Experience of Surgical Treatment for Spinal Canal Stenosis in Patients With Degenerative Cervical and Lumbar Spine Diseases

Abstract

To study results of surgical treatment for spinal canal stenosis in patients with degenerative-dystrophic diseases of the cervical and lumbar spine. Material and Methods. Complex pre-and postoperative examination of 56 patients with congenital and/or acquired spinal canal narrowing was performed. Clinical diagnosis was based on findings of neurological and orthopedic examination, X-ray investigation, spiral CT, MRI, Doppler sonography, and electroneuromyography. Treatment results were assessed at discharge and at 6 months after surgery. Immediate and longterm indices of pain syndrome intensity, vertebroneurological semiology, and scores of Oswestry Low Back Pain Disability Questionnaire and of Neck Disability Index were compared. Results. We succeeded in significant decrease in pain intensity in most patients; the score of pain sense at discharge was 1 to 3. At follow-up after 6 months 30 patients had no radicular pain, 26-had unpleasant pain senses, though transient, with intensity score of 3 to 4. Conclusion. The choice of access, volume and nature of surgical exposure should be planned based on consideration of all factors promoting development of myeloradiculopathy. The cervical spine is operated using predominantly anterior decompression and stabilizing procedures, the lumbar spine-using posterior procedures. The choice of spine stabilization method depends on instability causes, degree of displacement and mobility of vertebrae.

Radiological Diagnostic Technique Selection in Early Cervical Lateral Stenosis

“…During partial replacement of destroyed tissue of the intervertebral disc by connective tissue there was the enlargement of marginal osteophytes in the area of vertebral bodies and intervertebralis. These processes are compensatory and adaptive mechanisms in response to unstable spinal motion segment of the cervical spine due to hypermobility of the pulpal nucleus with partially lost fixation capability of the disc and developing disc fibrosis with the height decrease between the vertebral bodies [5]. As a result, frequently, persistent radicular pain syndrome develops, and it is the complaint patients refer to a doctor to diagnose a case.…”