Spinal stenosis - Treatment

Conservative therapy:Patients with lumbar stenosis benefit from physical therapy.Extension column must be avoided because it worsens the symptoms. Spinal flexion exercises should be increased to reduce lordosis and decrease the stress on the spine. If symptoms are moderate nonchirurgicala therapy can be effective. Nonchirurgical Treatment includes physical therapy, administration of anti-inflammatory drugs and epidural steroid injections. These methods can be used to control symptoms in patients who are not candidates for surgery.
Surgical therapy:Stenosis, surgery is indicated for people with significant myelopathy, radiculopathy and claudication significant. The choice depends on the region medullary decompression, spinal alignment and anatomical nature of the compression elements. There is ongoing controversy about the need for stabilization is usually reserved for cases of instability rough.
For the cervical spine there are debates about the superiority previously addressed or higher. Posterior decompression laminectomy is advantageous in multilevel disease and congenital stenosis. But this can lead to instability and deformity cifotica.Some surgeons prefer to preserve the integrity laminoplastia and amiscarii posterior elements. Using simultaneous fusion and fixation reduces the risk of posterior approach.Previously addressed for addressing cervical decompression herniated disc pathology and the formation of spurs. This approach can be used in any spinal alignment. Disectomiile can be performed with or without concomitant fusion.
For lumbar spinal decompression surgery is performed by multilevel laminectomy and foraminotomy for decompression of the roots. Depending on the pathology of compression may be required partial or total and disectomiile faceectomiile. In general techniques used microdecompresie side hemilaminectomiile laminectomiilor instead to preserve the full integrity of the biomechanics of the posterior tension band.The need to stabilize the lumbar spine fusion and fixation is still controversial. Dynamic stabilization and has won popularity with mobile devices protect adjacent segments.
Prognosis:Early treatment is important for a good prognosis. Surgical decompression of neural structures effectively treats the symptoms. Long-term pain is common. Symptomatic spinal stenosis therapy and prevention targeting neurological sequelae.Conservative measures bring temporary relief but remain important for the entire preceding decompression surgical treatment algorithm. Surgery is indicated when signs and symptoms correlate with radiological aspects of spinal stenosis. In general, surgery is recommended when is this significant radiculopathy, myelopathy, neurogenic claudication or incapacitating pain. The choice of a surgical procedure and the decision to cement column should be individualized to optimize outcome.