In medical practice, the term "stenosis" is used to refer to narrowing, diminishing the lumen and / or diameter of something. Therefore, if we are talking about stenosis of the cervical spinal canal, there is a decrease in the diameter of the cervical spine.
In most cases, stenosis is diagnosed in elderly patients, which is the basis for inclusion of the disease in the category of so-called.senile diseases. Along with this, young people are at risk of developing the disease. In their cases, the causes, as a rule, lie in the congenital pathologies of the spinal column.
The main symptoms of the pathology studied are painful sensations in the affected part of the spine, often "giving" to the lower limbs. Having become acquainted with the information below, you will get a full picture of the causes of the disease, its flow and manifestations, the procedure for diagnosing and subsequent treatment.
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- 5.3 Video - Cervical spinal stenosis
Causes and symptomsoccurrence of illness
For full understanding of the reasons of appearance of the studied pathological process, it is necessary, at least,nostno acquainted with the peculiarities of the anatomical structures of the spine.
The spine consists of tightly articulated arms and vertebral bodies. One of the most important components of the human body passes through the internal cavity of the canal - the spinal cord. In the interval between it and the walls of the internal canal is fatty tissue, as well as cerebrospinal fluid. By means of this kind of "interlayer", small decreases in the width of the channel that occur in the process of human activity are compensated.
If the channel is too narrow, squeezing of the nerve roots( in the worst case, the spinal cord itself) will occur. This will inevitably lead to the emergence of a variety of neurological syndromes.
scheme The narrowing of the canal can occur for various reasons. Most often as triggers are the following circumstances:
- trauma, hernia and various neoplasms;
- osteophytes( outgrowths);
- arthrosis;
- protrusions, etc.
In each of the above cases, stenosis is defined as a secondary disease progressing against the background of the underlying ailment.
Primary stenosis of the spinal canal is exclusively congenital and occurs due to disruption of the processes of normal development of the vertebrae. If such a pathology takes place, it will make itself felt at an early age.
Progression of stenosis is inevitably accompanied by disruptions in the processes of oxygen transport and, not least, of nutrients to the body of the spinal cord. Along with this, any physical activity requires increased consumption of oxygen and basic nutrients. In this pathological situation, there will be an increase in interstitial pressure in the spinal canal followed by vasoconstriction. As a result, the squeezed vessels can not provide the necessary blood circulation. As a result - painful sensations, weakness and other characteristic signs localized in the affected area.
Forms and varieties of the disease
Stenosis is classified by several indicators. First of all, according to anatomical criteria. About this in the following table.
Table. Anatomical classification of stenosis
Varieties of the disease | Description |
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Central stenosis | Characterized by a significant change in the size of the canal of the spine. There may also be a decrease in the lumen between the posterior plane of the vertebra and the nearest opposite point located on the arch. In addition, the central type of stenosis is classified into relative( the value of the gap is less than 1.2 cm) and absolute( decreases to 1 cm and further) forms. |
Lateral stenosis | The size of the canal and intervertebral foramen decreases to 4 mm or even more. |
The second common classification is based on the causes of stenosis. More details in the table.
Table. Classification according to the causes of
Causes of | illness Explanations |
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Disorders of formation and further development of the | skeleton Progression against the background of congenital spine pathologies. |
Degenerative changes | The disease progresses against a background of various ailments accompanied by degenerative-dystrophic disorders. As an example, the last stages of such a disease as osteochondrosis can be cited. |
Acquired non-degenerative causes of | In such conditions, stenosis develops as a complication of other diseases, as well as against the background of the injuries sustained. |
Combined causes of | Combinations of any of the above provoking factors. |
Symptoms and signs of the disease
The nature of the manifestation of stenosis depends on how the pathological process progresses.
- If the vertebral canal is narrowed, the patient experiences painful sensations, feels a breakdown, as well as heaviness in the neck. The intensity of symptoms and signs, as a rule, increases after physical exertion and decreases after rest. Also, relief may be noted after the adoption of certain positions of the neck.
- If stenosis is accompanied by squeezing the nerve roots, the patient feels acute and severe pain in the affected areas. Also, pain can be felt in the legs.
The risk of stenosis of the cervical region, among other things, is that the part of the channel that is located here already has a small clearance, so that any constrictions instantly give the patient painful and uncomfortable sensations.
Against the background of compression of the spinal cord in the studied area, myelopathy can occur, which is a serious disease of the neurological group and is accompanied by an excessive increase in muscle tone with the simultaneous appearance of weakness in the arms and legs. In parallel, the pathology of the pelvic organs may progress.
Diagnostic procedure
First of all, the specialist hears complaints of the patient and studies the existing medical history. The peculiarities of painful sensations, as well as their localization, interrelations with physical activity, etc. are revealed. Additionally, accompanying symptoms, for example, general weakness, sensitivity disorders, etc., are established.
For information on the diagnostic manipulations in use, see the table.
Table. Methods for diagnosing stenosis
Available methods | Description |
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Carried out for a preliminary diagnosis. As a result, a plan for a follow-up examination is developed, during which the diagnosis is either confirmed or refined. | |
A ubiquitous, fast, painless and informative enough method. Based on the results of the survey, visualization of the existing bone formations is carried out. The presence of stenosis will be indicated by the following: - decrease in the size of the intervertebral fissure; - formations in the form of osteophytes; - instability of the spine during special tests; - hypertrophy of joints. In addition, radiography allows you to diagnose existing lesions, fractures, various infections. As negative qualities of radiography, it should be noted that there is no possibility of visualization of soft tissues. For this reason, in most situations, MRI or CT is additionally used. | |
Informative and safe diagnosis. It is based on the use of radio-magnetic waves, which give an idea of the internal state of the whole body. The results of MRI give the maximum amount of necessary information to correctly diagnose and identify virtually any possible pathologies, including degenerative-dystrophic changes, which are often satellites of stenosis. | |
The study is based on the use of X-rays. However, here, in contrast to the previously considered radiography, the processing of information is handled by a computer. The specialist also receives images of slices similar to the results of MRI. This diagnostic study allows you to identify existing degenerative-dystrophic changes in bone tissue, as well as hypertrophies, various spurs, etc. In some situations, CT is performed in combination with a myelogram, which improves the visualization quality of the soft tissues studied. |
Methods of treatment
Having made sure of the presence of stenosis, the doctor will begin to develop a treatment program that is most optimal and effective for a specific clinical case. Treatment can be conservative or surgical. Here everything depends on the stage of the disease and its severity.
So, if pathology can be detected at the initial stages and without significant complications, try to do with conservative treatment. The decision as to the necessity, appropriateness and safety of surgical intervention is taken individually.
Features of conservative treatment
The rate for conservative treatment is made if the disease has a moderate degree of severity and progression.
The basis of conservative therapy - drug treatment, as well as methods of physiotherapeutic and massage effects. Of the drugs predominantly used painkillers and non-steroidal anti-inflammatory drugs selected by the doctor specifically for the patient, taking into account the peculiarities of his clinical case.
Sometimes resort to the introduction of hormonal drugs in the place of localization of pathology. This helps reduce the signs of inflammation, swelling and painful sensations. Glucocorticoid hormones, as a rule, are used in combination with short-acting anesthetics. Immediately hormonal injections facilitate the patient's well-being on average for 3-4 weeks.
It is important to understand and the fact that the use of steroids does not give the expected results in all situations. In accordance with the average statistical data, such treatment is effective only in 50-60% of cases. At the same time, steroid drugs are dangerous by a number of complications and adverse reactions, therefore, they are used only if there is no proper effectiveness of using other conservative methods.
Nuances of surgical intervention
The operation is performed in the presence of severe complications, unbearable pain and in case of any other threat to the health and life of the patient.
Surgical intervention in the spine is traumatic and requires the performer to have high qualifications and experience. In particular, it is difficult to carry out operations by patients of advanced age.
The main objective of surgical intervention is to eliminate pressure on the nerve roots and / or spinal cord. Specific methods of exposure are chosen by the physician individually.
Stay healthy!
Video - Cervical spinal stenosis
Find out what is the stenosis of the cervical spinal canal. Causes of appearance and features of the manifestation of the disease. Diagnosis and treatment. Photo + video.