy should be prescribed only by a specialist. Do not take any of the above medicines yourself without consulting your doctor. Otherwise, you can hurt yourself even more.

Features of physiotherapeutic treatment

Degenerative stenosis of the cervical spinal canal without proper treatment can lead to disastrous consequences. But at an early stage in the fight against the disease can help physiotherapy. Your doctor will give you one of the following procedures:

1. Electrophoresis with novocaine. This procedure promotes effective analgesia, since the drug is delivered directly to the affected area.
2. Magnetotherapy. It makes it possible to eliminate pain and swelling.
3. Back massage and manual therapy. These procedures help to reduce muscle tone and at the same time strengthen them. Thanks to the massage, you can also reduce pain.
4. Exercise therapy. Therapeutic physical training makes it possible to make the spine more flexible and mobile. At the initial stage of the exercise should not be difficult, and the load - intensive. The fact is that when the channel is narrowed, there may be a violation of blood circulation.
5. Acupuncture. This procedure should be done only by an experienced specialist, so as not to harm the patient even more.
6. Traction of the spine. The procedure of traction can provoke the appearance of intervertebral hernias, therefore it is not always shown.

Physiotherapy treatment gives very good results, if the pathology is still at the first stages of development. Otherwise, surgery may be necessary.

Features of surgical intervention

If you are diagnosed with stenosis of the cervical spinal canal, surgery may be unavoidable.

They resort to it, if conservative therapy has not given good results, or the area of ​​the lumen of the canal is catastrophically small.

You can name several types of operations that are performed with such a disease of the spine:

1. Removal of those growths and formations that could provoke a narrowing of the lumen: tumors, osteophytes, hernias. This operation is called "decompressive laminectomy."
2. Installation of systems that contribute to the strengthening and stabilization of the spinal column.
3. Intermittent fixation of the vertebrae. This operation involves the installation of an implant instead of a remote affected area.

The main principle, according to which surgeons should act, is not to harm.

That is why before the appointment of any intervention of these specialists, the patient must undergo a thorough examination and have absolute testimony.

The health risk should be lower than the probability of a positive result.

What complications can occur?

As you already understood, both primary and secondary stenosis of the cervical spinal canal requires careful treatment. However, if the therapy for some reason was not started on time, the patient may experience such complications:

• Reversible or irreversible loss of sensitivity or paralysis of the body (its individual parts).
• The possibility of complete immobilization.
• Stroke. This happens due to impaired blood circulation and innervation of the spine. Normal mutual functionality of the spinal cord and brain becomes impossible.
• Myelopathy. This is an extremely complicated disease of a neurological nature, in which there is a strong weakness in the extremities. But the muscle tone is very high.
• Lethal outcome.

As you can see, complications can be fatal, so treatment should be started as quickly as possible.

Prevention of pathology

If you do not want to develop a spinal stenosis (symptoms, causes and treatment of the disease we have already considered), you must follow simple rules:

• Do not allow prolonged stay in the same position or lack of motor activity. It is desirable to periodically do gymnastics neck.
• Exercise therapy. It is used not only for treatment, but also for prevention.
• In all circumstances, watch your posture. This is especially important with sedentary work.
• Try to eat right, so that the body receives all the necessary substances.
• Any pathology should be treated on time.

Timely appeal for specialized care gives a chance for recovery.

A source: http://.ru/article/248136/stenoz-pozvonochnogo-kanala-sheynogo-otdela-prichinyi-simptomyi-diagnostika-i-lechenie

Spinal stenosis: types, symptoms, treatment

Stenosis of the spinal canal or spinal stenosis is a chronic progressive pathology, characterized by narrowing of the spinal canal and leading to compression of the spinal cord or spinal roots. Depending on the location of the constriction, spinal stenosis is identified at the level of the cervical, thoracic and lumbar regions (l4-l5).

Before turning to the features of diagnosis and treatment of the disease, it is worthwhile to understand what it is primary and secondary, and also relative, absolute, central, lateral and foraminous stenosis of the vertebral channel.

To date, many different classifications of this disease have been compiled. Let us dwell on the most clinically significant:

View
Name

Due to the	Primary or idiopathic Secondary or acquired Combined
At the point of narrowing	Central Lateral or foraminous
According to the size of the constriction

The cause of the appearance of primary spinal stenosis are congenital malformations of the spine.

Secondary constriction may be triggered by certain diseases (Paget's disease, rheumatoid arthritis, progressive spondylitis), and degenerative processes in the spine (osteoarthritis, various arthropathies, thickening of ligaments, spondylolisthesis).

Due to the development of secondary spinal stenosis is often called degenerative stenosis of the spinal canal.

It is customary to distinguish between its central and lateral variety.

It is worth noting that, with relative stenosis of the spinal canal, the size of the constriction is up to 12 mm, while for the absolute - less than 10 mm.

Clinical picture

In the lateral stenosis of the cervical spine, a typical neurological pattern is observed, characteristic of the lesion of the spinal roots at this level.

At the same time, motor disorders will be more pronounced, compared with the sensitive disorders in the corresponding innervation zone.

First of all, patients will complain about:

• Pain in the neck, shoulder girdle and upper limb.
• Dysfunction of the muscles of the shoulder girdle.
• Appearance of a sensation of numbness and tingling in the back of the neck, neck and upper limb.

The narrowing of the spinal canal at the level of the thoracic spine is mainly due to trauma. Degenerative diseases less often provoke this pathology in this department of the spine. What symptoms are possible with such a lesion:

1. Pain at the injury site.
2. Sensation of soreness of various nature in the organs of the abdominal cavity.
3. Dermal sensitivity in the chest and abdomen is broken.
4. The work of internal organs suffers.

Spinal stenosis in the lumbar region (l4-l5) will be characterized by pain and weakness in the lower extremities, especially manifested during walking.

There may be a significant decrease in the tone and strength of the leg muscles. Sensitivity in the perineum and lower extremities also suffers.

Possible disruption of the internal organs, such as the large intestine and bladder.

Foraminar spinal stenosis in the lumbar region is most often localized at the level of l4-l5 (between the 4th and 5th lumbar vertebrae).

Diagnostics - instrumental methods

The clinical picture is important for the diagnosis of the narrowing of the spinal canal, but the results of instrumental diagnostic methods are of primary importance for the diagnosis. The diagnostic scheme may include such examinations:

• Radiography.
• Magnetic resonance imaging (MRI).
• Computer tomography (CT).
• Myelography.

Radiography

Such a survey can identify traumatic lesions, tumors, structural changes in the vertebrae, pathological deposition of calcium, osteophytes (outgrowths), which can change the size of the spinal channel.

MRI

The most complete diagnostic information on the state of the cervical, thoracic and lumbar (especially, l4-l5) departments of the spine can be obtained by magnetic resonance imaging.

In addition, due to MRI, it is possible to determine the exact size and nature of the constriction, which will allow an accurate diagnosis of the disease and determine the best method of treatment.

Computed tomography and myelography

In the presence of contraindications to magnetic resonance imaging, alternative methods of diagnosis are chosen, which are considered computed tomography and myelography.

If there is a suspicion of a spinal fracture or metastasis, it is recommended to perform a radionuclide scan.

Treatment

Clinical experience shows that it is necessary to treat the narrowing of the spinal canal in a complex way, using a multicomponent approach. Nevertheless, the choice of a full course of therapy should be approached individually.

Conservative therapy

Despite the fact that in most cases it is impossible to get rid of the factor that compresses the spinal cord without an operation, the stenosis of the spinal canal is still beginning to be conservative. Usually used:

• Non-steroidal anti-inflammatory drugs (diclofenac, tilfen, ibuprofen).
• Drugs that improve nerve conduction (proserine, neuromedin).
• Semi-rigid corset.
• Physiotherapy.
• Electrostimulation of muscles.
• Massage sessions.
• Classes of physiotherapy.

With severe pain in stenosis of the spinal canal, injections can be performed in the spaces between the spinal cord envelopes, which are called caudal and epidural blockades.

Operative intervention

As a rule, the only way to help relieve pressure on the spinal cord and spinal roots is surgery.

To get rid of dynamic constriction, a modern technique is used, in which a special metal structure between the spinous processes of the vertebrae, preventing the extension of the vertebral column at a certain level.

A source: http://MedOtvet.com/drugie-zabolevaniya-pozvonochnika/stenoz-pozvonochnika-vidy-simptomy-lechenie.html