Treatment of spinal canal stenosis without surgery
What is a Foraminoplasty?
Neural foramina are small canals at every level of the spine through which nerves leave the spinal cord and reach the limbs and other parts of the body. Narrowing of this canal is called foramina stenosis. Narrowing may be caused by bone spurs, a herniated or bulged disc, spinal facets arthritis, ligament thickening or enlargement of a tendon in the spinal canal. This creates a high pressure on the nerve roots causing symptoms that include pain, muscle weakness, muscle spasms, cramping, numbness, and tingling. The symptoms may be felt in the neck, back, shoulders, arms, hands, legs, buttocks, or feet depending on the position of the affected foramen.
To diagnose spinal canal stenosis, your doctor may ask you about signs and symptoms, discuss your medical history, and conduct a physical examination. He or she may order several imaging tests to reach the probable diagnosis..
These tests may include:
- X-rays. An X-ray of your back can reveal bony changes, such as bony spurs that cause narrowing to spinal canal.
- Magnetic resonance imaging (MRI). An MRI uses a powerful radio-magnetic waves to produce cross-sectional images of your spine. The test can detect damage to your disks and ligaments, as well as the presence of tumors. Most important, it can show where the nerves in the spinal cord are being pressured.
- CT or CT myelogram. If you can't have an MRI, your doctor may recommend computerized tomography (CT), a test that combines X-ray images taken from many different angles to produce detailed, cross-sectional images of your body. In a CT myelogram, the CT scan is conducted after a contrast dye is injected. The dye outlines the spinal cord and nerves, and it can reveal herniated disks, bone spurs and tumors.
How foramina stenosis is treated?
As before mentioned causes for the stenosis, the management plan differs. If the main cause of your foramina stenosis is bone spurs, the most appropriate management is open surgery or endoscopic foraminoplasty. If the cause was thickening of ligamentum flavum then the most appropriate management is the claudicare or endoscopic foraminoplasty. Your spine physician will discuss which method is most appropriate for you after seeing the scans requested.
it is technique which is similar to the disc fx technique but instead of removing a part from the herniated disc, Claudicare removes the thickened part of the ligamentum flavum.
It’s a minimally invasive procedure which is mostly alike to endoscopic discectomy but with other specialized tools in removing the bony spurs or the thickened ligamentum flavum. The main difference between the endoscopic foraminoplasty and claudicare is that we can see what we are doing with a microscopic camera.
Advantages of both Endoscopic foraminoplasty and Claudicare
Both endoscopic foraminoplasty and claudicare are minimally invasive procedures and their benefits include:
-Small incision and good cosmetic scar
-No or little blood loss
-Does not cause spinal instability
-Usually done under local anesthesia, thus the risks of general anesthesia are avoided
-Can be performed in medically high-risk patients and obese patients
-Can be performed in multiple levels in the same procedure
-Physiotherapy can start the same day unlike the surgery
-Less post-operative pain
-Less risk of infection
-Both Claudicare and Endoscopic foraminoplasty patients get back home on the same day of the operation
Endoscopic foraminoplasty is a safe and effective non-surgical option for treatment of foraminal stenosis.
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