Disc Problems After 2 Surgeries in Neck Losing Feeling in Right Arm Again

Overview

Spinal stenosis is a narrowing of space around the spinal cord itself and the nerve roots that branch off your spinal cord.

What is spinal stenosis?

Spinal stenosis is the narrowing of one or more spaces within your spine. Less space inside your spine reduces the amount of space available for your spinal cord and nerves that branch off your spinal cord. A tightened space can cause the spinal string or nerves to go irritated, compressed or pinched, which tin pb to back hurting and sciatica.

Spinal stenosis ordinarily develops slowly over time. It is most commonly caused by osteoarthritis or "wear-and-tear" changes that naturally occur in your spine every bit yous age. For this reason, yous may non accept any symptoms for a long time even though some changes might be seen on X-rays or other imaging tests if taken for another reason. Depending on where and how astringent your spinal stenosis is, you might feel pain, numbing, tingling and/or weakness in your neck, back, artillery, legs, hands or feet.

Normal spine with no narrowing of the space effectually the spinal cord or nervus roots exiting the spinal column.

Where does spinal stenosis occur?

Spinal stenosis can occur anywhere along the spine but nearly unremarkably occurs in two areas:

• Lower back (lumbar canal stenosis).
• Cervix (cervical spinal stenosis).

What is lumbar canal stenosis?

Lumbar canal stenosis is the narrowing of the spinal canal or the tunnels through which nerves and other structures communicate with that canal. Narrowing of the spinal culvert unremarkably occurs due to changes associated with aging that subtract the size of the canal, including the movement of one of the vertebrae out of alignment.

The narrowing of the spinal canal or the side canals that protect the nerves ofttimes results in a pinching of the nerve root of the spinal cord. The nerves become increasingly irritated every bit the bore of the canal becomes narrower.

Symptoms of lumbar canal stenosis include pain, numbness or weakness in the legs, groin, hips, buttocks, and lower back. Symptoms commonly worsen when walking or continuing and might decrease when lying down, sitting, or leaning slightly forward.

Who gets spinal stenosis?

Spinal stenosis tin develop in anyone but is most common in men and women over the age of l. Younger people who are born with a narrow spinal canal can likewise have spinal stenosis. Other conditions that affect the spine, such as scoliosis, or injury to the spine can put you at take chances for developing spinal stenosis.

What are the parts of the spine?

Your spine (or backbone) is a stack or column of 24 bones (vertebrae) plus the fused bones of the sacrum and coccyx. It begins at the base of your skull and ends at your pelvis. Your spine supports your body's weight and protects your spinal string. Each vertebrae has a round front portion (the body), a fundamental band-shaped opening (the spinal canal), flat bony areas (facet joints) where 1 vertebrae comes into contact with others above and beneath it, and bone sections along the sides (transverse processes) and dorsum (laminae). Part of the lamina called the spinous process is the ridge you feel when you run your hand downward your back. Between each vertebrae torso is a flat, round pad called an intervertebral disk that serves every bit a cushion or shock absorber. Ligaments are strong fiber bands that hold the vertebrae together, go on the spine stable and protect the disks.

The spinal cord – the body's "master cable cord" that sends and receives messages betwixt the body (including muscles and organs) and the brain – runs through the heart of the spinal canal. It is completely surrounded by the bony parts of the spine. Nerves roots are the initial segment of a parcel of nerve fibers that come off the spinal cord and exit the spinal column through side spaces between the vertebrae called the neural foramen. The nerve fibers or "fretfulness" (the "mini cable network") then get out to all parts of the body.

Symptoms and Causes

What causes spinal stenosis?

Spinal stenosis has many causes. What they share in common is that they modify the structure of the spine, causing a narrowing of the infinite around your spinal cord and nerves roots that exit through the spine. The spinal cord and/or nerve roots become compressed or pinched, which causes symptoms, such every bit depression back pain and sciatica.

The causes of spinal stenosis include:

• Os overgrowth/arthritic spurs: Osteoarthritis is the "wear and tear" condition that breaks down cartilage in your joints, including your spine. Cartilage is the protective covering of joints. As cartilage wears away, the bones begin to rub against each other. Your body responds past growing new bone. Bone spurs, or an overgrowth of bone, commonly occurs. Bone spurs on the vertebrae extend into the spinal canal, narrowing the space and pinching nerves in the spine. Paget's disease of the os as well tin can also cause on overgrowth of bone in the spine, compressing the fretfulness.
• Bulging disks/ herniated disk : Between each vertebrae is a flat, round cushioning pad (vertebral disk) that acts equally shock absorbers along the spine. Age-related drying out and flattening of vertebral disks and cracking in the outer edge of the disks cause the gel-like heart of these disks to break through a weak or torn outer layer. The bulging disk then press on the nerves near the deejay.

Herniated disks and bone spurs are 2 common causes of spinal stenosis.

• Thickened ligaments: Ligaments are the cobweb bands that concord the spine together. Arthritis can crusade ligaments to thicken over time and bulge into the spinal canal space.
• Spinal fractures and injuries: Broken or confused bones and inflammation from damage occurring near the spine can narrow the canal space and/or put pressure on spinal nerves.
• Spinal cord cysts or tumors: Growths within the spinal cord or betwixt the spinal cord and vertebrae can narrow the infinite and put force per unit area on the spinal cord and its nerves.
• Congenital spinal stenosis: This is a status in which a person is born with a small spinal culvert. Another congenital spinal deformity that can put a person at hazard for spinal stenosis is scoliosis (an abnormally shaped spine).

What are the symptoms of spinal stenosis?

You lot may or may not have symptoms when spinal stenosis first develops. The narrowing of the spinal canal is usually a slow process and worsens over time. Although spinal stenosis tin can happen anywhere along the spinal column, the lower back (number one most mutual area) and neck are common areas. Symptoms vary from person to person and may come and go.

Symptoms of lower back (lumbar) spinal stenosis include:

• Pain in the lower back. Pain is sometimes described as dull ache or tenderness to electric-like or burning sensation. Hurting can come up and become.
• Sciatica. This is pain that begins in the buttocks and extends down the leg and may keep into your foot.
• A heavy feeling in the legs, which may lead to cramping in one or both legs.
• Numbness or tingling ("pins and needles") in the buttocks, leg or foot.
• Weakness in the leg or pes (as the stenosis worsens).
• Pain that worsens when standing for long periods of time, walking or walking downhill.
• Pain that lessens when leaning, bending slightly frontward, walking uphill or sitting.
• Loss of bladder or bowel control (in severe cases).

Symptoms of cervix (cervical) spinal stenosis include:

• Neck pain.
• Numbness or tingling in the arm, hand, leg or foot. (Symptoms tin be felt anywhere below the point of the nerve compression.)
• Weakness or clumsiness in the arm, hand, leg or foot.
• Bug with balance.
• Loss of part in hands, like having problems writing or buttoning shirts.
• Loss of float or bowel command (in severe cases).

Symptoms of abdomen (thoracic) spinal stenosis include:

• Pain, numbness, tingling and or weakness at or below the level of the belly.
• Issues with balance.

Can spinal stenosis cause permanent paralysis?

While the narrowing of the spine can cause pain, it usually doesn't crusade paralysis. However, if a spinal nervus or the spinal string is compressed for a long period of fourth dimension, permanent numbness and/or paralysis is possible. This is why it is especially of import to see your healthcare provider right away if y'all experience numbness or weakness in your arms or legs.

Diagnosis and Tests

How is spinal stenosis diagnosed?

Your healthcare provider will review your medical history, ask nearly your symptoms and conduct a physical exam. During your physical exam, your healthcare provider may feel your spine, pressing on different expanse to see if this causes pain. Your provider will probable ask you to bend in different directions to see if different spine positions bring on pain or other symptoms. Your provider will bank check your residuum, watch how you motility and walk and check your arm and leg strength.

You will have imaging tests to examine your spine and determine the exact location, type and extent of the problem. Imaging studies may include:

• X-rays: 10-rays use a minor amount of radiation and can show changes in bone structure, such as loss of disk height and evolution of bone spurs that are narrowing the space in the spine.
• MRI: Magnetic resonance imaging (MRI) uses radio waves and a powerful magnet to create cross-sectional images of the spine. MRI images provide detailed images of the nerves, disks, spinal cord and presence of any tumors.
• CT or CT myelogram: A computed tomography (CT) scan is a combination of 10-rays that creates cross-exclusive images of the spine. A CT myelogram adds a dissimilarity dye to more than clearly see the spinal cord and nerves.

Direction and Treatment

What are the treatments for spinal stenosis?

Choice of stenosis treatments depend on what is causing your symptoms, the location of the problem and the severity of your symptoms. If your symptoms are mild, your healthcare provider may recommend some self-care remedies get-go. If these don't work and as symptoms worsen, your provider may recommend physical therapy, medication and finally surgery.

Self-help remedies include:

• Use oestrus: Heat usually is the better choice for pain due to osteoarthritis. Heat increases blood flow, which relaxes muscles and relieves aching joints. Be careful when using heat – don't set the settings also loftier then y'all don't get burned.
• Apply cold: If estrus isn't easing your symptoms, try ice (an ice pack, frozen gel pack, or frozen pocketbook of peas or corn). Typically water ice is applied xx minutes on and 20 minutes off. Ice reduces swelling, tenderness and inflammation.
• Practice: Bank check with your healthcare provider first, but exercise is helpful in relieving hurting, strengthening muscles to support your spine and improving your flexibility and residual.

Non-surgical treatments include:

• Oral medications: Nonsteroidal anti-inflammatory medications (NSAIDs) – such as ibuprofen (Advil®, Motrin®), naproxen (Aleve®), aspirin – or acetaminophen (Tylenol®) can help relieve inflammation and provide pain relief from spinal stenosis. Exist sure to talk with your healthcare provider and learn nearly possible long-term problems of taking these medicines, such as acid reflux and stomach ulcers. Your healthcare provider may besides recommend other prescription medications with pain-relieving backdrop, such equally the anti-seizure drug gabapentin (Neurontin®) or tricyclic antidepressants such as amitriptyline (Elavil®). Opioids, such as oxycodone (Oxycontin®) or hydrocodone (Vicodin®), may exist prescribed for short-term pain relief. However, they are usually prescribed with circumspection since they tin become habit forming. Muscle relaxants such every bit cyclobenzaprine (Amrix®, Fexmid®) tin can treat muscle camps and spasms.
• Physical therapy: Physical therapists will work with you to develop a dorsum-good for you exercise program to help you gain forcefulness and better your balance, flexibility and spine stability. Strengthening your dorsum and abdominal muscles — your core — will brand your spine more resilient. Physical therapists can teach you how to walk in a way that opens up the spinal canal, which can help ease pressure on your nerves.
• Steroid injections: Injecting corticosteroids near the space in the spine where nerve roots are being pinched or where worn areas of bone rub together tin aid reduce inflammation, pain and irritation. Nevertheless, merely a limited number of injections are usually given (typically iii or 4 injections per year) because corticosteroids can weaken basic and nearby tissue over fourth dimension.
• Decompression procedure: This outpatient procedure, also known equally percutaneous prototype-guided lumbar decompression (PILD), specifically treats lumbar spinal stenosis caused by a thickening of a specific ligament (ligamentum flavum) in the back of the spinal cavalcade. It is performed through a tiny incision and requires no general anesthesia and no stitches. The process is guided by an Ten-ray and a contrast amanuensis that is injected during the procedure. The surgeon uses special tools to remove a section of the thickened ligament, which frees up infinite within the spinal canal, reducing compression on nerve roots. Some of the advantages of this procedure are that the bony architecture of the spine is left intact and there is piddling disruption in the mechanics of the spine so people recovery quickly. People ordinarily go home a couple hours after the process and begin walking and/or concrete therapy soon thereafter. Compared with earlier the process, you will exist able to walk and stand for longer periods of fourth dimension and feel less numbness, tingling and muscle weakness.

When is spinal stenosis surgery considered?

Because of the complexity of spinal stenosis and the delicate nature of the spine, surgery is usually considered when all other treatment options take failed. Fortunately, nigh people who have spinal stenosis don't need surgery. All the same, talk with your healthcare provider most surgical options when:

• Your symptoms are intolerable, you no longer have the quality of life you desire and y'all can't do or enjoy everyday life activities.
• Your pain is caused by force per unit area on the spinal cord.
• Walking and maintaining your balance has go hard.
• Yous accept lost bowel or float control or accept sexual function issues.

What are the surgical treatments for spinal stenosis?

Surgery options involve removing portions of bone, bony growths on facet joints or disks that are crowding the spinal canal and pinching spinal fretfulness.

Types of spine surgery include:

Laminectomy (decompression surgery): The most common type of surgery for this condition, laminectomy involves removing the lamina, which is a portion of the vertebra. Some ligaments and os spurs may too be removed. The procedure makes room for the spinal cord and nerves, relieving your symptoms.

In a laminectomy, the lamina portion of the vertebral bone is removed.

Laminotomy: This is a partial laminectomy. In this procedure, only a small-scale office of the lamina is removed – the expanse causing the most pressure on the nerve.

Laminoplasty: In this procedure, performed in the cervix (cervical) area only, part of the lamina is removed to provide more than culvert space and metallic plates and screws create a hinged bridge across the surface area where bone was removed.

Foraminotomy: The foramen is the area in the vertebrae where the nerve roots exit. The procedure involves removing bone or tissue this area to provide more space for the nervus roots.

Interspinous process spaces: This is a minimally invasive surgery for some people with lumbar spinal stenosis. Spacers are inserted between the bones that extends off the back of each vertebrae chosen the barbed processes. The spacers help go on the vertebrae apart creating more space for nerves. The procedure is performed under local anesthesia and involves removing part of the lamina.

Spinal fusion: This procedure is considered if y'all have radiating nerve hurting from spinal stenosis, your spine is not stable and you have not been helped with other methods. Spinal fusion surgery permanently joins (fuses) two vertebrae together. A laminectomy is unremarkably performed beginning and bone removed during this procedure is used to create a bridge between two vertebrae, which stimulates new bone growth. The vertebrae are held together with screws, rods, hooks or wires until the vertebrae heal and abound together. The healing process takes six months to one year.

Is spinal surgery safe? What are the risks of surgery for spinal stenosis?

All surgeries take the risks of infection, bleeding, blood clots and reaction to anesthesia. Additional risks from surgery for spinal stenosis include:

• Nerve injury.
• Tear in the membrane that covers the nerve or spinal cord.
• Failure of the bone to heal after surgery.
• Failure of the metal plates, screws and other fasteners.
• Need for additional surgery.
• No relief of symptoms/return of symptoms.

How do I prepare for spinal stenosis surgery?

To gear up for spine surgery, quit smoking if you fume and exercise on a regular basis (after checking with your healthcare provider first) to speed your recovery time. Ask your provider if you need to stop taking any not-essential medications, supplements or herbal remedies that you lot may be taking that could react with anesthesia. Also, never hesitate to inquire your healthcare team whatever questions y'all may accept or discuss any concerns.

What happens later spinal surgery?

If you've had a laminectomy, you may exist in the infirmary for a day or two. If you lot've had spinal fusion, you may have a 3- to 5-24-hour interval hospital stay. If yous're older, you may be transferred to a rehabilitation facility to receive boosted care before going domicile.

Y'all will be given pain medications and/or NSAIDs to reduce hurting and swelling. You may be given a brace or corset to clothing for comfort. You will likely be encouraged to get upwards and walk equally presently every bit possible. Your healthcare provider or physical therapist will recommend a light form of practise right after spinal surgery to insure that your back does not stiffen and to reduce swelling. Your physical therapist volition develop an individualized do program to stretch and strengthen muscles to support your dorsum and stabilize your spine.

Taking hot showers and using hot compresses may help alleviate pain. Additionally, using an ice pack may ease pain before and later on exercise.

How long is the recovery flow subsequently spinal stenosis surgery?

Full recovery afterward surgery for spinal stenosis and return to normal activities typically takes three months and possibly longer for spinal fusion, depending partially on the complexity of your surgery and your progress in rehabilitation.

When can I return to work subsequently spinal surgery?

If you've had a laminectomy, you volition likely be able to go back to work at a desk job within a few days of returning home. If you've had spinal fusion, y'all'll likely be able to return to piece of work a few weeks later on your surgery.

Prevention

Can spinal stenosis be prevented?

Since most causes of spinal stenosis are normal age-related "wear and tear" conditions, such as osteoarthritis and loss of bone and muscle mass, you can't 100% prevent spinal stenosis. However, you tin can take certain measures to lower your take chances or tiresome the progression, including:

• Eat a good for you diet and maintain an ideal body weight.
• Don't fume. If yous do smoke, quit. Inquire your healthcare provider for assistance to quit.
• Maintain good posture.
• Exercise. Avert exercises that crusade pain but do stay agile. Check with your healthcare provider or concrete therapist before starting a home exercise program. Likewise much rest tin can be more harmful than helpful.

Also keep in mind that although in that location is no "cure" for spinal stenosis, its symptoms can exist successfully managed with the nonsurgical or surgical options discussed in this article.

Outlook / Prognosis

What can I await if I accept spinal stenosis?

First, spinal stenosis develops slowly over time, so you may not have symptoms even though changes are occurring in your spine. Your first noticeable symptoms may be pain, numbness, tingling or weakness in your back or neck or artillery and legs depending on the location of the stenosis. Conservative treatments – such every bit hurting-relieving and anti-inflammatory medicines, ice or rut, and physical therapy – may exist enough to relieve pain for a period of time. As stenosis worsens and your quality of life is no longer acceptable to yous, talk with your healthcare provider. Most people who undergo spinal stenosis surgery achieve good to splendid results with pain relief. Surgery results depend on your general health and presence of other medical conditions, severity and location of your spinal stenosis, experience and skills of your surgeon and your commitment to your recovery programme.

Living With

Can spinal stenosis be reversed? Can spinal stenosis get ameliorate?

No, spinal stenosis can't be reversed but the procedure might be able to exist slowed if y'all take skillful care of yourself by maintaining a good for you weight, eating salubrious foods, exercising regularly to keep your basic and muscles stiff, and following your healthcare provider'due south instructions to best manage any existing medical conditions you may take. If you do develop symptoms, there are many options – upwards to and including surgery – that can be considered to salvage your pain and other symptoms so yous experience better.

Can spinal stenosis heal on its own?

Generally no considering the most common causes of spinal stenosis is normal age-related "wear and tear" on the bones and structures of the spine. However, if the cause of your spinal stenosis is a herniated disk, information technology can sometimes get ameliorate on its own with a short amount of rest or with treatments such every bit physical therapy, anti-inflammatory medications or spinal injections.

Can spinal stenosis happen in more one area of the spine at the same time?

Yeah. Spinal stenosis can happen in multiple locations at the aforementioned time, such as in both the lower back (lumbar spine) and neck (cervical spine).

Tin spinal stenosis cause pain in my groin, hip, thigh and calf?

Yep, this is certainly possible. If your spinal stenosis is pinching your sciatic nervus – a nerve that originates in your lower (lumbar) spine – you might feel pain or have numbness, tingling or musculus weakness along this nerve's pathway from your lower back, down your leg to your pes. This status is known every bit sciatica.

What types of healthcare professionals might exist involved in my care if I have spinal stenosis?

In additional to your regular healthcare provider, you may exist seen by a squad of healthcare professionals that could include:

• A rheumatologist to treat arthritis and related disorders.
• A neurologist to treat nerve disorders.
• An orthopaedic surgeon to operate on bones.
• A neurosurgeon to operate on conditions affecting the nervous system.
• A pain management specialist to command hurting and discomfort.
• A radiologist to interpret imaging studies such as X-rays, CT and MRI scans.
• A concrete therapist to develop a healthy back and back surgery recovery practise programme.
• A physiatrist/rehabilitation specialist to treat dorsum pain using nonsurgical approaches.
• An acupuncturist to administer acupuncture therapy.
• A chiropractor to manipulate your spine and related muscles, ligaments and bones.

Tin alternative treatments, such every bit acupuncture or chiropractics, help salve pain from spinal stenosis?

Acupuncture and chiropractic manipulation may assistance relieve mild pain in some people with spinal stenosis. It'southward important to go on in mind that similar to other nonsurgical treatments, these alternative therapies don't better the narrowing of the spinal canal. As well, chiropractic manipulation must be used in the proper person. For case, manipulation may worsen symptoms or cause other injuries if a herniated disk is the crusade of your spinal stenosis. That existence said, alternative therapies are increasingly popular and are used to treat and manage all kinds of pain. Be sure to inquire your healthcare provider if these alternative treatments also as others, like yoga, massage or biofeedback, may be safe and appropriate to manage the cause of your spinal pain.

What medical problems tin be confused with spinal stenosis?

Medical problems that can sometimes mimic spinal stenosis include neuropathy, peripheral artery illness, diabetes-related neuropathy and inflammatory arthritis, such equally ankylosing spondylitis. Rare, but nonetheless other possible medical conditions that might be mistaken for spinal stenosis include cancer and abdominal aortic aneurysms.

A note from Cleveland Clinic

• Spinal stenosis is the narrowing of the spaces inside the spine, which eventually results in pressure on the spinal cord or nerve roots.
• Symptoms of spinal stenosis vary widely from person to person and range from no symptoms to pain in the dorsum or neck and numbness, tingling and weakness in the artillery and/or legs.
• Handling depends on the severity and location of the stenosis and its effects on the quality of your life. Treatment usually starts with nonsurgical options and may move to surgical options if other methods no longer relieve your hurting.
• Although at that place is no cure for spinal stenosis, exercise to keep your muscles strong, better your flexibility and reduce pain. Ever bank check with your provider before starting any exercise or move program.
• If needed, utilise assistive devices such as a cane or walker to safely move about.
• Find positions that relieve your hurting. A slight forward lean, for case, may relieve hurting if you take lumbar spinal stenosis. Ask for a referral to a physical therapist who can develop an individualized exercise program for you.

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Source: https://my.clevelandclinic.org/health/diseases/17499-spinal-stenosis

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