FAQ : PELVIC SPINAL STENOSIS
What is Pelvic Spinal Stenosis?
Pelvic Spinal Stenosis is usually caused by degenerating changes in our body and so most of the time begins in patients over 60. In the spinal cannal (where the dural sack passes with the roots) there is a ligament called LIGAMENTUM FLAVUM this ligament thickens with time as par of the aging process also the back elements of the spine (patzetaric joints) thicken as well. The thickening of the ligament and the joints narrows the spinal cannal and puts pressure on the nervs.
Are those degenerating changes preventable?
Unfortunately medicine has not yet found a way to prevent the degeneration process in the human body. We still haven't found procedures or exercises that slow those processes.
What are the classic symptoms of Pelvic Spinal Stenosis?
Difficulty walking and standing due to lower back pain that usually projects on the buttlocks and lower limbs. It is easier to walk while leaning forward (easier to walk with a cart it the grocery store) and difficulty walking with a straight posture. walking only short distances with frequent sitting breaks to rest and ease the pain. It is important to note that usually it is a slow degeneration in functioning and a consistent but slow worsening in the quality of daily life. In advanced cases walking is only possible with a walking aid or wheelchair and mobility even around the house is limited.
Does Pelvic Spinal Stenosis always require surgery?
No, it is a surgery meant to improve quality of life. The patient, in most cases, decides for himself when he thinks a surgical intervention is necessary. In extreme cases a surgery is recommended to prevent irreversible neurological damage that can lead to lower limbs weakness or lack of control of the sphincters.
Are preventive procedures effective?
In light and medium cases there is some improvement from doing preventive procedures such as:
Pain treating epidural injection.
In hard or extreme cases unfortunately preventive procedures are rarely effective and a Spinal Stenosis surgery is necessary.
Who is the surgery for?
To any patient who wants to improve their quality of life.
What is being done in the surgery?
I expand the cannal to its pre narrowed state. I perform the surgery in a minimally invasive method using a microscope made for spine surgeries and special soft tissue expanders. The cut is 3-5 centimeter long. Through it I reach the back elements of the back. By using the space between vertebras I make a small measured cut in the bone and through this work window I cut the ligament excess (LIGAMENTUM FLAVUM) and the thickened pztaric joints and release the pressure on the spinal sack and roots. All of this is done without causing spinal instability.
Is there any need to fuse the back with screws and rods?
Most patients that suffer from Spinal Stenosis don't need back fusion with screws and rods. Expanding the cannal in a minimally invasive method will bring optimal results without needing fusion.
What are the surgery's success rates?
80-90 percent success rates. Success is measured by the reduction of the pain projected to the lower limbs, being able to walk with better stature and longer distances.
What are the risks of the surgery?
The surgery's risks are relatively small and for a surgery in one height they include: Cerebrospinal fluid leak- 8%, a reversible complication- it is possible to stitch the rip in the sack if one appeared or to glue it with biological glue. Infections- 1%, a reversible complication, antibiotics can be prescribed to eradicate the infection. Neurological damage- limb weakness or lack of control of the sphincters- less than one percent. Damage to the big blood vesseles- less than one percent. Deep venous thrombosis or pulmonary embolism- less than one percent.
How long does the surgery take?
For a single height an hour and a half. For every additional height another hour.
How many hospitalization days after the surgery?
Usually one day of hospitalization is enough. A patient will not be released home before he has gained full independent mobility and can take care of his everyday needs.
Is there any need to stay in bed after the surgery?
No, I encourage getting out of bed after the surgery. There is no restriction on climbing up and down stairs.
Is there any need for a back brace after the surgery?
No, there is no need for a back brace after the surgery.
What is the size of the surgical scar?
3-5 centimeters for one height
Is there any need for stitch removal?
No, I use dissolvable stitches.
Can I go back to participate in any activity I want after the healing period?
Yes, there should not be any restriction on functioning.
How long will I be missing from work?
If you have an office job 7-10 days. A month and a half for a physical job.