Spinal Stenosis

The next series of blog entries will focus on a few spine wellness tips.  Simple solutions that provide health benefits to your spine. 

One popular New Year’s resolution is to go on a diet and lose weight.  Losing weight provides many health and wellness benefits, including spine wellness.  Did you know that obesity is one contributing factor to back pain? 

Spine Wellness Tip #1: Drop Some Pounds 

Spinal stenosis is a general term that refers to the narrowing of the spinal canal. Often this is a degenerative condition resulting from aging. More commonly found in the lumbar (lower back) spine, it also occurs in the cervical (neck) spine. 

Learn more about spinal stenosis, the diagnosis and treatment with this education video featuring Dr. Kenneth Renkens.   Dr. Renkens is a neurosurgical spine surgeon with Indiana Spine Group. Orthopaedic spine surgeons with Indiana Spine Group include Rick Sasso, M.D., Thomas Reilly, M.D., and Paul Kraemer, M.D.

Recently we have updated the educational resources on our Indiana Spine Group web site.  With this update, we included a few educational videos.  These videos include myself and other physicians with Indiana Spine Group discussing different topics; i.e. artificial cervical disc, spinal pain, spinal stenosis, etc.

Other topics that will be discussed during Back Talk, the continuing medical education conference sponsored by Indiana Spine Group, are common spinal disorders. 

Dr. Paul Kraemer, a spine surgeon with Indiana Spine Group, will highlight common spinal diagnoses that affect the pediatric, adolescent and adult population. Recommended screening tests will be reviewed, and Dr. Kraemer will discuss how to differentiate between patient complaints and symptoms for effective spinal diagnosis. A few common diagnoses that will be reviewed include spinal stenosis, spondylosis, spondylolisthesis and scoliosis.

Recently, I had the honor of being the co-chairman of an annual spine meeting hosted by the American Academy of Orthopaedic Surgeons.  The focus of this meeting was “Contemporary Techniques in Spinal Surgery 2008”.

At this meeting I gave presentations on spinal decompression and reconstruction techniques, including; ACDF, corpectomies and struts.  I also presented information that compared the cervical artificial replacement procedure with the spinal fusion.  Additionally, I was a lab instructor – which provided hands-on training to orthopaedic surgeons. A few procedures reviewed included X-Stop – a procedure which utilizes a device in spine surgery for lumbar spinal stenosis; XLIF – this is a minimally invasive spine surgery procedure used to treat back pain that is caused by degenerative disc disease. 

In an earlier blog, I talked about the AO Spine International meeting that I presented at in December. With this blog entry, I wanted to define a few of the terms that were used. These were spine surgery topics that I presented on.

One term is cervical myelopathy. In defining cervical myelopathy – first I will define myelopathy. When the word myelopathy is used it refers to any condition that affects the spinal cord. Therefore cervical myelopathy is a condition of the cervical (neck) area of the spinal cord. In respect to cervical myelopathy it means that there is compression on the spinal cord that is either a result of disc herniation or spinal stenosis. Cervical myelopathy is a degenerative spine disease that is more common in the elderly. 

Another term used in the blog entry was cervical radiculopathy. The term radiculopathy refers to a disease of the spine nerve roots and spinal nerves.  Cervical radiculopathy is when a spinal nerve root in the neck (cervical) is compressed and/or irritated. This can be caused by disc herniation, spinal stenosis or other degenerative spine disorders. 

A recent blog entry highlighted a surgical procedure for lumbar spinal stenosis the X-STOPÒ.  This newer procedure decompresses the spinal cord that has narrowed as a result of lumbar spinal stenosis.  Once decompressed (opened), the pressure on the spinal cord is relieved, thereby eliminating the pain. Dr. Rick Sasso, a spine surgeon with Indiana Spine Group was one of the first surgeons to perform this procedure in Indianapolis.  This device was approved by the FDA in November 2005.  Here is a link to the press release, which provides more detail on this procedure. 

Here is more information about spinal stenosis. 

A prior blog entry provided an overview of a spine surgical research study that Dr. Kenneth Renkens is participating in for severe spinal stenosis.  This blog entry will highlight another spine surgical treatment for less severe lumbar spinal stenosis. 

A prior blog entry highlighted a research study that Dr. Renkens, a neurosurgical spine surgeon with Indiana Spine Group, was participating in for lumbar disectomy.  Dr. Renken’s is also participating in a clinical research study for the surgical treatment of spinal stenosis. 

Spinal stenosis is a degenerative spine disease where one or more areas of the spine narrows.  Usually affecting individuals in their 50’s and 60’s, spinal stenosis is most often caused by osteoarthritis-related bone damage.
 
Symtpoms include pain or numbness in the lower legs, back, neck, shoulders or arms, a loss of sensation in extremities, tingling or weakness.  Depending on the severity of the spinal stenosis – treatment may range from physical therapy to surgery.  

The study that Dr. Renkens is participating in is for more severe cases of spinal stenosis – where surgery is required.  The name of this study is A Prospective and Randomized Controlled Trial to Evaluate the Safety and Effectiveness of Total Facet Arthoplasty in the Treatment of Degenerative Spinal Stenosis.  In this study, Dr. Renkens will be using the Archus Total Facet Arthoplasty System (TFAS), which is a non-fusion spinal implant for the treatment of patients with moderate to severe spinal stenosis.  This TFAS, provides an alternative treatment for spinal stenosis as an alternative to spinal fusion – which is one spine surgical treatment for spinal stenosis. 

For more study information, click here. 

Spinal disorders such as spinal stenosis, excessive kyphosis, vertebral fractures, degenerative disc disease or other spinal disorders – can sometimes affect more than one vertebrae level of the spine.  In instances where surgery is necessary, this can provide a challenge to spine surgeons.

One common term used to describe pain is sciatica.  Sciatica is used to describe the pain that radiates along the sciatic nerve.  The sciatic nerve is the longest and largest nerve in the body – connecting the spinal cord with the leg and foot muscles.  When someone has sciatic pain, they generally describe it as “shooting pain”. 

This pain is caused when the nerves in the lower spine are either compressed or irritated.  There are many causes of sciatica and a few include:  pinching or stretching of the sciatic nerve, herniated disc, spinal stenosis or spondylolisthesis, just to name a few.  

Many times, this pain will go away with minimal treatments; i.e. avoiding the activity that causes the pain, cold / heat treatments, pain relievers and/or exercise.  If this pain continues for more than 6 weeks or becomes severe, it is recommended that the individual see their physician or a spine specialist. 

Indiana Spine Group is a center of excellence for the treatment of spinal disorders and abnormalities.  Located in Indianapolis - with offices in Kokomo and Anderson, we provide comprehensive spine care – including interventional pain management treatments, nonsurgical spine treatments, minimally invasive spine procedures, minimally invasive spine surgery and spine surgery.  Treating both adults and children, some common diagnoses that we treat include degenerative disc disease, spinal stenosis, herniated cervical disc, failed back syndrome, osteoporosis and scoliosis. 

Physicians with Indiana Spine Group include:

§          Ken Renkens, MD (neurosurgical spine surgeon)

§           Rick Sasso, MD (spine surgeon)

§           Kevin Macadaeg, MD (minimally invasive spine specialist)

§           Thomas Reilly, MD (spine surgeon)

§          Jonathan Gentile, MD (minimally invasive spine specialist)

§          John Arbuckle, MD (minimally invasive spine specialist

As a spine surgeon, my days are varied.  The majority of my day – is in surgery, specifically spine surgery.  Types of surgery are varied – cervical spine surgery, lumbar surgery, minimally invasive spine surgery, etc.  But my days are also devoted to seeing patients in the hospital following surgery, seeing patients in the office and I am involved in research.

Last summer, I was contacted by a reporter from my alma mater - Wabash College (Jim Amidon).  Jim was doing a story about me for an upcoming issue of the Wabash Magazine.  For this article, he needed pictures of me in surgery.  Well, long story short – he attended a spine surgery.  Once all the proper permissions were gathered, and paper work was signed – his day begun at 6:00 am one summer morning. 

To learn more about Jim’s day in surgery, read his blog.

The surgery he watched was a laminectomy for spinal stenosis.  Spinal stenosis is a narrowing of the sine – and this narrowing puts pressure on the nerves resulting in pain.