It usually affects the lumbar (lower back) or cervical spine, showing different symptoms. It occurs equally often in men and women, especially after the age of 50. “It occurs mainly in the lumbar spine, less in the cervical spine and very rarely in the thoracic spine. This happens because our waist and neck are the places where the spine receives the greatest stress, in contrast to the thoracic spine where mobility is more limited due to the chest,” explains Mr. Pantelis Stavrinou, Director of Neurosurgeon at Metropolitan Hospital, Assistant Professor at the University of Cologne. Mr. Stavrinou answers the questions that concern patients about the symptoms, diagnosis and treatment of spinal stenosis:

What are the causes of spinal stenosis?

The causes are varied and result from a combination of various factors that narrow the diameter of the spinal canal. Among them are intervertebral disc degeneration (so-called disc herniations or disc projections), ligament hypertrophy and spondylolisthesis. In the case of advanced degeneration of the intervertebral disc, the most basic cause is the posterior displacement of the disc material towards the spinal canal and the creation of osteophytes in combination with the thickening of the joints and ligaments of the area.

What symptoms does it present with?

“The main symptom of lumbar spinal stenosis is neurogenic intermittent claudication, with the patient finding it difficult to walk a long distance without taking a break to rest, and as time passes, unable to move due to pain, which worsens with standing and walking, while it stops with sitting or bending the patient forward. In addition, other symptoms reported by patients include numbness and tingling in the legs, but also cramps that occur during the night’s sleep,” he answers.

How is the diagnosis made?

The diagnosis of spinal stenosis is based on the patient’s history, clinical and radiological examination. The doctor asks the patient to do an MRI, which accurately shows the width of the spinal canal and foramina, the presence of a protrusion or herniation of the intervertebral disc, pressure on the nerve roots and hypertrophy of the ligaments. In cases where it is not possible to do an MRI, the diagnosis can also be made with a CT scan.

How is spinal stenosis treated?

“Treatment depends on various factors such as the quality of the symptoms (e.g. is there only numbness or pain as well?), the intensity of the symptoms (how strong is the pain?), the duration of the problem, whether the patient has to exhaust the conservative treatment methods and of course, from the severity of the stenosis as seen in the magnetic. In general, the first reason is conservative treatment with drugs and physical therapy. The goal of physical therapy is to strengthen the muscles around the spine and decongest the nerves through exercises and stretches.

A next step in conservative treatment involves steroid injections in the spinal area. This procedure is done by injection near the irritated or pressed nerves, in order to reduce the inflammation. The results of injections are usually good in a large percentage of cases. However, the duration of relief varies from two weeks to six months.

The only method that treats the problem at its root is surgery, in which the narrowed spinal canal is widened,” the expert emphasizes.

What methods of surgical repair of spinal stenosis are there?

There are various methods of surgical repair, depending on the type and severity of the problem, as well as the needs of the patient. Some methods are:

• The traditional petalectomy is a classic operation in which all the posterior elements of the vertebra are removed to make room for the nerves, but at the same time elements that do not exert pressure but support the spine are also removed.
• More modern approaches they follow the same logic, but focus on the area under pressure, without removing unnecessary elements that contribute to the support of the spine. Such techniques are called minimally invasive and have less surgical trauma and therefore less pain and faster recovery compared to classic petalectomy.

Is there a chance of complications after the operation?

“The decompression of spinal stenosis, both in the neck and in the lumbar spine, is an extremely safe operation with a particularly low rate of complications,” concludes Mr. Stavrinou.

*The Neurosurgery Clinic of the Metropolitan Hospital provides care for all types of neurological diseases, including both chronic and day-to-day conditions.

The operation of the Neurosurgery Clinic covers:

• Emergencies.
• Nursing patients.
• One Day Care (ODC) Services.
• Daily visits to the outpatient clinic.

* *The Metropolitan Hospital not only provides care for all conditions related to the neurological system, but does so with dedication, professionalism, and an ongoing commitment to patient health. With emergency departments, daily outpatient services and specialized departments, it offers comprehensive care for patients with a variety of neurological needs. The specialized doctors and modern services offered by the hospital meet the highest level of quality and care, helping patients regain their health and improve their quality of life.