Narrow canal disease is a spinal cord disease that is often confused with a herniated disc, and its incidence has been increasing over the last 20-30 years due to the increase in the average age of the population and lack of exercise. Narrow canal disease is a disease that usually occurs after the fifties and is caused by narrowing of the spinal canal in the lumbar region. It is most common in older ages. It develops slowly. However, it can also occur in younger individuals for various reasons.
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Causes
Patients' narrow canals from birth compress the lumbar part of the spinal cord at an older age, causing the disease.
Degeneration: The most common cause. With aging, the discs between the vertebrae shrink, bony protrusions, commonly known as calcification, appear on the vertebrae and cause the canal to narrow.
Vertebral Slippage: Congenital or acquired vertebrae slipping over each other and destabilization of the spine can cause canal stenosis.
Large Lumbar Hernias: Large hernias that move into the spinal canal can also cause canal stenosis.
Symptoms
- The classic complaints of patients with canal stenosis are pain in both hips and legs that occurs when walking, standing or sitting. Low back pain may be absent.
- Patients gradually shorten their walking distance.
- Patients feel comfortable when they lean forward while walking and start to avoid standing upright.
- In the advanced stages of the disease, leg cramps may occur when walking short distances and urinary incontinence may occur in the last stage.
How is the diagnosis made?
Magnetic Resonance Imaging (MRI) is the best way to show spinal canal stenosis. This method, which does not use X-rays, can visualize whether the spinal cord and nerves are under compression. Computerized tomography is another method. In CT, bone structures are better visualized. The physician may also order nerve conduction studies (EMG, UP) or blood tests if necessary.
Treatment
Surgical or non-surgical treatments are applied according to the findings. Stretching exercises to strengthen the lumbar muscles are applied. These exercises are performed with special devices. By strengthening the trunk muscles, a natural corset is created around the patient's waist. In more advanced cases, injections can be made around the spinal cord. Your physician will decide which method will be applied. However, it is not recommended to use a corset.
Surgical Treatment
It is the most effective treatment. The surgeries of the past, which required bilateral opening of the patient's muscles and widening of the entire canal, are now a thing of the past. In this group of patients without fixation, slippage between the vertebral bones could occur. Today, in patients who undergo posterior decompression, the accompanying pathologies such as rotoscoliosis are corrected and fixation is performed. This method can be safely applied in the advanced age group and in patients with comorbidities such as diabetes, hypertension and heart disease.
Postoperative Period
Patients are ambulated on the day of surgery and discharged after 2-3 days.
- Patients are advised to spend the first week at home and do walking exercises taught by the spine center physiotherapy department.
- Patients are enrolled in an isometric exercise program in the spine center physiotherapy department to develop the trunk root muscles.
- Patients can go out of the house and return to their daily activities after the second week.
Is instrumentation necessary in narrow canal patients?
In most patients with narrow canal, surgeries commonly referred to as platinum implantation are unnecessary. However, it may be necessary in cases of spinal instability caused by vertebral slippage.
