Diagnosis and Treatment of Serious Spinal Stenosis
Severe degenerative changes related to arthritis are usually seen in x-ray images. However, the extent of spinal stenosis and severity of cord compression may be more properly evaluated with other imaging techniques such as CT scan, myelogram and MRI.
Conservative treatment using pain medications and physiotherapy are more effective for mild to moderate cases of spine arthritis. For serious spinal stenosis decompression of the spine with surgical methods is more effective.
Surgery must be considered when neurologic symptoms like numbness and weakness are present to prevent permanent loss of function or paralysis. This is also true to bowel and bladder problems which are more serious signs of nerve compression.
The goal of surgery, called laminectomy is to remove the pressure on the spinal cord and nerves so as to relieve pain and restore function. If the vertebrae are misaligned, spinal fusion may also be done to prevent cord damage. However, the procedure is not without risks, considering the delicate tissues involved and the general health condition of the elderly patients who are more commonly affected. Bleeding, blood clotting, infection and nerve damage are the more common complications of surgery which can prolong hospital stay and increase risk for mortality.
Other types of decompression surgery may also be done depending on the indication, such as laminotomy, foraminotomy, facetectomy, discectomy and corpectomy.
Although improvement of function and pain relief may be obtained after surgery, the aging process cannot be prevented, and degenerative changes will continue after treatment.