Stenosis
Serving the South Florida and Orlando Areas
Dr. Andreas C. Tomac, MD, PhD, FAANS is a distinguished neurosurgeon specializing in diagnosing and treating Stenosis.
What is a Stenosis?
Spinal stenosis refers to the narrowing of the spinal canal or neural foramina, which are the openings through which nerves exit the spinal cord. This narrowing can exert pressure on the spinal cord or nerve roots, leading to a range of symptoms. Stenosis can occur in various regions of the spine, with lumbar stenosis (affecting the lower back) and cervical stenosis (affecting the neck) being common. Causes of spinal stenosis include degenerative changes associated with aging, such as the thickening of ligaments and the formation of bone spurs. Symptoms may include pain, numbness, weakness, or tingling in the affected area, and these symptoms can be aggravated by certain movements or activities. Diagnosis typically involves imaging studies such as Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans. Treatment options range from conservative measures, including physical therapy and medications, to surgical interventions aimed at relieving pressure on the spinal cord or nerves.
Who can it affect?
Spinal stenosis can affect individuals across various age groups, although it is more commonly observed in older adults. As a degenerative condition, the risk of developing spinal stenosis increases with age due to the natural wear-and-tear on the spine over time. However, it can also affect younger individuals, particularly those with congenital conditions or a history of spine-related injuries. Other risk factors include a family history of spinal disorders, certain medical conditions like arthritis, and lifestyle factors such as obesity. While spinal stenosis is often associated with aging, its impact can vary widely among individuals. As symptoms may develop gradually, individuals experiencing persistent back pain, numbness, or weakness should seek medical evaluation. Orthopedic specialists, neurosurgeons, or spinal surgeons are typically involved in diagnosing and managing spinal stenosis, tailoring treatment plans based on the individual’s specific circumstances and overall health.
What are the symptoms?
The symptoms of spinal stenosis can vary based on the location of the narrowing and the affected nerves. Common symptoms may include:
- Pain: Persistent pain in the neck or lower back, often radiating to the arms or legs, depending on the location of stenosis.
- Numbness or Tingling: Sensations of numbness or tingling in the extremities, such as the hands or feet.
- Weakness: Muscular weakness, particularly in the arms or legs, which can affect coordination and balance.
- Cramping or Painful Leg Movements: Pain or cramping in the legs, especially during walking or other activities (neurogenic claudication).
- Difficulty Walking: Progression of symptoms may lead to difficulty walking or maintaining balance.
- Bowel or Bladder Dysfunction: In severe cases, spinal stenosis can impact the nerves controlling bowel and bladder function.
Symptoms may worsen with certain activities or positions and may be relieved with rest or changes in posture. Seeking medical attention is crucial for an accurate diagnosis and the development of an appropriate treatment plan. Orthopedic specialists, neurosurgeons, or spine surgeons typically play a key role in diagnosing and managing spinal stenosis based on the individual’s specific symptoms and overall health.
Treating Spinal Stenosis
How is Spinal Stenosis diagnosed?
Diagnosing spinal stenosis involves a thorough evaluation, and a neurosurgeon like Dr. Tomac is well-equipped to lead this diagnostic process. Dr. Tomac typically begins by conducting a detailed medical history, gathering information about the onset and characteristics of symptoms, any relevant injuries or traumas, and the patient’s overall health. A comprehensive physical examination assesses neurological function, pain levels, and signs of nerve compression. Imaging studies, such as Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans, are crucial to visualize the spine and identify the presence and extent of stenosis. Dr. Tomac’s expertise in neurosurgery allows for a precise analysis of imaging results, aiding in the accurate diagnosis of spinal stenosis. The collaborative approach between the patient and Dr. Tomac is crucial in determining the severity of the condition and developing an individualized treatment plan tailored to address the specific characteristics of spinal stenosis. Seeking timely medical attention is essential for an accurate diagnosis and appropriate management of this narrowing of the spinal canal.
What treatments are available?
The treatment of spinal stenosis can involve various approaches, and a neurosurgeon like Dr. Tomac can provide expertise in both non-surgical and surgical interventions. Treatment options include:
Conservative Measures:
- Physical Therapy: Targeted exercises to improve flexibility, strengthen supporting muscles, and alleviate symptoms.
- Pain Management: Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and pain relievers to manage pain and inflammation.
- Lifestyle Modifications: Adopting a healthy lifestyle, including maintaining proper posture, staying physically active, and managing weight.
Interventional Procedures:
- Epidural Steroid Injections: Injections of corticosteroids into the epidural space to reduce inflammation and relieve pain.
- Nerve Blocks: Targeted injections to numb specific nerves and alleviate pain.
Surgical Interventions:
- Laminectomy: Surgical removal of part of the vertebra to alleviate pressure on the spinal cord or nerves.
- Spinal Fusion: Surgical procedure to fuse vertebrae together, stabilizing the spine.
- Foraminotomy: Enlargement of the neural foramen to relieve pressure on nerve roots.
Dr. Tomac will assess the specific case, discuss treatment options, and recommend the most appropriate course of action based on the severity of spinal stenosis and the individual’s overall health. Surgical intervention is typically considered for cases where conservative measures do not provide sufficient relief or in the presence of neurological deficits. The decision on the most suitable treatment plan is made collaboratively between the patient and Dr. Tomac, considering the unique circumstances and goals of the individual.