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What is Spinal Stenosis?

'Stenosis' is a Greek word, meaning 'choking'. Spinal Stenosis, however, doesn't relate exactly to choking but compression of spinal cord.

To be more precise, spinal stenosis is a narrowing of spaces in the spine that results in pressure on the spinal cord and/or nerve roots. It may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. This disorder involves the narrowing of one or more of three areas of the spine: 1. The vertebral or spinal column through which the spinal cord and nerve roots run. 2. The canals at the base or roots of nerves branching out from the spinal cord, or 3. The openings between bones of the spine through which nerves leave the spine and go to other parts of the body.

The symptoms of spinal stenosis include pain, numbness, and loss of motor control. Pressure on the lower part of the spinal cord or on nerve roots branching out from that area may give rise to pain or numbness in the legs. Pressure on the upper part of the spinal cord may produce similar symptoms in the shoulders, or even the legs.

There are two types of spinal stenosis: lumbar stenosis and cervical stenosis. While lumbar spinal stenosis is more common, cervical spinal stenosis is often more dangerous because it involves compression of the spinal cord, as explained below in more detail. In lumbar stenosis, the spinal nerve roots in the lower back are compressed, or choked, and this can produce symptoms of sciatica -- tingling, weakness or numbness that radiates from the low back and into the buttocks and legs - especially with activity. In rarest of rare cases, lumbar stenosis can go no further than to produce severe persistent disabling pain and even weakness in the legs. Most cases of stenosis in the lumbar spine, however, have pain that radiates into the leg(s) with walking, and that pain will be relieved with sitting. This is called claudication, which can also be caused by circulatory problems to the legs, as discussed later in this article.

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The location of the stenosis determines which area of the body is affected. With spinal stenosis, the spinal canal is narrowed at the vertebral canal, which is a foramen between the vertebrae where the spinal cord (in the cervical or thoracic spine) or nerve roots (in the lumbar spine) pass through. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.

Cervical spinal stenosis can be even more dangerous when it compresses the spinal cord. Spinal cord stenosis may lead to serious symptoms, including major body weakness or even paralysis. Such severe spinal stenosis symptoms are virtually impossible in the lumbar spine, however, as the spinal cord is not present in the lumbar spine.

The chances that a person will encounter spinal stenosis usually is in in the 5th decade of life and it can extend throughout every subsequent age group. It is related to degeneration in the spine and most patients first visit their doctor with symptoms of spinal stenosis at about age 60 or so. Patients need only seek treatment for lumbar spinal stenosis if they no longer wish to live with significant activity limitations, such as leg pain and/or difficulty with walking. With age, the body's ligaments through connective tissues between the bones in the spine can thicken. Small growths may develop on the bones and into the spinal canal. The cushioning disks between the vertebrae may begin to deteriorate. The facet joints (flat surfaces on each vertebra that form the spinal column) also may begin to break down. All of these factors can cause the spaces in the spine to narrow.

Two forms of arthritis that may affect the spine are osteoarthritis and rheumatoid arthritis. Symptoms of spinal stenosis may show up in a relatively young person if the spinal canal is too small at birth. Structural deformities of the involved vertebrae can cause narrowing of the spinal canal.

Also, when one vertebra slips forward on another, that can narrow the spinal canal. Abnormal growths of soft tissue may affect the spinal canal directly by causing inflammation or by growth of tissue into the canal. Tissue growth may lead to bone resorption (bone loss due to overactivity of certain bone cells) or displacement of bone and the eventual collapse of the supporting framework of the spinal column. During accidents too, injuries may either dislocate the spine and the spinal canal or cause burst fractures that produce fragments of bone that penetrate the canal. Spinal stenosis can occur in a variety of ways in the spine. Approximately 75% of cases of spinal stenosis occur in the lumbar spine (low back), which is called lumbar spinal stenosis, and most will affect the sciatic nerve which runs along the back of the leg. When this happens, it is commonly called sciatica.

There are several treatments for spinal stenosis. People with spinal stenosis may find that flexing the spine by leaning forward while walking relieves their symptoms. Lying with the knees drawn up to the chest also can offer some relief. These positions enlarge the space available to the nerves and may make it easier for people with stenosis to walk longer distances. In some cases, the pressure on the nerves is caused by inflammatory swelling. Nonsteroidal anti-inflammatory medications (NSAIDS) such as aspirin or ibuprofen may help relieve symptoms. Rest, followed by a gradual resumption of activity, can help. Aerobic activity such as bicycling is often recommended.

If other treatments do not ease the pain, surgery may be recommended to relieve the pressure on affected nerves.

There are several Spine and Neuro Surgery Hospitals in India wherein the patients can get good treatment from specialised doctors. Hospital in Nagpur, India falls under the category of hospital that offers specialised treatment in Spinal Stenosis. Besides, there are hospitals in Delhi as well that offer treatment at an affordable price. The cost of surgery can be reduced by a good 30 per cent or so in places like Spine and Neuro Surgery Hospital in Nagpur

A large number of people have a positive result from surgery but like other surgeries, spinal surgery also carries some risks. Potential complications can be relatively minor, such as an infection at the operation site, to the more serious like permanent damage to the spinal nerves. Before choosing a spinal surgery, the surgeon will discuss the possible risks and benefits. It is important to choose the right surgeon. Spine and Neurosurgery Hospitals in India, especially in metropolitan cities like Delhi and Nagpur, provide promising treatment for spinal stenosis problems. Also the major boost factor is the lesser price. The overall expenses of treatment in India may cost as low as 25 % of what one may have to incur in the western countries, with the same excellence and efficiency in treatment.

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