1 in 3 people over 60 years old 'Spinal duct stenosis', more painful when standing
Oct 19, 2024
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Even though it is a good weather to walk, there are people who cannot even walk lightly due to back pain.
Although it is a back pain that everyone experiences at least once, spinal stenosis, which is accompanied by various symptoms such as numbness in legs, helplessness, and sensory abnormalities, requires special attention as it sharply lowers the quality of life.
Spinal canal stenosis refers to a disease that compresses the nerves with the narrowed spinal canal, which is the passage through which the nerves pass. It is a common disease that appears in about 30% of adults over the age of 60 in Korea. It occurs a lot in the lumbar spine, and the risk of development increases with age.
Patients with spinal canal stenosis usually experience worsening symptoms when walking or standing, and symptoms improve when sitting or bending their backs.
Typical symptoms are neurogenic intermittent claudication, which refers to pain in the legs after a short walk and relief of symptoms after a short break.
"In addition to back pain, radiating pain may occur to the hips, thighs, calves, and ankles, and walking disorders may occur if symptoms worsen," said Cho Seong-tan, head of the orthopedic surgery department at Seonam Hospital in Seoul.
The diagnosis of spinal stenosis begins with the patient's medical history, listening to symptoms, and neurological examination. Basic X-ray tests check for degenerative changes in the spine and perform MRI for more accurate diagnosis to evaluate the degree of stenosis between the nerve compression area and the spinal canal. Sometimes CT can further confirm the structural problems of bones.
Treatment of spinal stenosis is divided into conservative treatment and surgical treatment depending on the degree of symptoms and the patient's condition.
Conservative treatment is initially performed and includes medication, physical therapy, and injection therapy. Drug treatment focuses on relieving pain and reducing inflammation, but when drug treatment is not effective, treatment by injection or procedure is attempted.
Neuroplasty is one of the non-surgical treatment methods, and it is a treatment that places a catheter around the nerve to release the attached nerve and control inflammation around the nerve with stenosis. Neuroplasty can effectively reduce pain in patients with spinal canal stenosis and has the advantage of being discharged from the hospital on the day of the procedure and returning to daily life. In particular, it can be tried for patients who do not respond to drug treatment or various injection treatment.
If symptoms persist even with such active drug treatment or treatment by procedure, surgical treatment should be considered.
Chief Cho Sung-tan said "Among them, bilateral spinal endoscopy is a minimally invasive surgery that removes the stenosis that is compressing the nerve while minimizing nerve damage."
Two-way spinal endoscopy involves inserting an endoscope and surgical instruments through two small holes to widen the spinal canal and remove nerve-pressing lesions. Because the nerve can be enlarged through the endoscope, interoperative safety is secured, and surgery can be performed with only two small holes of about 1cm, so there is little risk of bleeding and infection, and the recovery speed after surgery is fast. However, patients with multi-segmental spinal stenosis accompanied by spinal instability may not be resolved with two-way endoscopic surgery, so accurate diagnosis through an orthopedic surgeon is necessary.
As spinal stenosis is a degenerative disease, lifestyle management is very important.
Chief Cho Seong-tan said, `It is important to maintain the right posture so as not to strain your back, avoid heavy lifting, and maintain spinal health through regular stretching and back strength exercises" he advised.
In addition, weight management is also an important factor, and obesity can put a heavy burden on the spine. Moreover, it is important not to sit in one position for a long time in normal times. For example, after sitting and working for about 50 minutes, it is helpful to do light stretching for about 10 minutes or to do activities while standing up.
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bellho@sportschosun.com
