Lumbar hernia and narrow spinal canal disease, also known as narrow spinal canal, is one of the more common disorders than people think. Stenosis of the spinal canal is most commonly seen in the lumbar region. If a person has a narrow canal with or without a herniated disc, the quality of life of this person sometimes decreases; work, family and social life can be turned upside down.
The spinal canal, through which the spinal cord and nerves pass, is a thin, long, curved tube composed of bones stacked on top of each other. If the width of this canal, which has a certain diameter, decreases, the narrowed canal easily compresses the nerves passing through it. As a result, symptoms such as pain in the lower back and legs, numbness, restlessness, tingling, gait disturbance, forced sitting after a while, shortening of walking distance, frequent urination, deterioration of urine and stool control, weakness in the legs, and adverse sexual functions may occur. The narrow canal in the neck region also affects the arms.
Correct diagnosis of narrow canal requires experience. While evaluating the patient’s examinations, not only the diameter of the spinal canal, but also the effective canal area should be considered. Thickened and hardened connective tissues associated with the canal, narrowing the canal, should always be considered. Sometimes, the anatomical structures on the side, which we call the lateral recess, may narrow and compress the nerve elements. This issue should not be overlooked in diagnosis and treatment.
If a person has spinal canal stenosis, even a small lumbar hernia or calcification can cause great pain to the patient as they will easily compress the nerves in the narrow canal, and the clinic can be very noisy. Sometimes the disease progresses silently, symptoms occur when duct stenosis reaches below the critical level, and patients come to us in advanced age groups. For this reason, we encounter many patients over the age of 80 and perform surgery when necessary.
Physical therapy and other non-surgical treatment methods are generally insufficient in patients whose walking distance and standing time are significantly shortened. However, an adequate surgical intervention performed in experienced hands can relieve patients. For this reason, if the specialist doctor deems surgery necessary, it would be beneficial not to delay it. In addition, the earlier the operation is performed, the more satisfactory the results will be. If not intervened in time, the disease progresses gradually, because as the years pass, the spinal canal naturally narrows more and more.
Spinal stenosis, which is called narrow canal, and its operations are not known enough by the public and are seen as a nightmare. However, in experienced hands, much more satisfactory results are obtained in surgeries performed with the new technique (Internal Decompression with Microtechnique).
Microtechnics and microendoscopic techniques, which are safer and more comfortable methods compared to advanced and classical surgery, are applied by our experienced team in herniated disc surgeries. Similarly, we perform internal decompression with microtechnique in narrow canal surgeries. In other words, we expand the canal from the inside by entering the spinal cord canal with microtechnique.
In recent years, internal decompression surgery with microtechnique, which we have made a routine practice with our spinal surgery team in patients with narrow spinal canal, can only be performed by experienced surgeons in certain centers in the world. In this surgery, the inner part of the narrow spinal canal is entered and the canal is widened from the inside, thus preserving the anatomical structure as much as possible. Since the anatomical structure that provides the stabilization is preserved, it is not necessary to insert screws or similar instruments in these patients who have remained stable. As a result, it is a great advantage that no foreign body is placed in the patients.
Safety comes first in operations. First of all, it is necessary not to harm the patient. Just like in our hernia operations, these patients can walk on the same day and are discharged the next day without facing the risk of paralysis after the surgeries performed in experienced hands. This is a great boon to humanity.
Assoc. Dr. Ahmet Yıldızhan
Neurosurgery Specialist
