SPINAL STENOSIS (WAIST STRENGTH, SPIRAL STRAINING) and TREATMENT
The disease, known as spinal stenosis, low back narrowing, spinal cord narrowing and similar names, is generally seen in 55-60 years of age and above. Patients complain of not being able to walk as long as before, and leg pain and numbness that increases with walking. They complain that they can no longer walk even 50 meters, and they apply to the doctor.
Spinal stenosis is diagnosed in patients with canal narrowing in the lumbar region, which we call the lumbar region, in the examinations. This narrowing occurs after the thickening of the connective tissues called ligaments between the spine joints over time, and may also increase further with the degeneration of the structure we call the disc, overflowing into the canal. After walking a short distance, patients feel pain and numbness and the need to sit or stand and lean forward. Lying down pain goes away. Neurological disorder is usually not detected.
Diagnosis is most easily made by MRI. In addition, myelography and tomographic myelography can be performed for patients who cannot undergo MRI. Standing motion radiographs and hip radiographs of the patients should also be seen to examine whether there are additional problems. The bone structure of the main canal and the channels where the nerves exit should be examined in detail by having a tomography taken in the patients who are considered for surgery.
The contraction is usually at several levels. It is progressive. Medication and other treatment methods (physical therapy, manipulations, algological methods, heat, ultrasound, acupuncture, etc.) usually do not respond, or even if a short-term response is received, the complaints begin again.
The most comfortable and up-to-date method in the operations of eligible patients today is the operation of bilateral enlargement of the spinal canal by entering from one side with the microsurgical method. After this surgery, the muscles on one side of the waist are stripped with a minimal method and the stenosis is entered under the microscope, and the formations that narrow the entire canal are removed. This can be defined as emptying the inside of the orange by entering through a small opening. The joints in the spine are not damaged. The muscles of the opposite side remain intact. In this way, patients can walk 4 hours after the operation and are discharged the next day, even if they have this operation at multiple levels. In the surgery, the amount of bleeding for each level of stenosis does not exceed 35-50 cc. There is usually no need to donate blood to the patient. Approximately 250 patients have been treated with this method in our clinic in the last 2.5 years. In these patients aged 60 and over, with weak bones, the risks and problems caused by the foreign body are eliminated by attaching materials incompatible with the bone such as screws, platinum, prosthesis, plate, etc. With this method, the state and the patient also save a lot of money. The cost of this surgery is 25-35% of the cost of other methods. Even in the best spinal surgeons, the rate of screw misdirection is 10-15%. So if you have 10 screws attached to your waist, at best, 1 or 2 of them may not be in the ideal condition they should be!! Unfortunately, screws, platinum and similar materials used today are not compatible with bone. Therefore, unlike young people, the screws loosen and play in these patients, most of whom are osteopenic and osteoporotic, over time. These loosening and fluctuations cause chronic low back and hip pain in patients. Patients spend most of their time in neurosurgery, physical therapy, pain clinics and in bed. In our clinic, these screws were removed from 120 patients in the last 2 years!!
For the last 10-15 years in the world, neurosurgeons have mostly preferred this method in the surgeries of these patients. In our country, the number of operations with this method is gaining prestige day by day and the number of neurosurgeons who prefer these operations is increasing day by day. Long-term results of this method have been published in reputable journals in the world literature and have been found very successful. Of course, this is not the only and miraculous method for patients with narrowing in the whole waist. Methods can be changed, additions and subtractions can be made according to the patient and his/her disease and additional disorders.
WHICH SPINE DISEASES DO WE USE SCREWS AND OTHER MATERIALS?
We use screws and other materials in some parts of scoliosis, severely mobile lumbar shifts (2nd degree and above), vertebral tumors, vertebral fractures and we provide serious benefits. In short, the correct diagnosis, correct patient, correct treatment rule is valid.
CONCLUSION
The basic rule of success in spine surgery is to make the correct diagnosis. After the diagnosis is made correctly, the choice of treatment should be ordered from the most effective and minimal method to the most complex method according to the patient’s condition. Bilateral canal widening surgery by entering from one side with the microsurgical method is the most comfortable method with the least risk and very impressive results in suitable patients with single or multilevel canal narrowing in the waist.
