Sebastian Lattuga M.D. - Lumbar Spinal Stenosis


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Sebastian Lattuga M.D. provides patient education materials on Lumbar Spinal Stenosis.
*What is lumbar spinal stenosis?
*What are the symptoms of lumbar spinal stenosis?
*Non-surgical treatment
*Surgical treatment
*Living with lumbar spinal stenosis

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Sebastian Lattuga M.D. - Lumbar Spinal Stenosis

  1. 1. + Lumbar Spinal Stenosis New York Spinal Specialists© 2012 SpineSearch LLCDesign BRAVA Creative
  2. 2. + What is lumbar spinal stenosis?  Spinal stenosis is a narrowing of the spinal canal. The spinal canal runs down the center of your spine and surrounds the spinal cord.  The word “stenosis” means “narrowing of a bodily canal or passageway.” Some people are born with spinal stenosis, but most often, it occurs as a result of aging or wear and tear on the spine.  Conditions such as osteoarthritis and degenerative disc disease can cause an overgrowth of bone and soft tissue in the spine. This “overcrowding” reduces the space in the spinal canal and prevents the spinal cord and nerves from functioning normally. Lumbar spinal stenosis  Other causes of stenosis include bone spurs, tumors, is a common cause of previous surgery and trauma. back and leg pain.  Spinal stenosis can occur anywhere along the spine, but the cervical (neck) and lumbar (lower back) regions are most commonly affected.Patient Education
  3. 3. + Are there different types of stenosis? Stenosis is frequently classified by its location. Learning a few basics about spinal anatomy can help you better understand your condition and make informed treatment decisions. Foraminal stenosis occurs when the foramen (opening) through which the nerves branching off the spinal cord exit the canal is Spinal stenosis is most obstructed. Each vertebra has 2 foramina, one on each side. commonly caused by osteoarthritis and Lateral stenosis indicates that the nerve is being compressed at degenerative disc the point of exit through the lateral (side) foramen. Far lateral disease. stenosis means that the nerve is affected after it passes through the lateral foramen. Central stenosis refers to compression that occurs in the spinal canal. This type of stenosis is usually caused by a bulging or herniated disc.Patient Education
  4. 4. + What are the symptoms of lumbar spinal stenosis?  Lower back pain – can range from mild to severe  Sciatica – often described as burning pain that starts in the buttocks and runs down the leg/s  Numbness, tingling, or an ache in the buttocks or leg/s  Leg fatigue/weakness, pins and needles sensation  Foot drop – foot seems to slap on the ground when walking  Pain occurs when walking, standing for long periods, or walking downhill  Pain relieved by sitting or leaning forward  Bowel and bladder problems – rare Symptoms are caused by compression of the nerves or spinal cord.Patient Education
  5. 5. + What is neurogenic claudication? Neurogenic claudication is set of symptoms specific to lumbar spinal stenosis. Symptoms may be felt in the back, buttocks or legs (or any combination thereof) and consist of: Learning to make simple  Pain adjustments can help you manage your condition. For  Weakness example, if walking for long  Alterations in sensation, e.g., tingling, pins and needles periods causes painful  Cramping symptoms, try to plan ahead for periods of rest. Neurogenic claudication typically manifests itself when individuals with lumbar spinal stenosis are walking or standing for an extended period of time. Symptoms may be felt on one or both sides of the body.Patient Education
  6. 6. + How is lumbar spinal stenosis diagnosed? What to expect at the doctors’ office Truck drivers, heavy equipment The doctor will talk to you about operators, and construction your medical history and perform a workers have the highest rate of physical exam. You may be asked back injuries. when the symptoms began, what makes the symptoms better or worse, and what treatments or surgeries you have had. During the physical exam, the doctor will probably check your back, feeling for painful areas. Your legs will be examined to see if there are any areas of weakness or altered sensation. Your Early diagnosis and treatment ability to sit, stand and walk will be increase your chances of being able to assessed. Imaging studies are usually return to your previous level of activity. ordered to confirm the diagnosis.Patient Education
  7. 7. + Tests to confirm a diagnosis of lumbar spinal stenosis  X-ray – films of the spine can show bone spurs, disc damage, and abnormal motion between the vertebrae.  CT scan – computerized axial tomography is more advanced than X-ray. It can show whether or not the nerves in the back are compressed.  MRI – the images produced by magnetic MRI is considered the best resonance imaging allow for precise imaging test for diagnosis of visualization of the spine and accurate spinal stenosis because it assessment of the stenosis. produces cross-sectional (slices) images of the spine.  EMG – an electromyogram can show which If something is pressing on the spinal cord or nerves, nerves have been damaged as a result of MRI can detect it. long-term compression.Patient Education
  8. 8. + Non-surgical treatment Symptoms can sometimes be managed with non-surgical treatment such as: Medication to reduce inflammation Pain medication – prescription or over the counter drugs Cortisone injections Physical therapy – often effective As a general rule, the physician will first recommend non-surgical Lifestyle changes and/or remedies treatment for relief from painful e.g., walking aids symptoms. Lumbar spinal stenosis is a condition that usually worsens over time. Response to treatment depends on many factors.Patient Education
  9. 9. + Surgical treatment If non-surgical treatment doesn’t work, surgery is a reasonable next step. The goal of surgery is to take pressure off the spinal cord and/or nerve roots. Decompression surgery, as it called, means that the surgeon removes or trims the bone/tissue that is causing the compression. If needed, the surgeon may combine a decompression surgery with a spine stabilization procedure. Early diagnosis and treatment increase your chances of being able to return to Spinal fusion is an example of a your previous level of activity. stabilization surgery. Vertebrae are fused together in an attempt to prevent abnormal movement in the spinal column.Patient Education
  10. 10. + The most common surgeries to treat lumbar spinal stenosis Decompressive laminectomy – the surgeon removes part of the vertebra to create more space for the nerves in the spinal canal. This is a very common procedure. Discectomy – a herniated disc can press on nearby nerves. With this procedure, the surgeon may remove all or part of the disc that is causing problems. Spinal fusion – a fusion may or may not be Today, patients have more combined with other procedures. Vertebrae can be treatment options than ever before. fused together with metal screws/plates or bone Many surgeries that were once graft. Surgeons fuse vertebrae together to stop open back procedures can now be them from moving against each other. Over time, done with minimally invasive the fused vertebrae bind together and become like techniques. one.Patient Education
  11. 11. + Minimally invasive surgery Minimally invasive surgery is done through small incisions. Surgeons use small, high-tech instruments and probes with cameras attached. Because the surgeon operates through a “keyhole,” trauma to the muscle and tissue in the back is reduced. Benefits of minimally invasive surgery:  Less pain  Shorter hospital stay All surgery has risks and benefits. Talk to your doctor,  Faster recovery, less down time ask questions and have realistic expectations for your surgical  Smaller scars outcome.Patient Education
  12. 12. + Living with lumbar spinal stenosis It’s difficult living with chronic back and leg pain. Talk to your doctor about what you can do to manage your condition. Ask about physical therapy. Start an exercise program. Consider alternative therapies that you might not have considered before. Most important, try to maintain a positive attitude. Living in a constant state of distress or anger about your condition doesn’t help. Stay active. If you feel upset more often than Stay involved. not, find the courage to talk about it with your doctor. Stay hopeful. LIVE your life.Patient Education