Spinal narrowing
About
This common condition due to ‘wear and tear’ (spondylosis) arthritic changes occurs, as we get older. This can squash the spinal cord or push all the nerve roots together causing symptoms in the arms or legs.
In the neck, the pressure on the spinal cord can cause deteriorating fine hand function (difficulty doing up buttons, picking up coins, holding normal cutlery) and problems with walking (‘feels as if you are walking on sponges’ or numb and clumsy legs). This type of spinal cord damage is a called cervical myelopathy.
In the lower back, the pressure on the nerve roots can cause a cramping / aching numbing sensation in the legs when walking. Bending forwards or resting may alleviate some of the symptoms. This is called neurogenic claudication.
Many patients will also have back or neck pain due to these ‘wear and tear; changes. Unfortunately, in the absence of any red flags surgery is not a treatment for this type of degenerative spinal pain.
**If you develop severe pain in both legs, difficulty in passing urine, incontinence, or loss of sensation around your genitals, then you should attend your nearest A&E department as a matter of emergency**
Treatments:
- Gentle exercise and simple analgesia (ibuprofen)
- Physiotherapy
- Anterior cervical discectomy and fusion
- Posterior cervical laminectomy
- Lumbar laminectomy
Outcomes:
- 80% of patients improve following surgery, with the majority seeing a significant improvement in their neurological symptoms (especially those symptoms that have developed in the last 3 months).
- A few patients will have a technically successful operation but continue to have symptoms due to persisting nerve injury
- A few patients will go on to develop scar tissue or a recurrent narrowing, causing recurrent symptoms which can be difficult to manage
In addition to an outpatient assessment and examination you may require an MRI scan if your symptoms persist. (Most patients with a slipped disc will improve without surgical treatment within 6 weeks). An MRI scan is a powerful magnet that creates a picture of your spine without any radiation exposure. The scanner is a long tunnel. The modern scanners now available are less narrow and do not cause claustrophobia for most patients. It is still fairly noisy during the scan however as the magnet clicks on and off.
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