Back pain is not a symptom of age, it can be treated.

When the first symptoms of the spinal canal stenosis appear, patients often dump them on the basis of age.
02.01.2020

When the first symptoms of the spinal canal stenosis appear, patients often dump them on the basis of age. Because the conviction is that spine pain is something normal after the age of 60. Only when the pain becomes unbearable, the suffering persons begin to seek help. Usually, however, they receive further painkillers or a surgery proposal with the indication that it is a risky, complication-prone treatment. Everything changes when they go to the St. Adalbert’s Hospital in Poznan, where for the past one and a half years endoscopic spine surgery has been performed.

About 80% of our patients are people over 60 – says Piotr Winkler, neurosurgeon at St. Adalbert’s Hospital in Poznan. Most of them come to us having different experiences in other institutions. They are surprised when they hear that the stenosis can be cured in such a minimally invasive way, without the risk of traditional surgery.

Stenosis is a narrowing of the spinal canal that causes pressure on nerve structures. Narrowing is usually the result of progressive degenerative changes in the spine. They arise due to the weakening of the spine stabilizing muscles that appear with age. Stenosis manifests itself as back pain radiating towards the legs, thighs or buttocks. – The nerve roots run through the spinal canal, which should loosely swim in the cerebrospinal fluid – explains Dr. P.Winkler. – In the situation when the canal is narrowing, the roots are blocked, and any attempt to move them, for example when walking, causes pain.

The traditional operation of stenosis involves the removal of a fragment, the back of the spine, affected by degenerative changes. The treatment of the open spine is associated with a few or even a dozen centimeters incision on the back, requires not only cutting the skin, but also the spine muscles detachment. After such extensive removal of hypertrophied interatrial joint bags, instability of the operated part of the spine often occurs. The use of implants is then indispensable. The vastness of this type of surgery means that patients get well for a long time. The healing scar itself often lasts several weeks. Such a large incision in a place that is constantly exposed to movement is a high risk of infection. What is more it requires many months of rehabilitation.

In the case of endoscopic surgery, we use a minimal incision and what is most important, implants are not needed – explains Dr. Winkler. – During treatments in our hospital, to expand the spinal canal, we only remove the excess ligament and part of the joint, i.e. only those elements that are responsible for the narrowing, and hence the pain. It is a surgery much less invasive than traditional one.

To perform the endoscopic surgery of the spine, the surgeon inserts an introducer through the small incision, i.e. a metal tube with a diameter of 8 mm, which allows access to the spinal canal stenosis. The procedure is carried out using a miniature surgical instruments. Using micro scissors, bone crushers and diamond drills, the fragments responsible for nerve compression are removed. Diamond drills allow to cut bones without the risk of nerve structures damage. They slide on them, but they cannot damage them. In the case of traditional open-back surgery, the patient loses a lot of blood. There is no such risk when using an endoscope. There are not many contraindications to the use of this method. These include taking medicines that significantly interfere with blood clotting and diseases that exclude the use of general anesthesia.