Spinal stenosis in adults: symptoms, causes, treatment

Chudinskaya

Galina Nikolaevna

Experience 29 years

Neurologist, member of the Association of Interdisciplinary Medicine

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A condition in which the size of the spinal canal or intervertebral foramina decreases is intervertebral canal stenosis. As a result of this process, the roots of the canal and the spinal cord are severely compressed. This disease is most often diagnosed in the lower lumbar vertebrae. But cases when stenosis of the intervertebral canal makes itself felt in the thoracic and cervical spine are no exception.

The spinal canal also has a second name – the spinal canal. It represents a certain space that is located inside the spinal column. It forms:

• in front – vertebral bodies;
• intervertebral discs;
• behind and on both sides - the vertebral arches (they are connected to each other by a special biological yellow ligament).

Looking at it in cross section, you can see that it can be either round or oval.

The spinal canal includes:

• the spinal cord with paired nerve roots that depart from it and extend beyond this canal through their specific openings (they are surrounded by the dura mater);
• loose and fatty connective tissue, which consists of nerves, arteries and veins.

The spinal cord, in turn, performs two main functions:

• conductive (sends and transmits a nerve impulse from the center of its location to the periphery, and then returns this signal back);
• reflex (forms a response to all kinds of irritations from the nervous system).

Spinal stenosis of the lumbar, as well as thoracic and cervical, can be either congenital or acquired.

Symptoms and signs of spinal stenosis

Spinal stenosis at the level of the lumbar, thoracic or cervical spine develops quite slowly. This process can take several years of a person's life. The main symptoms are gradually increasing pain in a certain location. Moreover, discomfort and unpleasant sensations make themselves felt not only in the back, but also in the legs. At first, the disease manifests itself only when walking, and then the pain is present at rest.

Painful sensations do not have a clear localization. When walking, weakness in the legs increases. The person wants to sit down or even lie down. Bend your legs slightly or bend your torso slightly forward to relieve symptoms. Typical sensory disorders with lumbar spinal canal stenosis are numbness, decreased sensitivity in the legs, and a sensation of “pins and needles.”

The function of the pelvic organs can often be impaired. This manifests itself in a decrease in potency in men, defecation, retention, or vice versa - a sudden urge to urinate. With prolonged compression of the nerve roots of the spinal cord, you can notice that the lower limbs begin to gradually lose weight. Symptoms of cervical or thoracic spinal canal stenosis also manifest themselves in increasing spasticity in the legs.

Often this disease goes unnoticed. It is usually diagnosed at later stages of development. Especially when it comes to damage to the cervical spine. Pain may gradually appear in the neck. It can be either one-sided or two-sided. Unpleasant and painful sensations appear in the shoulder blades, shoulders, back of the head and arms. With certain movements of the neck, these pains begin to intensify. There is a feeling of “cottonness” in the legs. Cervical spinal canal stenosis is characterized by constipation and urinary retention.

If compression occurs at the level of 3-4 vertebrae, then respiratory dysfunction is noticeable. Spastic phenomena appear in both the legs and arms.

These are the main symptoms of spinal canal stenosis.

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Pathogenesis

The mechanism of initiation and further development of the disease is observed in a certain location. It should be understood that the free (reserve) space around the spinal cord and nerve roots should remain normal, since the vessels are located here. If it decreases or completely disappears, then circulatory disturbances occur both in the spinal cord and in the nerve roots. The circulation of cerebrospinal fluid is also impaired. Pathological narrowing of the reserve space is caused by the introduction of soft tissue, cartilage and bone structures.

The vascular bed begins to experience chronic stagnation due to compression of blood vessels and nerve elements. The spinal cord and roots experience “starvation,” that is, oxygen deficiency and lack of blood supply. As a result of this process, the function of the nerve elements is seriously impaired.

If there is a long-term disruption of the nutrition of the spinal cord and nerve roots, then scar tissue begins to form and grow, and the formation of adhesions is noticeable. Spinal stenosis of the cervical, thoracic, and lumbar regions often causes severe pain. A person develops vegetative, motor, sensory and trophic disorders.

Vascular stenosis

Atherosclerosis

Diabetes

Ulcer

5514 12 August

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Vascular stenosis: causes, symptoms, diagnosis and treatment methods.

Definition

Vascular stenosis (Greek στενός - “narrow, cramped”) is a partial or complete persistent narrowing of the lumen of blood vessels with limitation or complete cessation of blood flow.

Causes of vascular stenosis

Depending on which vessels are affected, a distinction is made between stenosis of arterial vessels (aorta, arteries, arterioles) and stenosis of venous vessels (superior vena cava, inferior vena cava, veins, venules).

Vascular stenosis can be either congenital or acquired.

The main cause of acquired stenosis of the aorta, arteries of the lower extremities, and coronary arteries of the heart is atherosclerosis, a systemic metabolic disease with predominant damage to the vascular wall. The degree of narrowing of the artery and its length may vary. When blood pressure increases, the sclerotic inner layer of the vessel (endothelium) is easily damaged, as a result, the blood clotting process is activated and a blood clot is formed.

Blockage of the vessel can lead to ischemia or necrosis of the tissue or organ.

Risk factors for the development of atherosclerosis include:

• male gender;
• elderly age;
• smoking;
• dyslipidemia (violation of the normal ratio of blood lipids);
• diabetes,
• arterial hypertension,
• increased blood homocysteine;
• elevated levels of C-reactive protein (CRP);
• increased blood viscosity and hypercoagulable states;
• chronic renal failure.

Another disease leading to arterial stenosis is obliterating endarteritis (spontaneous gangrene) - a chronic disease of peripheral blood vessels (mainly affecting the arteries of the feet and legs).
Mostly men under the age of 25-40 are affected. Those at risk include smokers, as well as people with frostbite on their feet. Diabetic angiopathy, characterized by damage to both small vessels and large and medium-sized arteries, develops in patients with diabetes mellitus. In diabetic macroangiopathy, when large blood vessels are affected, changes characteristic of obliterating atherosclerosis are found in the wall of the great vessels. With microangiopathies, when small blood vessels are affected, thickening of the walls of microvasculature vessels (arterioles, capillaries, venules) occurs, which leads to a narrowing of the lumen and deterioration of the blood supply to organs and tissues.

Coarctation of the aorta (congenital segmental narrowing of part of the aorta that obstructs blood flow) occurs as a result of improper fusion of the aortic arches in the embryonic period. The length of the narrowing is usually 1-2 cm. The ascending aorta and branches of the aortic arch expand, their diameter increases significantly, and the walls of the arteries participating in the collateral circulation become thinner. Two modes of blood circulation are formed in the systemic circle: up to the point of obstruction to blood flow there is arterial hypertension, and distal (or below) there is hypotension.

Venous stenosis most often occurs as a result of direct damage to the vascular wall during catheter insertion and is then aggravated by the constant presence of a foreign body and mechanical irritation. Inflammation and activation of the blood coagulation system are observed in the vessel wall. These changes lead to proliferation (multiplication) of smooth muscle cells, thickening of the vein wall, and the formation of microthrombi.

Thus, risk factors for the development of central venous stenosis are: the use of a central venous catheter, infections associated with the installation of a catheter, and concomitant diseases.

Systemic vasculitis, tumor diseases and other causes of vascular stenosis are detected much less frequently.

Classification of the disease
According to the type of blood vessels:

• arterial stenosis;
• venous stenosis

Due to the occurrence:

• congenital;
• acquired.

By localization:

1. Stenosis of the arteries of the lower extremities.
2. Stenosis of the carotid (carotid) and cerebral arteries.
3. Stenoses of the arteries of internal organs:

• renal arteries,
• mesenteric arteries etc.

1. Aortic stenosis.
2. Stenosis of coronary vessels.

By caliber of damage:

• stenosis of large vessels (aorta and its branches);
• stenosis of medium-diameter vessels;
• stenosis of small vessels (arterioles and capillaries).

Symptoms of vascular stenosis
Damage to the blood vessels of the brain is one of the main causes of mortality and disability in the population. 2/3 of ischemic strokes are associated with narrowing and deformation of the carotid arteries.

The risk of developing ischemic stroke is directly related to the degree of narrowing of the artery lumen.

Occlusion (closure) of the internal carotid artery leads to the development of stroke in 40% of cases.

Damages to the blood vessels of the brain can occur in several forms:

• The asymptomatic form is characterized by the absence of focal and cerebral neurological symptoms (impaired consciousness, headache, vomiting, slow pulse).
• Discirculatory encephalopathy is characterized by a predominance of general cerebral symptoms; focal neurological symptoms are absent or appear in a very mild form.
• Transient ischemic attacks manifest themselves in the form of transient disorders of cerebral circulation of the ischemic type and are accompanied by the appearance of focal neurological symptoms that resolve within 24 hours.
• The consequences of a minor stroke are an acute ischemic cerebrovascular accident with the development of neurological symptoms, which almost completely regress within a month as a result of conservative therapy.
• The consequences of a completed stroke are an acute ischemic disorder of cerebral circulation, accompanied by the development of persistent focal neurological and cerebral symptoms.
• Ischemic stroke is damage to brain tissue with disruption of its functions due to obstruction or cessation of blood flow.

Atheroslerotic lesion of the coronary arteries of the heart is manifested by angina pain, but can sometimes be perceived by the patient as discomfort, a feeling of heaviness, compression, tightness, distension, burning or lack of air.
Most often, the pain is localized behind the sternum or along the left edge of the sternum; it can radiate (give) to the neck, lower jaw, teeth, interscapular space, and less often to the elbow or wrist joints, mastoid processes. Pain with angina pectoris usually lasts from 1 to 15 minutes. Occurs during significant physical or emotional stress. After taking nitroglycerin or stopping the exercise, the pain stops. As angina progresses, an attack may occur with minimal exertion and then at rest.

The main symptom of renal artery stenosis is a persistent increase in blood pressure, which is difficult to respond to drug therapy. Approximately 90% of cases of renal artery stenosis are caused by atherosclerosis; in 10% of cases, stenosis occurs due to fibromuscular dysplasia, a group of diseases that affect the walls of the arterial vessel.

With renal artery stenosis, the blood supply to the kidney tissue is reduced, hormonal factors (renin-angiotensin-aldosterone system) that regulate blood volume and blood pressure are activated, and the development of chronic kidney disease is accelerated.

Stenosing damage to the vessels supplying blood to the abdominal organs (mesenteric arteries) is more often observed in middle-aged and elderly people and manifests itself as chronic abdominal ischemia syndrome, so the main complaint of patients is pain, which appears after 20-25 minutes. after eating, lasts 1-2 hours and usually subsides on its own. The pain can be localized in the epigastric region, directly under the xiphoid process, and radiate to the right hypochondrium or spread from the periumbilical region throughout the abdomen. Some patients note a feeling of constant heaviness in the abdomen, and vomiting is rarely observed.

Other symptoms of chronic abdominal ischemia are intestinal dysfunction, expressed by disturbances in its motor, secretory, absorption functions, and progressive weight loss.

Obliterating atherosclerosis of the aorta and main arteries of the lower extremities is more common in men over 40 years of age and deprives them of their ability to work. The process can be localized in large vessels (aorta, iliac arteries) or medium-sized arteries (femoral, popliteal).

Small atherosclerotic lesions of the arteries of the lower extremities may not be clinically manifest. With continued vasoconstriction, intermittent claudication occurs, which is manifested by discomfort or pain in the muscles of the lower limb during physical activity. Damage to the terminal aorta and iliac arteries can cause pain in the buttocks, thigh, and calf. Impaired patency of the femoral-popliteal segment is characterized by pain in the calf. Occlusion of the arteries of the leg usually causes pain in the calf, foot, absence or decrease in skin sensitivity in them.

With obliterating endarteritis, trophic disorders are observed (cracks, dry skin, brittle nails, ulcers), intermittent claudication, leg pain, necrosis and gangrene of the limb.

In the generalized form of obliterating endarteritis or atherosclerosis, not only the vessels of the extremities are affected, but the visceral branches of the abdominal aorta, branches of the aortic arch, cerebral and coronary arteries.

The clinical picture of diabetic macroangiopathy consists of the clinical picture of microangiopathy and atherosclerosis of the great vessels, but is characterized by a more severe and progressive course, often ending in gangrene.

The clinical picture of diabetic microangiopathy of the lower extremities is similar to that of obliterating endarteritis.

With coarctation of the aorta, symptoms depend on the severity of the disease. In the case of significant narrowing of the aorta, the parents of the newborn pay attention to the pale skin, sweating, and difficulty breathing of the child. In older children and adults, the symptoms are usually mild: high blood pressure, headache, cold extremities, nosebleeds.

Stenosis of the central veins is clinically manifested by swelling of the extremities, pain in them and trophic changes (cyanosis, thinning of the skin, cracks, ulcers, etc.).

Diagnosis of vascular stenosis

Diagnosis of the disease is based on the analysis of patient complaints, medical history data, clinical picture, data from laboratory and instrumental research methods.

To clarify the cause of vascular stenosis, the following may be recommended:

• clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes);

Causes of occurrence and development

Before starting treatment for lumbar or cervical spinal stenosis, you should find out what causes the onset and development of the disease.

A congenital or primary type of stenosis is formed during the intrauterine development of the human embryo. This happens in the period from 3 to 6 weeks of development. The genetic factor plays a role here. But absolute spinal canal stenosis can also develop due to infectious, toxic factors that affect the fetus.

Also the cause of congenital stenosis is:

• chondrodystrophy or achondroplasia (chronic). This manifests itself in intrauterine bone growth disorder. In this case, the spinal canal narrows due to shortening or thickening of the vertebral arches, fusion of the vertebrae themselves;
• Diastematomyelia. It is characterized by bifurcation of the spinal cord, separation of the spinal canal by a septum (it consists of either bone or cartilage tissue).

Secondary spinal stenosis appears and develops in childhood or in adulthood.

The following reasons may contribute to this:

• traumatic displacement of the vertebrae or intracanal hematomas;
• changes in the intervertebral joints, which manifest themselves in the growth of bone tissue inside the spinal canal. These changes are degenerative-dystrophic in nature;
• anatomical defect of the spinal arch;
• intervertebral hernia;
• inflammation in ankylosing spondylitis (in this case, the capsules of the intervertebral joints thicken);
• Forestier's disease;
• cysts and tumors that appear inside the spinal canal.

Regardless of the cause, treatment for spinal stenosis should begin as soon as the disease is detected.

What's happened

First, it’s worth understanding what a carotid artery is: in the human body there are two carotid arteries, running from the chest through the sides of the neck to the head. Their main task is to nourish the brain. Like any artery, they are confirmed by atherosclerosis - a serious disease, the nature of which is not fully understood, as well as the causes. This disease manifests itself in the deformation of the walls of blood vessels, when the tissues lining the vessel grow, cholesterol deposits appear between them, and the lumen of the vessel becomes smaller and smaller until it becomes completely blocked (obstruction). Oxygen-enriched blood flows through the carotid arteries for brain cells, so narrowing the lumen of the vessel is very dangerous - it can cause a stroke.

Risk factors

There is a category of people who are most susceptible to the disease absolute spinal canal stenosis at the level of the lumbar, chest and neck. This disease predominantly affects older people. This is caused by age-related changes and degenerative spinal diseases. In the age group (50 years and older), this figure is 1.8-8%.

Most often, acquired spinal canal stenosis occurs at the level of l5 s1 and l4 l5 of the last stage of spinal osteochondrosis, that is, when the bone tissue of the vertebral bodies and osteophytes actively grows.

Decompression surgery of the cervical spine

Surgical interventions on the cervical spine can be performed through an anterior or posterior approach. In the first case, the surgeon “makes his way” from the spine through the tissue spaces of the neck, in the second, he cuts through the soft tissues from the back.

Anterior access.

Indications for operations with anterior access:

• kyphosis;
• MRI-verified anterior compression;
• the extent of stenosis is no more than 2 vertebrae;
• severe spinal instability.

During surgical interventions, doctors perform discectomy and spinal fusion. If there are no contraindications, they can install a dynamic DCI implant in place of the IVD. Surgeries with anterior access are traumatic and lead to the development of complications.

Surgical interventions with a posterior median approach are less invasive and safer. During these procedures, the specialist performs a laminectomy or laminoplasty. If necessary, he performs spinal fusion. The surgeon can use a variety of structures to fix the vertebrae.

Indications for operations with posterior access:

• the presence of extended posterior compression;
• cervical lordosis;
• identification of ossification of the posterior longitudinal ligament;
• congenital stenosis.

In case of osteoporosis, ligamentous insufficiency and a high probability of developing pseudarthrosis, doctors prefer operations with a posterior surgical approach.

Complications

If timely treatment of lumbar, cervical or thoracic spinal canal stenosis is not started, pathological manifestations of this disease are possible. Complications are also observed if there have been other spinal injuries (sports injury, fall from a height, etc.). In this case, increased compression of the spinal cord occurs. The resulting hematomas, scars, fragments of the spine, and displaced vertebrae can put pressure on it.

The most severe complications are:

• paresis;
• paralysis of limbs;
• pelvic disorders that manifest themselves due to damage to the nerve roots of the spinal cord with a surgical instrument;
• a slowly and gradually progressing adhesive process, which additionally compresses the roots and the spinal cord itself.

The most rare inflammatory processes occur in nerve elements, membranes and vertebrae. This is due to the fact that after surgery for lumbar spinal stenosis, strong antibiotics are used. But it is still not uncommon that the consequences after surgery of spinal stenosis of the lumbar, cervical and thoracic region give more severe consequences than the disease itself.

How to prevent laryngeal stenosis in children and adults - prevention

Prevention of laryngeal stenosis consists of:

• competent and timely treatment of diseases that can cause narrowing of the airways;
• exclude neck injuries;
• timely diagnosis and treatment of upper respiratory tract infections;
• refusal of long intubation (no more than 3 days);
• strict adherence to the timing of tracheostomy;
• observation by an otolaryngologist after laryngeal surgery;
• avoiding inhalation of caustic smoke, ingestion of acids and alkalis into the respiratory tract;
• carrying out allergen-specific and immune therapy;
• avoiding contact with allergens.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

Diagnosis of spinal canal stenosis

Any signs of spinal stenosis require urgent diagnosis of the disease. This allows you to either identify the disease or refute its presence. But if detected, it is possible to begin treatment to prevent the active development and progressive process of spreading relative spinal stenosis at any level.

In JSC "Medicine" (clinic of academician Roitberg), which is located in the central district of Moscow (not far from the Mayakovskaya, Belorusskaya, Novoslobodskaya, Tverskaya, Chekhovskaya metro stations), you can carry out a complete diagnosis of the spine. Doctors will prescribe the necessary treatment and, if necessary, give recommendations on how to prevent the disease. Our multidisciplinary medical center is located at 2nd Tverskoy-Yamskaya lane 10.

Stenosis of the spinal canal c5 c6 and other levels of various locations can be detected using lateral radiographs by calculating and assessing the M.N. index. Tchaikovsky (this is a certain ratio of the sagittal size of the canal to the sagittal indicator of the vertebral body).

If there are certain symptoms of lumbar spinal canal stenosis, additional examination methods are carried out to measure the size of the spinal canal and identify the main causes that cause compression of all nerve elements included in the system. This allows us to understand how to treat spinal stenosis.

Diagnosis can be carried out using:

• radiography;
• computed tomography (CT);
• magnetic resonance imaging (MRI).

To assess the condition of nerve conduction and the spinal cord, methods are used:

• electroneuromyography;
• myelography;
• scintigraphy.

Stenosis of the spinal canal l5 s1 and other levels is diagnosed based on the totality of identified signs of pathological narrowing. Experts can identify both relative spinal canal stenosis and degenerative spinal canal stenosis.

Classification and stages of development

Lateral and central spinal stenosis can be diagnosed. It depends on the localization. The first type is a reduction in the size of the opening between the vertebrae to 4 millimeters or less. But central spondyloarthrosis, spinal canal stenosis can be either relative (less than 12 mm) or absolute (less than 10 mm).

When all dimensions of the spinal canal change, combined stenosis is diagnosed, that is, spinal canal stenosis at level L4, as well as at other levels of development. Sagittal spinal canal stenosis is also distinguished.

Causes of the disease

To identify possible causes, it is necessary to first classify the disease into several types. There is congenital and acquired stenosis. Their reasons, of course, are different.

Congenital pathology

In turn, there are two types: lateral and central. In the first variant, the space in which the branches of the cerebral roots are located is narrowed (its other name is lateral).

In the second, the central canal is narrowed to a significant reduction in its volume.

When to see a doctor

At the first symptoms of spinal stenosis in the lumbar, cervical or thoracic region, you should consult a specialist. JSC "Medicine" (clinic of academician Roitberg), located in the center of Moscow (near Mayakovskaya metro station, Belorusskaya metro station, Novoslobodskaya metro station, Tverskaya metro station, Chekhovskaya metro station), offers the opportunity undergo professional diagnostics and effective treatment. The staff consists of highly qualified doctors. Treatment of spinal canal stenosis l4 l5 and other levels is carried out by:

• vertebrologist
• neurologist.

Specialists prescribe the optimal treatment method, taking into account the degree of development of the disease and the individual characteristics of the patient.

Prevention

To slow down the progression of the disease, you should choose the right special exercises.

Every day you should do exercises, dedicating at least 30 minutes to it. Aerobic training (in the form of swimming or walking) is recommended. Proper control of your body and good posture should become a habit.

Examples of treatment of stenosis at the A.N. Center for Pathology and Neurosurgery Baklanova

Treatment

Some cases allow you to resort to treatment without surgery for spinal stenosis. In the early stages of the disease, conservative methods are available. But this is only possible when there are no pronounced neurological disorders, and the patient is only bothered by pain in the lower back and legs.

Drug treatment of spinal canal stenosis l4 s1 and other levels is used:

• non-steroidal anti-inflammatory drugs. They help relieve inflammation and relieve pain;
• muscle relaxants. Relieves muscle tension;
• B vitamins;
• vascular and diuretics;
• drug blockades with local anesthetics and hormones. Relieves pain and swelling.

Also, for spinal canal stenosis at the l4 l5 level, physiotherapeutic procedures are prescribed. This includes:

• electrophoresis;
• amplipulse;
• physical therapy (physical therapy);
• magnetic therapy;
• light massage;
• water and mud therapy.

Exercises that do not put a lot of stress on the back, but at the same time perfectly develop the vertebrae, help with spinal stenosis.

How to treat laryngeal stenosis in children and adults

First aid for laryngeal stenosis in children and adults includes:

• calling an ambulance;
• giving the patient a semi-sitting position;
• opening the window;
• freeing the chest from constricting clothing;
• alkaline inhalations (for laryngeal stenosis, before the ambulance arrives, it is advisable for the patient to breathe saline solution).

Also, to improve the patient’s well-being, you can immerse his legs in warm water or rub them (this will reduce swelling for a while).

Treatment tactics for laryngeal stenosis depend on the cause of the disease:

• If the problem is caused by an allergic reaction, antihistamines and glucocorticoids are indicated (relieve swelling and inflammation).
• If the matter is a blockage of the larynx with a foreign body, you need to remove it immediately.
• If the pathology occurs as a result of infection, medications are needed to improve respiratory function and relieve swelling. Afterwards, antibacterial/antiviral therapy is carried out.
• In case of paralysis of the larynx, removal of the vocal cord along with the adjacent cartilage is indicated.

In case of asphyxia, doctors perform a tracheotomy - they make an incision on the front surface of the neck and insert a tube into the respiratory tract through which the patient can breathe. Intubation is also possible - a tube is inserted into the larynx, expanding its lumen. The duration of this procedure is no more than three days. But within a day you need to try to remove the mechanism that expands the larynx and see if the patient can breathe on his own.

Chronic, long-term, as well as congenital stenosis is treated with surgical methods:

• excision of tumor, scars;
• implantation of stents (tubes that prevent the larynx from narrowing).

There are specialized otolaryngology centers in Moscow

, which successfully cope with this problem.

How to make an appointment with a vertebrologist, neurologist

At the first symptoms of the disease, you need to go to the appropriate specialist: a vertebrologist, a neurologist. In the central district of Moscow, you can make an appointment with a doctor at JSC “Medicine” (clinic of Academician Roitberg), which is located near the Belorusskaya and Mayakovskaya metro stations. You can get to the medical center from the Novoslobodskaya metro station, and the Tverskaya metro station and Chekhovskaya metro station are also within walking distance.

If you doubt your diagnosis, then first you can visit a therapist, who, after an examination, will give a referral to the appropriate specialist at the clinic in the Central Administrative District: a vertebrologist, a neurologist.

You can make an appointment through a special application form, which is available on the clinic’s website. You can also do this by calling: +7 (495) 775-73-60. We are located at the address: Moscow, Central Administrative District, 2nd Tverskoy-Yamskaya lane 10. There is also the possibility of a consultation appointment, where you can receive all the recommendations for preventing the development of the disease.

Recovery after surgery for stenosis

After surgical decompression of the nerve endings and spinal roots, the pain in the limbs goes away immediately. Associated neurological symptoms (numbness and weakness) may take a little longer to resolve, depending on how long the patient has endured the symptoms and how much the disease has progressed. For several hours after surgery, the patient can stand and walk around the room. For 1-2 days (depending on the chosen method of surgery for stenosis), the patient is under the supervision of a doctor and medical staff. The doctor can then send him home with recommendations for the recovery period. After a month, it is advisable to come for a follow-up examination with a neurosurgeon - the doctor is always in touch and guides his patients until the recovery is successfully completed. The patient may be indicated for correction of motor habits. As a rule, no further additional restoration measures are required.

Lifestyle and Home Remedies

Regular visits to the doctor are necessary to monitor the condition. The doctor may recommend that the patient use several home treatments, including:

• Taking over-the-counter analgesics such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others), and acetaminophen (Tylenol, others) may help reduce pain and inflammation.
• Use of hot or cold packs. Some symptoms of cervical spinal stenosis can be relieved by applying heat or ice to the neck area.
• Maintaining a healthy weight. The patient should strive to maintain a healthy weight. If a patient is overweight or obese, the doctor may recommend that they lose weight. Losing excess weight can reduce pain and reduce excess stress on the back, especially the lumbar spine.
• Gymnastics. Stretching and strengthening exercises can help relieve stress on the spine and reduce compression of nerve structures.
• An exercise program to be carried out at home must be agreed upon with a physical therapy doctor.
• Using a cane or walker. In addition to providing stability, these assistive devices can help relieve pain by allowing the patient to lean forward while walking.

Preventive measures

Some simple steps will help prevent the development of lumbar spinal stenosis or quickly get rid of the problem if it has already arisen:

• It is necessary to visit a specialist’s office if you have any alarming symptoms, pain or discomfort.
• Weight should remain within normal limits so as not to cause excessive stress on the spine and other body systems.
• It is important to ensure that healthy physical activity is maintained - frequent walks, morning exercises, warm-up during the day during sedentary work.

Stenosis reduces the patient’s quality of life and inevitably brings discomfort. If you consult a doctor on time, when the pathology has not developed into a serious stage, it can be eliminated using conservative methods, without surgery. Surgical intervention is required when the situation is advanced, the stenosis progresses and disables the entire body.

Patients who have undergone surgery note that timely seeking qualified help could significantly simplify the situation. For a complete recovery, it is important to maintain a healthy lifestyle and consult a doctor on time.

Decompression procedure

In this procedure, needle-like instruments are used to remove part of the thickened ligament at the back of the spine to increase space in the spinal canal and eliminate impact on the nerve root. This decompression procedure is only reserved for patients with lumbar spinal stenosis and a thickened ligament.

The procedure is called percutaneous guided lumbar decompression (PILD).

Because PILD is performed without general anesthesia, it may be an option for some patients with high surgical risks due to underlying medical conditions.

Features of surgical treatment of complicated stenosis

In cases of spinal stenosis combined with spinal instability, the use of decompression or interspinous fixation systems alone is unacceptable. Surgical interventions will lead to even greater loosening of the spinal motion segments and aggravate the patient’s condition. In this case, the installation of front or rear stabilizing systems is considered optimal.

Titanium stabilizer.

If there are IVD hernias, a person undergoes a microdiscectomy or a classic discectomy. The first operation is usually supplemented with the installation of interspinous spacers, the second - with stabilization of the spine with a titanium cage.

Causes of coronary artery stenosis

The main cause of stenosis is atherosclerosis, in which cholesterol deposits accumulate on the walls of blood vessels, gradually forming plaques that block the lumen.

Also among the provoking factors include:

• anomalies in the development of coronary vessels (tortuosity, incorrect location);
• cardiomyopathy;
• endarteritis;
• systemic diseases (vasculitis, systemic lupus erythematosus, rheumatoid arthritis);
• benign and malignant tumors;
• heart transplantation.

Increase the risk of vasoconstriction:

• hereditary predisposition;
• hypertension;
• diabetes;
• pathologies of the thyroid gland;
• excess weight;
• sedentary lifestyle;
• smoking;
• frequent stress;
• elderly age.