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Spinal stenosis
Case Sharing
45-year-old Mr. Chen started to feel pain in his left lower back in July 2008. After a month, he felt a stinging pain in his left knee. The most unique thing about his case is that after walking for about ten minutes each time, the legs and lower back is tire and has pulling pain, so he must stop and rest and bent backward, otherwise the pain will increase in the feet and lower back. But he also noticed that whenever he started to feel pain in the lower back and feet, he will just bend his lower back slightly forward or squat down to relieve the pain.
From Mr. Chen’s MRI scans, we can see that his L4/L5, L5/S1 disc are moderately protruded, but it should not cause him so much pain. After careful observation of the cross-section in the scans, it was revealed that Mr. Chen’s lumbar spine canal has degenerated and narrowed the spinal canal. Therefore, even if it is not a serious disc protrusion, the nerve in the spinal foramen have been compressed and produced more than the mentioned symptoms.
The Structure of the Spinal Canal
There is a cavity in the middle of each spine called a spinal canal. Our spinal cord passes through this canal to help us transmit information. Nerve fiber pass through the spine canal, and then through the intervertebral foramen to distribute to various parts of the body.
However, this canal will change with age. After years of wear and tear, the function of disc will gradually decrease, and the area around the spinal canal will degenerate and obstruct the nerve flow inside the canal, resulting in narrowing of the canal and compressing the spinal nerves. If accompany with disc protrusion, the pain will be more noticeable.
Case Analysis
In fact, Mr. Chen's disc protrusion is not very serious, so the professional advice that Mr. Chen received in the past is to deal with it like a normal lower back problem. But the spinal stenosis has a greater impact. If there is 2mm disc protrusion occurs in a person without spinal stenosis, he may have no symptoms. On the other hand, if this 2mm disc protrusion occurs in a person with spinal stenosis, this may cause severe symptoms. This can point out that even if you see a slight protrusion of disc on the scan, you must observe the condition of the spinal canal to determine the severity of the condition.
Treatment Process
Treatment of disc herniation plus spinal stenosis is more complicated, and the treatment time is relatively slow. Generally, it may take 3 to 6 months, because the degenerated spinal canal cannot be changed, only thru the process of decompression therapy, the distance between the vertebrae is increased a little, and the nerve root pressure is reduced as much as possible to relieve the pain of the patient. If the patient has emergency symptoms such as incontinence, persistent weakness of muscle strength, and sharp increase in pain, the necessity of surgery must be considered.
