Canal stenosis, as the name implies, is the decrease in the diameters of the lumbar canal where the end of the spinal cord and the cauda equina nerve roots, responsible for movement in the lower limbs and sphincter control, are located.
These normal diameters may be decreased congenitally or by a degenerative process.
This degenerative process begins at the age of 45 years. It is a very frequent process: 95% of men and 80% of women over 65 years of age present canal stenosis clinically or radiologically.
The clinical symptoms are mainly low back pain in the lower limbs and sensory disturbances in the lower limbs in the form of tingling, as well as loss of strength after walking more than 100 meters or less and relief of symptoms when sitting or standing and also when flexing the trunk over the pelvis and worsening when extending the trunk. This is why it is called the window dressing syndrome, as the patient has to stand for a few minutes for the symptoms to disappear.
The treatment of severe stenosis of the lumbar canal is laminectomy, which consists of removing the posterior part of the vertebra. Sometimes it is necessary to place transpedicular screws.
Recently, this technique can be replaced by another technique that solves the problem and makes the symptoms disappear. It is a very simple intervention, it is to place an interspinous device between the upper and lower vertebrae and progressively increasing the dimensions of the channel and the duct or hole through which the nerves pass. This device has no complications and the operation is performed in 30 minutes. The patient is discharged after 24 or 48 hours and after two weeks can lead a normal life.
This type of prosthesis can also be used in the treatment of patients with very bulky lumbar herniated discs.
Herniated lumbar disc
Another type of spinal pathology is the herniated disc. It is estimated that 80-90% of people will have back pain at some point in their lives. A large percentage of this pain is caused by disc herniation, a disorder that causes 9 out of 10 back problems.
Why operate?
Conservative treatment of disc herniation, i.e. non-surgical treatment, is sometimes effective. Fortunately, it is estimated that 20% of hernias are reabsorbed. But 80% of herniations do not disappear on their own.
At present, there are multiple therapeutic options, although not in all cases the solution is surgery. When the pain becomes acute and does not subside after following a rest regimen, surgery is the best option. Microsurgery is the most effective technique in the treatment of herniated discs, as it can be applied in all types of cases and has a success rate of 97%.