21/8-2017 
 
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Spinal stenosis

Spinal stenosis in the elderly. - Elderly should not just put up with back problems and impaired walking ability. Back pain and impaired walking can be treated. Get help for the treatment of your back problems. Read about the “shop window syndrome”. Read about how a spinal stenosis operation is performed.
 

Symptoms of spinalstenose

  • Pain in the legs when walking.
  • Tired and heavy legs shortly after starting walking
  • No symptoms in sitting position.
  • Steering trouble in the legs - difficult to get them to obey the will.
  • Sensory disturbance in the legs, tingling sensations in the feet.

Back problems in the elderly

The numbers of elderly people with back problems are increasing rapidly. Unfortunately, only few get a correct diagnosis and receive treatment. This is a shame since a large proportion of these elderly people can be helped with a relatively simple surgical procedure - with better mobility and better quality of life as a result.

The vast majority of the back problems we see in older people are age related. An increasing number of older people will have back problems because we generally live longer today. One of the most common back problems among the elderly is called "spinal stenosis" which involves a narrowing of the spinal canal surrounding the spinal cord. This comes from osteoarthritis in the small joints between the vertebras. In addition the spinal tendons will have thickened.
 

The shop window syndrome

Spinal stenosis gives some characteristic symptoms in the legs - such as pain and sensory disturbances as well as increasing problems with walking. Patients with spinal stenosis are simply unable to walk more than a few hundred meters before the pain sets in and the legs feel like heavy concrete blocks. These symptoms obviously give the elderly big problems in everyday life.

Affectionately it is also called the “shop window syndrome". Who has not, ever so often, seen an elderly gentleman totter along the sidewalk and stopping seemingly studying the display in a shop window – usually the lower shelves? The apparent interest is probably rather due to the heavy and painful legs forcing him to stop, and leaning forward gives some relief to the back and the legs.
 

We are falling behind with treatment

The growing number of elderly people with back problems is a trend that we see everywhere in the Western world - and in the United States, the number back operations of the elderly over 70 years of age has grown explosively in recent years. The most common operation in the United States in people over 60 years is precisely spinal stenosis. It is estimated that in the U.S. there are around 100 such operation per 100,000 inhabitants per year.

Unfortunately, we must admit that other western countries lag behind with surgery which is given to only around 30% of the relative number treated in U.S. It is a fair assumption that up to three times as many should have the same offer. Too many are simply not diagnosed, and therefore not treated.

The failure to diagnose is probably due to a lack of knowledge about the diagnose - both among patients and general practitioners. Nevertheless, the diagnosis has been known for many years and is made initially on the basis of the symptoms with impaired walking and pain in the legs when walking. If there is suspicion of spinal stenosis your doctor will probably first examine whether the pain is caused by poor blood circulation in the legs as this may cause similar symptoms. Can this be excluded the GP will refer you for further examination.

Earlier an X-ray was carried out with the use of a fluid contrast medium injected into the spinal canal but today the investigation is carried out easily and painlessly in a MRI scanner.

If the scan confirms that there is a spinal stenosis, the only treatment option is operation. Training and physiological treatment has no lasting effect.
 

Simple operation with good results

The treatment of spinal stenosis is extremely effective. This is a relatively simple operation and the author of this article has performed more than a thousand operations on elderly people with this disorder.

During the operation bone and connective tissue causing the reduced space in the spinal canal is removed. Sometimes this is combined with a spinal fusion where two or more of the affected vertebras are joined together. This stabilizes the area, reduces the risk of recurrence and minimizes the risk of lumbar pain.

In patients where the medical history, objective examination and MRI scan is consistent with the diagnosis, the success rate of surgery is about 80-85 percent. Thus, for more than eight out of ten cases the symptoms in the legs will be significantly reduced or completely disappear.

There is no need to just accept and put up with the suffering connected with spinal stenosis - even if you have reached 70 years of age or more. It is never too late to be treated. So, if you have pain in the legs and the lumbar area when walking and the legs feel like concrete blocks there is only one thing to do. - Contact your doctor and ask to get an MRI scan of the spine.

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