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Lumbar canal stenosis

Lumbar canal stenosis is the narrowing of the anterior-posterior and transverse diameters of the spinal canal.

The symptoms are paraesthesia, pain, discomfort, weakness and feelings of heaviness in the legs. The intermittent sensory-motor difficulties in walking are similar to those that result from chronic vascular insufficiencies. These issues can affect one leg, or both and can occur after a prolonged period spent standing up, or even after just a short walk.

During the consultation, doctors will be aware of the rachis’ limited range of motion and will likely request an X-ray if they suspect stenosis is the cause. CT and MRI scans can allow for more precise grading of the stenosis intensity.

The rehabilitation cycle will usually involve last at least 2 months, with 2-3 sessions per week in the gym and swimming pool, accompanied by chiropractic treatments. It is very important to have massages to relax the dorsal-lumbar region, as well as stretching of the posterior chain muscles and core stability exercises.

Surgical treatment must be considered as a backup - the last option when faced with a particularly persistent and disabling case. 

Lumbar canal stenosis - Surgery

Removal of a herniated disc

Surgical treatment here is reserved for selected cases where conservative treatments have proved inefficient. Surgical interventions may also be used in cases where irreversible neurological damage through the worsening of symptoms is a risk.

Hernias removed through surgery are typically ‘hard’ i.e. dehydrated, these can cause substantial sensory and motor impairments and rarely improve over time, explaining the need for removal.

The treatment is usually done with non-invasive technique (2-3 cm scar). In cases of major complications, it might be necessary to take a more traditional approach using a laminectomy. Some surgeons may also perform percutaneous disc decompression, using lasers. However this treatment does not guarantee the symptoms will not recur.

After surgery, a fitting rehabilitation programme is essential to ensure optimum recovery.

 

Dorsal laminectomy

A dorsal laminectomy is a surgical procedure designed to reduce the cord compression of the lumbar spine (lumbar spinal stenosis). It is performed under general anesthesia and involves the removal of a portion of the vertebral bone called the lamina. The lamina helps to form the posterior vertebral arch of the spine.

The most frequent cause of spinal cord compression is a lumbar disc herniation (also known as a slipped disc).  Other possible causes may include osteoarthritis, spondylosis and spondylolisthesis.

The typical symptoms described in lumbar disc herniation include pain that may move down the leg, tingling and sensory disturbance of the skin over the leg (paraesthesia) and possible leg or foot weakness.

Depending on the severity, the initial therapy of choice may be conservative which involves an individually prescribed programme of rehabilitation and physiotherapy sessions.  Once our Isokinetic doctor has made the diagnosis and if indicatedthese individually tailored sessions may be prescribed. Our well-trained physiotherapy and rehabilitation specialists will support you throughout your sessions in order for you to reach your maximum functional recovery possible.

In cases where physiotherapy and rehabilitative treatment alone cannot guarantee a good recovery, a surgical procedure, for instance a laminectomy may be indicated.  We have a very good working relationship with spinal surgical teams and can request a surgical opinion if the doctor feels this is the best treatment option. Our team at Isokinetic will ensure you are fully informed or your progress.

Spinal stabilization

Spinal stabilisation is a surgical technique used to fix the spine. It is performed in an attempt to reduce back pain with leg symptoms as a result of pinching of a nerve from a disc herniation. It may be indicated in cases of vertebral misalignment such as spondylolisthesis and scoliosis where there is a threat of permanent nerve injury. The procedure is usually performed under general anesthesia and involves decompression of the ‘pinched nerve’, fixation of a spinous process with facet screws in order to stabilise the spine and facilitate fusion.

Physiotherapy and rehabilitation may help prevent the need for surgery. Our doctors at Isokinetic have experience in managing cases of back pain and disc herniation. Once our Isokinetic doctor has made the diagnosis and if indicated these individually tailored sessions may be prescribed. Our well-trained physiotherapy and rehabilitation specialists will support you throughout your sessions to reach your maximum functional recovery possible.

In cases where physiotherapy and rehabilitative treatment alone cannot guarantee a good recovery, a surgical procedure may be indicated. We have a very good working relationship with spinal surgical teams and can request a surgical opinion if the doctor feels this is the best treatment option. Our team at Isokinetic will ensure you are fully informed on your progress.

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