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Spinal stenosis treatment
Spinal stenosis treatment
In spinal stenosis there is a reduction in the diameter of the spinal canal and spinal foramina, resulting in compression of the spinal cord and / or roots and consequently pain, especially in standing and walking.
The causes are many although most of the time it is a mixture of causes.
What the patient notices is a decrease in his endurance in standing and walking on the road (claudication intermittent ).
The distance is slowly but steadily reduced to a minimum. The pain reduction usually occurs after bending of the shank or when seated. This is due to the reduction of lordosis
Other symptoms include numbness in the lower extremities, a feeling of instability and loss of balance, and in advanced conditions orthocystic disorders.
The treatment of spinal stenosis can be Conservative or Surgical
1. Conservative Treatment of spinal stenosis SPONDYLOS
Objectives in the treatment of spinal stenosis
The goal of the treatment is to decompress the posterior vertebral joints and, accordingly, to open the vertebral foramina, releasing the nerve roots.
Subconsciously our body realizes the problem and with the anterior flexion of the torso it forces the lumbar spine to straighten, reducing the normal lordosis.
So the goal of conservative treatment is to reduce lordosis.
This results in the opening of the intervertebral foramina (the gaps created between two vertebrae and a disc, through which the nerves of the spine pass) but also the dilation of the posterior vertebral joints (the posterior joints that articulate two vertebrae).
Antilordotic bending brace SPONDYLOS,
The anti-lord brace is a brace who corrects the lordosis in the lumbar spine in the spinal stenosis.
It is also called bending brace, since its purpose is to reduce the lordosis by bending the trunk low.
Studies have shown the relief of symptoms (pain, stiffness) by applying a hard thermoplastic antilordotic brace to patients with spinal stenosis and with good results in chronic pain.
Manufactured after receiving a model with Laser and digital processing in CAD CAM with precise reduction of lordosis.
It is easily applicable, ties from the front, is only 2.5 mm thick and is not visible through clothes.
How does it work in spinal stenosis?
The brace exerts two opposite forces on the body.
The anterior presses the abdomen pushing back the spine and the other consists of a pair of forces.
One pushes forward at the level of the 12th thoracic vertebra and the other below pushes the point of the sacrum.
This creates a lower body flexion, reducing lumbar lordosis.
It has been shown that if an antilordotic brace is applied correctly, the intra-disc pressure in the lumbar spine of the SS will be reduced by about 30%.
Anti-lordotic exercises
Special exercises to reduce lordosis and strengthen the lumbar muscles.
The exercises aim to strengthen the supporting muscles, which support the Lumbar but also reduce lumbar lordosis.
Muscles such as the transverse abdomen, the lumbar quadriceps, the iliopsoas, etc.), but also lordosis reduction exercises (patients are trained in the posterior tilt of the pelvis).
Training in daily activities without causing symptoms (bending over to make the bed, cooking, etc.), strengthening the torso muscles, balance exercises and posture control.
Many times, especially in elderly patients, exercise is something they do not want. Nevertheless, exercising even for a few minutes a day will offer them special relief.
Bending brace, supportive muscle and lordosis-reducing exercises, painkillers and chiropractic seem to be the treatment of choice for most elderly patients.
In all cases with the application of the anti-lordotic brace , we have a reduction until the disappearance of pain, at least as long as it is applied on the patient.
2. Surgical treatment of spinal stenosis
If conservative treatment does not work and the patient can be operated on, then the treatment of choice is extensive laminectomy with spinal fusion and use of materials.
That is, the posterior parts of the vertebrae are removed, in order to decompress the spinal cord and if this will create instability in the spine, 2 screws are placed per vertebra, which are held by 2 rods.
Unfortunately, people who suffer from spinal stenosis are elderly people and most often have concomitant major health problems, some of which do not allow them to have surgery and others, such as osteoporosis, create instability of the vertebral ligament.
There are many complications, both intraoperative and immediate postoperative, resulting in reoperations, which make surgeons particularly troubled, as long as the spinal fusion actually solves the problems of spinal stenosis.
So most of the time conservative treatment is the desired treatment for these patients.
