Spinal Stenosis:
Spinal stenosis is a condition in which there is not enough room within the spinal canal to comfortably contain the spinal cord and nerve roots, thereby compressing them. Spinal stenosis is most common after the sixth decade of life, and usually caused by accumulation of arthritis changes, bony overgrowth, dege
nerated bulging discs, and thickening of the normal supporting tissues inside the spinal canal. In some cases the condition occurs in younger patients because the spinal canal is smaller from birth in the absence of much degenerative change. The common denominator is an “hourglass” narrowing of the normally cylinder-shaped spinal canal at one or more levels which causes the compression of the spinal cord and nerve roots. The classic symptom is progressive pain and weakness in the buttocks and legs while walking or standing for prolonged periods, which doctors call “spinal claudication” or “pseudoclaudication” to differentiate spinal disease from other patients with poor circulation in the legs causing this symptom.
Treatment of spinal and or foraminal stenosis causing nerve root compression and pain used to require open spinal surgery, often with elaborate spinal fusion operations for relief. With advanced techniques, patients in the early stages of spinal stenosis associated with bulging discs may be treated by laser disc decompression alone. Patients with more advanced degrees of spinal stenosis, especially those with foraminal stenosis where bone spurs, scar tissue, and advanced disc degeneration have occurred can usually be treated with endoscopic microdiscectomy and foraminotomy . The spinal endoscope and specialized microinstruments are used to enlarge or widen the natural “keyhole” opening in the side of the spine without destabilizing or weakening it, thus avoiding the need for additional stabilization or “fusion” operations. Both procedures may be performed on an outpatient basis, and offer rapid recovery time and greater freedom from surgical complications and prolonged disability.
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