Spinal stenosis is a condition where the small openings in the bones of the spine, including the sacrum and the vertebrae, become narrow. These small openings provide shelter for the nerves from the spine to travel away from the back and through the body. When these openings begin to narrow, it provides less room for the nerves to pass through and can result in irritation to the nerves and eventually wear away the delicate sheath that protects them. This causes actual damage to the nerves and prevents them from healing naturally.
Spinal Stenosis affects patients 60 years of age and older. Sometimes it affects younger patients who are born with small spinal canals. The condition denotes narrowing of the spinal canal, the hollow tube that conducts the spinal cord and cauda equina, and or narrowing of the nerve root canals, which conduct the individual spinal nerves. It occurs as a result of the growth of bone spurs and intervertebral discs bulging into the spinal canal, which take up the space normally occupied by the spinal cord and or spinal nerves. In older patients it produces weakness and pain in the legs usually brought on by walking, and relieved by rest. Specifically sitting down and bending forward temporarily relieves the condition. The symptoms can come on slowly or rapidly. If the pain or weakness is disabling you need to have your hips checked for arthritis, and your circulation checked since hip arthritis, poor circulation, and spinal claudication (the symptoms of spinal stenosis) can often be confused.
Spinal stenosis begins to produce more pronounced symptoms as the narrowed openings in the vertebrae and sacrum start to irritate the nerves that pass through them. When the myelin sheath that protects the nerves eventually wears away, the patient will experience symptoms including tingling, numbness, muscle weakness, and cramps. When stenosis results in neuropathy, the symptoms become quite severe and run the length of the arm or leg. As the nerve damage extends outward toward to the extremities, it also returns to the spine, causing irritation and inflammation.
The most successful operation for spinal stenosis in the lumbar spine is laminectomy, or removal of parts of the posterior portion of the spine, which compress the spinal nerves. This can predictably improve your ability to walk. It does not cure symptoms of back pain. It is important for you to have a general check up to make sure you are a reasonably good surgical risk. Remember this operation is reserved for patients severely disabled by leg pain and weakness, who are healthy enough to undergo a surgical procedure. If you have other severe medical conditions, or if the problem is back pain alone, this type of surgery may not be indicated.
The need for surgery does not depend on the MRI scan, it again depends on the severity of the pain and the distance you are able to walk. If you can only walk 1 block, and you are in good condition, consider surgery. If you have little pain and normal function, do not have surgery merely because your MRI scan is abnormal. Also symptoms of back pain alone, without leg weakness or numbness, respond poorly decompressive surgery alone.
Dr. Light will discuss all the options available to treat spinal stenosis with each patient and determine the best way to address the specific needs of each individual patient.
We accept assignment on all Medicare patients, participating provider organizations (PPO), and Workers' Compensation. However, some insurance companies do cover the doctors' services as an out of network provider.
As a courtesy, we will bill your insurance company for you if you have provided us with the insurance name, policy numbers, address, place of employment and any other pertinent information. You are responsible for all deductibles, co-pays, and charges not covered by your insurance. Failure to submit payment for your portion of your bill may result in referring your account to a collection agency. All co-payments will be collected at the time of service.
"I strongly urge anyone with severe back, spinal, or related neurological problems to see this wonderful, brilliant, meticulous surgeon."
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