What if you often lose strength in your legs? It could be spinal stenosisNeurosurgeon Youngho Hong

 

 

 

 

 

 

1. What is spinal stenosis?

What is spinal stenosis?

 

The spinal canal is located in the middle of the spine and is the pathway through which nerves and spinal cord pass from the brain to the limbs. Degenerative changes begin in the discs between the bones of the spine, causing the discs and the spine to fall apart, narrowing the spinal canal due to the osteophytes formed in the shape of thorns, or thickening of the ligaments around the spinal canal and compressing the nerves, resulting in spinal stenosis. This can cause inflammation around the spinal canal, causing excruciating pain, and the thickened ligaments can compress the nerves, causing numbness, cramping, numbness, and muscle weakness.

 

What is the difference between spinal stenosis?

 

The spinal canal that appears to be narrowed by MRI scans is divided into three stages.

 

1. Mild stenosis

In the case of mild stenosis, the ligaments appear thickened when imaging, but the nerve cross-section is large and clearly visible. The spinal nerves are not compressed.

 

In moderate stenosis, the ligaments are slightly thicker than in mild cases, and the nerve cross-sections are seen to be small and blurry. There is a noticeable narrowing of the spinal canal rather than a mild one.

 

In the case of severe stenosis, the nerve cross-section is very narrowed on the image, and it is difficult to observe the cerebrospinal fluid between the nerves.

 

In this severe stage, stenosis is often ineffective with treatment, and symptoms such as numbness or weakness in the legs appear, making it difficult to walk, and in severe cases, even difficulty urinating, resulting in a decrease in the quality of life.

 

What are the step-by-step treatments for spinal stenosis?

 

There are different treatments that can be performed at different stages of spinal stenosis.

 

Even in mild cases of spinal stenosis, different treatments may be used depending on the severity of the symptoms. If the symptoms are not too severe, medication, physical and manual therapy is not performed directly. If the disease is more advanced, injection treatment may be performed.

 

In some cases, the treatment is lucky enough to improve and last for a long time, but in reality, the injection drug does not have a lasting effect, but rather a temporary reduction in inflammation and swelling.

 

In the case of moderate stenosis, epidural decompression is performed as a treatment. Epidural decompression is performed by inserting a tube into the end of the spinal canal and injecting drugs into the tube. At this time, the tube to be injected can be freely adjusted up, down, left and right, so it can be adjusted to the desired position, so it has the great advantage of being able to precisely treat the desired area.

 

In the case of severe stenosis, the quality of life is very poor, so surgical treatment is necessary. Among the surgical methods, bilateral spinal endoscopic surgery is recommended. The reason for this is that it has many advantages compared to conventional spine surgery.

 

First, the incision is very small. Conventional spinal cord surgery leaves an incision scar of about 4 cm, but in the case of bilateral spinal endoscopic surgery, it is very small, about 0.7 cm, so it will not be visible in the future. Second, there is little damage to muscles and normal tissues. Third, there is almost no bleeding. In the case of conventional spinal surgery, there is about 100~200cc of bleeding, but in bilateral spinal endoscopic surgery, there is almost no bleeding. Fourth, it is possible to have a quick procedure and leave the hospital quickly. The hospitalization period is about 3 days and 2 nights, which is significantly shortened compared to the 1~2 weeks of existing spine surgery, and it is a surgery that has great advantages in terms of patient convenience.