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Lumbar Spinal Canal Stenosis Treatment In India At Affordable Low Cost

 

Lumbar Spinal Canal Stenosis 

Stenosis means closing in. Spinal stenosis describes a condition in which the nerves in the spinal canal are closed in, or compressed. The spinal canal is the hollow tube formed by the bones of the spinal column. Anything that causes this bony tube to shrink can squeeze the nerves inside...

 

What part of the back is involved?

1 ] Vertebrae and Spinal Column : - The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to create the spinal column. The spinal column gives the body its form. It is the body's main upright support...

 

2 ] Spinal Canal and Spinal Cord : - The back portion of the spinal column forms a bony ring. When the vertebrae are stacked on top of each other, these bony rings create a hollow tube. This bony tube, called the spinal canal, surrounds the spinal cord as it passes through the spine...

 

3 ] Intervertebral Disc : - An intervertebral disc fits between each vertebral body and provides a space between the spine bones. The disc normally works like a shock absorber..

 

Causes of Lumbar Spinal Canal Stenosis

 

Why do I have this problem?

In the lumbar spine, the spinal canal usually has more than enough room for the spinal nerves. The canal is normally 17 to 18 millimeters around, slightly smaller than a penny. Spinal stenosis develops when the canal shrinks to 12 millimeters or less. When the size drops below 10 millimeters, severe symptoms of lumbar spinal stenosis occur. 

There are many reasons why symptoms of spinal stenosis develop. Some of the more common reasons include : -

1 ] Congenital Stenosis : - Some people are born with (congenital) a spinal canal that is narrower than normal. They may not feel problems early in life. However, having a narrow spinal canal puts them at risk for stenosis. ..

 

2 ] Degeneration : - Degeneration is the most common cause of spinal stenosis. Wear

and tear on the spine from aging and from repeated stresses and strains can cause many problems in the lumbar spine...

 

3 ] Spinal Instability : - Spinal instability can cause spinal stenosis. Spinal instability means that the bones of the spine move more than they should. Instability in the lumbar spine can develop if the supporting ligaments have been stretched or torn from a severe back injury...

 

4 ] Disc Herniation : - Spinal stenosis can occur when an intervertebral disc in the low back herniates (ruptures). Normally, the shock-absorbing disc is able to handle the downward pressure of gravity and the strain from daily activities...

 

Symptoms of Lumbar Spinal Canal Stenosis

 

What does the spinal stenosis feel like?

Spinal stenosis usually develops slowly over a long period of time. This is because the main cause of spinal stenosis is spinal degeneration in later life.

 

1 ] Pain and Weakness in Legs : - Patients with stenosis don't always feel back pain. Primarily, they have pain and weakness in their legs, usually in both legs at the same time...

 

2 ] Affected Sensation / Slow Reflexes : - Symptoms mainly affect sensation in the lower limbs. Nerve pressure from stenosis can cause a feeling of pins and needles in the skin where the spinal nerves travel...

 

Diagnosis of Lumbar Spinal Canal Stenosis

 

How do doctors diagnose the problem ?

Diagnosis begins with a complete history and physical examination. Your doctor will ask questions about your symptoms and how your problem is affecting your daily activities...

1 ] Physical Examination : - The doctor does a physical examination to see which back movements cause pain or other symptoms. Your skin sensation, muscle strength, and reflexes are also tested...

 

2 ] X-rays : - X-rays can show if the problems are from changes in the bones of the spine. The images can show if degeneration has caused the space between the vertebrae to collapse. X-rays may also show any bone spurs sticking into the spinal canal...

 

3 ] MRI : - When more information is needed, your doctor may order a magnetic resonance imaging (MRI) scan. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body...

 

4 ] CT Scan : - Computed tomography (a CT scan) may be ordered. The CT scan is a detailed X-ray that lets your doctor see slices of bone tissue..

 

5 ] EMG (Electromyogram) : - When the diagnosis is still not clear, doctors may recommend electrical tests of the nerves that go to the legs and feet...

 

6 ] SSEP (Somatosensory Evoked Potential) : - Doctors may also order a somatosensory evoked potential (SSEP) test to locate more precisely where the spinal nerves are being squeezed...

 

7 ] Blood Tests : - Not all causes of spinal stenosis are from degenerative conditions. Doctors use blood tests to determine whether symptoms are coming from other conditions, such as arthritis or infection....

 

Treatment

 

What treatment options are available?

Nonsurgical Treatment

1 ] Immobilization : - At first, doctors may prescribe ways to immobilize the spine. Keeping the back still for a short time can calm inflammation and pain...

2 ] Lumbar Support : - A lumbar support belt or corset may be prescribed, though their benefits are controversial. The support can limit pressure in the discs and prevent extra movement in the spine...

3 ] Medications : - Doctors sometimes prescribe medication for patients with spinal stenosis. Patients may be prescribed anti-inflammatory medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin...

4 ] Injections : - Some patients are given an epidural steroid injection (ESI). The spinal cord is covered by a material called dura. The space between the dura and the spinal column is called the epidural space...

5 ] Therapy and Exercise : - Patients often work with a physical therapist. By evaluating your condition, your therapist can assign positions and exercises to ease your symptoms. Your therapist may suggest using traction. Traction is a common treatment for stenosis. It gently stretches the low back, taking pressure off the spinal nerves...

 

B ] Surgery of Lumbar Spinal Canal Stenosis

If the symptoms you feel are mild and there is no danger they'll get worse, surgery is not usually recommended.

The main surgical procedures used to treat spinal stenosis are :

1 ] Lumbar Laminectomy : - The lamina is the covering layer of the bony ring of the spinal column. It forms a roof-like structure over the back of the spinal canal. When the nerves in the spinal canal are being squeezed by a herniated disc or bone spurs, a lumbar laminectomy removes the entire lamina to release pressure on the spinal nerves. This is the primary type of surgery used for lumbar spinal stenosis...

 

2 ] Posterior Lumbar Fusion : - A posterior lumbar fusion may be needed after a surgeon performs a lumbar laminectomy. The fusion procedure is recommended when a spinal segment has become loose or unstable...

 

Rehabilitation

Even if you don't need surgery, your doctor may recommend that you work with a physical or occupational therapist. Patients are normally seen a few times each week for one to two months. In severe cases, patients may need a few additional weeks of care...

 

After Surgery

After surgery, surgeons may have their patients work with a physical or occupational therapist. Patients who've had fusion surgery normally need to wait two to three months before beginning a rehabilitation program. They will probably need to attend therapy sessions for six to eight weeks and should expect full recovery to take up to six months...

 

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will avid shorty brakes work with standard shimano shifter levers?

I have bought a felt cross frame, and am trying to build it up with components from other bikes I have owned. I bought avid shorty 6 brakes, which are a cantilever brake. I was getting ready to install them when I noticed in the installation instructions that they are supposed to be used for brake levers designed for center pull brakes. I intended to use my old 105 or dura ace levers designed for sidepull brakes. Is this going to be a problem?

They'll work just fine. Traditional center-pull, cantilever brakes are designed to work with short pull, high tension brake levers like you find on a road bike. What you don't want to use are long pull levers like you would use on a mountain bike with linear pull (Vee) brakes.

Sheldon Brown has a good article on the theory of cantilever brake and brake lever compatibility. Here is the link:

http://www.sheldonbrown.com/cantilever-adjustment.html

Also, cantilever brakes do not have the stopping power of caliper brakes like your road bike has or linear pull brakes like many mountain bikes are fitted with. To get the best stopping power, they need to be pretty finely adjusted.

Here is another Sheldon Brown article on cantilever brake adjustment:

http://www.sheldonbrown.com/canti-trad.html.

Parktool also has a great article on adjusting cantilever brakes that includes lots of pictures.

http://parktool.com/repair/readhowto.asp?id=19

Hope this helps

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