SPINAL SURGERY

in Hull and East Yorkshire

GEORGE SPINK FRCS (Neurosurg.) BSc Hons

 

HOME SPINAL CONDITIONS SPINAL SURGERY MINIMAL ACCESS SURGERY INVESTIGATIONS POST OP RECOVERY INFORMATION FOR GPS CONTACT/APPOINTMENTS ABOUT ME LINKS

SPINAL CANAL NARROWING - STENOSIS

 -      This is a common condition which occurs as we get older.  The 'wear and tear' changes in the spine ('spondylosis') cause narrowing of the spinal canal. This can squash the spinal cord or push all of the nerves together causing symptoms in the arms or legs.

-      In the neck the pressure on the spinal cord can cause deteriorating fine hand function (difficulty doing up buttons, picking up coins, holding normal cutlery) and problems with walking ('feels as if you're walking on sponges'). This type of spinal cord damage is called a cervical myelopathy.

-      In the lower back the pressure on the nerve roots can cause a cramping / aching sensation in the legs when walking. Bending forwards or resting may alleviate some of the symptoms. This is called spinal or neurogenic claudication.

-      Many patients will also have back or neck pain due to these wear and tear changes. Unfortunately, surgery is not a treatment for this type of pain.

-      In addition to an outpatient assessment and examination you may require an MRI scan if your symptoms persist. An MRI scan uses a powerful magnet to create a picture of your spine. It does not involve any radiation exposure. The scanner itself is a long narrow tunnel, which some patients may find a bit claustrophobic. It is also fairly noisy during the scan.

 

Treatments

-      Physiotherapy (core-stability exercises / pilates)

-      Facet joint or epidural injections (may help with elements of the back pain)

-      Decompressive  laminectomy (neck or back)

-      Interspinous distraction device (minimal invasive surgery)

 

Outcomes

-      Back / neck pain is unlikely to improve following surgery

-      Leg symptoms and mobility improve in about 80% of patients who have a lower back operation

-      In patients with a cervical myelopathy (neck compression) the aim of the operation is to prevent further deterioration. Whilst many see some improvement in the use of their arms, hands and legs, it is more usual that the operation stabilises the disease ('stop the rot') rather than makes you better.