Advanced Diagnosis of Spinal Stenosis Treatment in Mumbai by Dr. Vishal Kundnani
Understanding Spinal Anatomy
Spinal Stenosis Treatment in Mumbai by Dr. Vishal
Kundnani begins with a deep understanding of spinal anatomy and its vital role in
movement and posture. The spine is a central structure that supports locomotion and
maintains posture, consisting of 33 vertebrae (bones) stacked one above the other. Between
these vertebrae are cushion-like structures known as discs, which act as shock absorbers.
Each disc has a tough outer layer called the annulus fibrosus and a soft, gel-like center
called the nucleus pulposus. Together, the vertebrae and discs form a protective tunnel
known as the spinal canal, which houses the spinal cord and spinal nerves. These nerves run
through the center of the spine and branch out to various parts of the body, ensuring proper
communication between the brain and limbs.
Anatomy of Spinal Stenosis
Spinal
stenosis means Narrowing of space for nerves in the spine due to compression.
When
the disc or cushion bulges and degeneration (wear and tear) of facet joints (joints in
the
spine) protrude into the spinal canal causing compression of the nerve then its called
Spinal Stenosis.
Lumbar Canal Stenosis, Lumbar Spinal Stenosis:
Degeneration of joints and disc bulge into the canal of nerves results in reduced space for
nerves into the canal of nerves resulting in a spinal stenosis. Compression of nerve results
in back pain, buttock pain, leg pain, leg numbness or buttock pain traveling down the leg
and patients complains of pain in leg with numbness and difficulty in walking. This pain in
legs with numbness in leg and heaviness in leg increase during walking and is called
claudication.
What is Spinal Stenosis?
Spinal stenosis is a condition where the space for nerve roots in the spinal column gets
narrow – narrowing of the spine means spinal stenosis. Spinal stenosis leads to narrowing of
channels where the spinal cord and nerve roots travel resulting in the spinal cord and nerve
roots getting squeezed also known as "compression of nerve roots."
Spinal stenosis can lead to pain in the lower back, leg pain, sciatica, neck, arms, or hands
depending on the exact location of the stenosis. Spinal stenosis most commonly happens in
the low back (lumbar spine) or in the neck (cervical spine and so is called lumbar spinal
stenosis or cervical spinal stenosis).
What Causes Spinal Stenosis? Lumbar Canal Stenosis? Lumbar Spinal Stenosis?
Spinal
stenosis is of two types – Primary spinal stenosis or developmental spinal stenosis
present
since birth although the symptoms appear in the latter part of the life. This is a form
of
inherited stenosis.
The
Second form of spinal stenosis category is common – Acquired spinal stenosis which
results
from wear and tear of the spine –disc and facet joints – called degeneration, where the
cartilage that cushions joints starts to degenerate wear out due to age.
Spinal
Stenosis also happens in the severe yet chronic bulge of disc /bulge disc. Slip disc
or
bulge disc or herniated disc protrudes into the spinal canal and pinches over the nerve.
Risk factors for both degeneration and lumbar spinal stenosis in the spine include
aging,
poor posture, high impact sports, and being overweight.
Dr.
Vishal Kundnani is an expert in Spinal Stenosis and is the Best spine specialist in
Mumbai
for Spinal stenosis. Dr. Vishal Kundnani is the best spinal surgeon who performs
minimally
invasive spinal surgery for spinal stenosis. Available for consultation in spine clinic
and
various hospital attachments in Mumbai.
What are Symptoms of Spinal Stenosis / Lumbar Canal stenosis / Lumbar spinal stenosis ?
Back
Pain, Leg pain, buttock pain, pain in legs, Numbness in legs, Heaviness in legs,
Imbalance
in walking, Difficulty in walking, Weakness in legs, Calf cramps are the common symptoms
of
spinal stenosis in the lumbar spine. All these symptoms increase with walking and are
called
as CLAUDICATION .
Spinal
stenosis in the low back (lumbar spine) can cause pain or cramp in legs during standing
or
during a walk for a smaller distance.
In
severe cases of lumbar spinal stenosis, nerves to the bladder or bowel may be
compressed,
which can lead to partial or complete incontinence. The earliest symptom of this may be
increased frequency of urination or urgency of urination and may progress to complete
incontinence/inability to control urine. This is a surgical emergency and may need
surgery
at earliest
Dr. Vishal Kundnani is the best spinal surgeon who performs minimally invasive spinal surgery
for spinal stenosis. Dr. Vishal Kundnani is the best spinal specialist in India for spinal
stenosis surgery and performs the surgery with minimally invasive spine surgery techniques.
What Is Cervical Spinal Stenosis? Cervical myelopathy ?
Spinal
stenosis in the neck -cervical spine compression the main nerve – spinal cord is called
spinal stenosis of the cervical spine and can cause neck pain, shoulders pain, vertigo,
giddiness, arm pain, pain in nape of the neck, forearm pain. However in advanced cases,
the
symptoms may be difficulty in walking, imbalance during walking, numbness in hands,
change
in fine functions of the hand, difficulty in holding a glass, change of signature, etc.
weakness of hands and grip.
Imbalance
during walking, clumsiness of gait, difficulty in walking and difficulty in fine
functions
of the hand are the commoner presentations of cervical stenosis.
How do we diagnose Spinal Stenosis / Lumbar Canal stenosis / Lumbar spinal stenosis ?
Spine specialist may examine you clinically and may ask for investigations like X-Ray and MRI
SCAN OR CT SCAN to diagnose the presence of Spinal Stenosis / Lumbar Canal stenosis / Lumbar
spinal stenosis in presence of symptoms . MRI scan can show various grades of Spinal
Stenosis / Lumbar Canal stenosis / Lumbar spinal stenosis and may also suggest if surgery is
really needed in view of ongoing compression of nerves in the spinal canal.
For diagnosis of the spinal problem meet the specialist in your locality. Dr. Vishal Kundnani
is available in Mumbai, Goregaon, Bandra, Kandivali on appointment. Dr. Vishal Kundnani is
the best spine specialist in Mumbai. Dr. Vishal Kundnani is Best spinal specialist in Mumbai
, Goregaon , Malad and Kandiwali
Do we need surgery for spinal stenosis / lumbar spinal stenosis ?
No.
Surgery is not the only option of treatment in a spinal stenosis. Surgery is required in
a
select group of patients with severe symptoms affecting daily living. Nonsurgical
treatment
helps in most patients significantly.
Non-surgical
treatment options to treat Slip Disc include physiotherapy, exercises, medication and
injection in spine. Meet your spine specialist to decide on which is the best treatment
option for you. The best spine specialist in India is Dr. Vishal Kundnani, Mumbai who
manages these problems with a scientific approach.
These
options of non-surgical management of slip disc are available at Spine Clinic Mumbai
–best
spine clinic in Mumbai for treatment of slip disc. Dr. Vishal Kundnani is the best spine
consultant in Mumbai and is available on appointment in Mumbai on appointment for spine
specialist.
What are Non surgical measures in spinal stenosis ?
No.
Surgery is required in select group of patients with severe symptoms affetcing daily
living
.Non surgical treatment helps in most patinets significantly.
The
non surgical treatment option is decided based on the duration and dseverity of symptoms
in
consultation with your spine surgeon/spinal surgeon the options available for slip disc
treatment are –
Medicines – NSAIDS/ Muscle relaxant / Pregabalin / TCA,S /non opiod analgesics
Hot fomentation
Cold sponging
Physical therapy
TENS
SWD
However before one resorts to any option one should have advise of Spine Surgeon
Dr. Vishal Kundnani is best spinal specialist in mumbai managing spinal stenosis and is best
spinal surgeon in india for spinal stenosis surgery .
These options of non-surgical management of slip disc are available at Spine Clinic Mumbai –
best spine clinic in Mumbai for treatment of slip disc. Dr. Vishal Kundnani is the best
spine consultant in Mumbai and is available on appointment in Mumbai on appointment for
spine specialist. Dr. Vishal Kundnani is the best spine speclaist in mumbai and best spinal
consultantin Goregaon, Kandiwali and Malad.
What is Physiotherapy for Spinal Stenosis ?
Physiotherapy
has a major role in spinal stenosis treatment and recovery. It teaches how to condition
your
body to prevent further injury and help in the recovery of the painful episode. There
are a
variety of physical therapy techniques. Passive and active treatments.
Passive
treatments relax your body and include deep tissue massage, hot and cold therapy,
electrical
stimulation (TENS), and hydrotherapy. Active treatment involves active stretching and
strengthening exercises trunk stability, core strengthening.
What are Passive Treatments / Exercise for slip disc / spinal stenosis ?
Deep
Tissue Massage: Deep tissue massage relieves deep muscle tension and spasms, which
develop
to prevent muscle motion at the affected area.
Hot
and Cold Therapy: Both hot and cold therapies offer their own set of benefits, and your
physical therapist may alternate between them to get the best results. This reduces
inflammation, muscle spasms and pain.
Hydrotherapy:
gently relieves pain and relaxes muscles.
TENS
(transcutaneous electrical nerve stimulation): uses electrical current to stimulate your
muscles and reduces muscle spasms and is generally believed to trigger the release of
endorphins, which are your body's natural pain killers. TENS machine stimulates your
muscles
through variable (but safe) intensities of electrical current. TENS may increase your
body's
production of endorphins, your natural pain killers. The TENS equipment your physical
therapist uses is larger than the "at home" use machine.
Ultrasound:
By increasing blood circulation, an ultrasound helps reduce muscle cramping, swelling,
stiffness, and pain. It does this by sending sound waves deep into your muscle tissues,
creating a gentle heat that enhances circulation and healing.
Traction:
reduce the effects of gravity on the spine. the intent is to reduce the disc herniation
and
is usually performed in the cervical or lumbar spine.
The
McKenzie Method is a system of evaluating and treating spinal disorders, including
spinal
stenosis. McKenzie Method does not actively treat spinal stenosis. It is a
non-responding
condition to mechanical therapy, so the typical techniques used in the McKenzie Method
will
not help the pain from spinal stenosis.McKenzie Method involves patient education and
active
patient involvement. For spinal stenosis, a clinician will help you learn how to avoid
sustained extension positions because the extension can increase pain if you have spinal
stenosis. And helps you on flexed positions when pain is less with bending forward. The
protocol involves you to learn abdominal flexors.
These options of non-surgical management of slip disc are available at Spine Clinic Mumbai
–best spine clinic in Mumbai for treatment of slip disc. Dr. Vishal Kundnani is the best
spine consultant in Mumbai and is available on appointment in Mumbai on appointment for
spine specialist. Dr. Vishal Kundnani is the best spine specialist in Mumbai and best spinal
consultant in Goregaon, Kandivali and Malad.
What are Active physiotherapy Treatments / Exercise for slip disc / spinal stenosis?
Help to reduce recurrent pain but will also benefit your overall health.
Core
stability: Many people don't realize how important a strong core is to their spinal
health.
Your core (abdominal) muscles help your back muscles support your spine. When your core
muscles are weak, it puts extra pressure on your back muscles. Your physical therapist
may
teach you to core stabilizing exercises to strengthen your back.
Flexibility:
Learning proper stretching and flexibility techniques will prepare you for aerobic and
strength exercises. Flexibility helps your body move easier by warding off stiffness.
Muscle
strengthening: Strong muscles are a great support system for your spine and better
handle
pain. and strengthening of muscles which can cause your back stretches and strengthen
along
with pelvic tilt, which helps you find a neutral spine position
What is the Surgery for Spinal Stenosis ?
Surgery for Spinal stenosis or lumbar spinal stenosis involves decompression – freeing the
nerves of the compression from disc or facet joints in the spine. it involves partial
removal of the compressive elements which are causing spine compression and are the cause of
symptoms.
Various options of spine surgery include conventional open spine surgery and Minimal Invasive
Spine Surgery or MIS surgery for spinal stenosis. These options of surgical management of
Slip Disc and spinal stenosis are available at Spine Clinic Mumbai – Best Spine Clinic in
Mumbai for treatment of Slip Disc and spinal stenosis. Dr. Vishal Kundnani is the best spine
consultant in Mumbai and is available on appointment in Mumbai on appointment for spine
specialist. Dr. Vishal Kundnani is the best spine specialist in Mumbai and best spinal
consultant in Goregaon, Kandivali and Malad.
How is surgery for Lumbar spinal stenosis done ?
Most patients with lumbar spinal stenosis respond well to non-surgical treatments (such as
medication)
Indications
for spinal surgery in spinal stenosis are:
No response / partial response to non-surgical treatments
Progressive radiculopathy, – pain, numbness, and tingling in the arms or legs.
Loss of power sensation in your arms or legs.
Lost bowel or bladder control.
Goal
of stenosis surgery is to free up area for your spinal cord and/or the nerve roots.
That's
called spinal decompression.
Two
surgical techniques for spinal stenosis surgery:
Decompression: Tissue pressing against a nerve structure is trimmed, which makes
more
room in the spinal canal (for the spinal cord) or in the foramen (for the nerve roots)
Stabilization: to limit motion between vertebrae when instability is the cause of
problem giving rise to pain and numbness / weakness
Various options of spine surgery include conventional open spine surgery and minimally
invasive spine surgery or MIS surgery for spinal stenosis. These options of surgical
management of Slip Disc and spinal stenosis are available at Spine Clinic Mumbai – Best
Spine Clinic in Mumbai for treatment of Slip Disc and spinal stenosis. Dr. Vishal Kundnani
is the best spine consultant in Mumbai and is available on appointment in Mumbai on
appointment for spine specialist. Dr. Vishal Kundnani is the best spine specialist in Mumbai
and best spinal consultant in Goregaon, Kandivali, and Malad
What is Decompression Surgery? What are the types of decompression surgery ?
Surgery for spinal stenosis is safe and simple. To remove the tissue that's pressing on a
nerve, the spine surgeon may perform one of the following:
Foraminotomy:
If part of the disc or a bone spur (osteophyte) is pressing on a nerve root in its path
(an
exit called the foramen), a foraminotomy – widening of the path for nerve root- may be
done.
Ostomy means "to make an opening." So a foraminotomy is making the opening of the
foramen
larger, so the nerve can exit without being compressed.
Laminotomy:
laminotomy makes a larger opening, this time in bony plate protecting the spinal canal
and
spinal cord. The lamina bony sheath over the nerves along with the nerve roots may be
pressing on your nerve, which is removed to make more room for the nerves using a
laminotomy.
Laminectomy:
Sometimes, in severe cases and multilevel cases small opening in the bone may not be And
what is needed is to remove all or part of the lamina, and this procedure is called a
laminectomy. This can often be done at many levels without any harmful effects.
Indirect
decompression is a variation of decompression surgery where pressure is relieved by
spreading the bones apart instead of removing the bone. This can be done with different
techniques and various instrumentation some examples are distraction laminoplasty with
or
without implants like interspinous process devices or interbody cages. Even artificial
discs
can accomplish some indirect decompression by restoring the height between adjacent
vertebrae.
Various options of spine surgery include conventional open spine surgery and Minimal Invasive
Spine Surgery or MIS surgery for spinal stenosis. These options of surgical management of
Slip Disc and spinal stenosis are available at Spine Clinic Mumbai – Best Spine Clinic in
Mumbai for treatment of Slip Disc and spinal stenosis. Dr. Vishal Kundnani is the best spine
consultant in Mumbai and is available on appointment in Mumbai on appointment for spine
specialist. Dr. Vishal Kundnani is the best spine specialist in Mumbai and best spinal
consultant in Goregaon, Kandivali, and Malad
What is Minimally Invasive Surgery for spinal stenosis ? what is laser surgery in spine ?
Spinal
surgery can be done in open conventional technique or by MIS surgery – Minimal Invasive
Spine Surgery. However Minimal invasive spinal surgery is extremely safe and simple and
most
efficient. The best technique to do spinal surgery for lumbar spinal stenosis surgery is
Minimal Invasive Spinal Fusion surgery is performed through a relatively large incision
in
your back, that's called open surgery. Another option is minimally invasive surgery,
which
is done through small incisions. The surgeon may use a microscope, endoscope, or tiny
camera
and very small surgical instruments.
With
developing infrastructure and technology in surgical science spine surgery can be easily
and
safely performed with small incisions – keyhole spine surgery or minimally invasive
spine
surgery.
Conventionally
done spine surgery has demerits and involves retraction of muscles and stripping of
muscles
with the removal of bone from spine although extremely safe, patients who undergo open
spine
surgery may require a longer hospitalization due to relatively higher post-operative
pain,
blood loss, infection chances and prolonged rehabilitation period.
Whereas
Minimal Invasive Spine Surgery not only aims at giving the benefits of open surgery but
also
cuts down the demerits of open spine surgery. Minimal Invasive Spine Surgery or keyhole
spine surgery aims at smaller incisions, less blood loss, no postoperative pain, shorter
hospitalization, no infection, early rehabilitation and returns to work . also it has a
minimal scar which is cosmetically better.
The
keyhole surgery technique or minimally invasive surgery for spinal surgery can be safely
and
easily performed with the help of microscope or endoscope and so are called microscopic
spine surgery or endoscopic spine surgery. this technique has been successfully used to
treat slip disc/herniated disc/sciatica/spinal stenosis/spinal
instability/spondylolisthesis, spinal fractures etc.
Various options of spine surgery include conventional open spine surgery and minimally
invasive spine surgery or MIS surgery for spinal stenosis. These options of surgical
management of slip disc and spinal stenosis are available at Spine Clinic Mumbai – Best
Spine Clinic in Mumbai for treatment of slip disc and spinal stenosis. Dr. Vishal Kundnani
is the best spine consultant in Mumbai and is available on appointment in Mumbai on
appointment for spine specialist.Dr. Vishal Kundnani is the best spine specialist in Mumbai
and best spinal consultant in Goregaon, Kandivali and Malad.
How fast is Recovery from Surgery for Spinal Stenosis? Lumbar canal stenosis ?
After surgery patient is mobilized out of bed within 24 hours, and pain medications are
continued for 2 weeks. After the surgery, general do's and don'ts instructions are given
about. With Minimal, Invasive spine surgery patient can go home within 48 hrs and can resume
job within 2 weeks however Contact sports is generally avoided for 6-10 weeks.
One
should follow
Follow
your doctor's treatment plan
Sit
and stand properly and maintain posture
Learn
to lift correctly
Exercise
regularly (low impact aerobic exercise is especially good, but check with your doctor
first)
Attain
and maintain a healthy body weight
Eat
healthy foods (a well-balanced, low-fat diet rich in fruits and vegetables) and get
enough
calcium
Stop
smoking
How to prevent Spinal Stenosis ? Lumbar canal stenosis ?
Spinal stenosis is mostly due to the degenerative process which is inevitable. However, the
ill effects of spinal stenosis and symptomatic state can be reduced and prevented. This
includes-
Exercise-
Exercise strengthen your spine and protect it from the everyday effects of wear and tear
and
keeps your body weight under control and puts less pressure on spine preventing the
development of symptoms Some general rules to exercise start slowly. Gradually build up
your
sessions and target exercising for 40 mins every day. stretching is an effective way to
lengthen and warm up your spinal muscles. Best exercise regime is to Combine aerobic
activities (such as walking or swimming) with resistance training (such as yoga or
weight
lifting).
Posture-
Having good posture and practicing proper mechanics are some of the best ways to prevent
stenosis from progressing and ensure the health of your back. Good posture and body
mechanics should be practiced all the time—whether you're sitting, standing, lifting a
heavy
object, or even sleeping.
Weight
Control – Ideal weight for your body should be Height in cms – 100 = Weight in
kgs
.What is more important than your weight is your Body Mass Index which should be managed
to
less than 25 at all times.
Lifestyle
– Avoid Stress, frequent relaxation, proper posture, better ergonomics are key
to
spine care.
For further information on spinal stenosis You should meet the spinal specialist in your
locality. Dr. Vishal Kundnani is the best spine specialist in Mumbai and best spinal
consultant in Goregaon, Kandivali and Malad
Who is the Best Spine Surgeon in Mumbai for Spinal stenosis surgery? Who is the best Spine
Specialist in Mumbai for treatment of Lumbar Spinal stenosis surgery ?
Dr. Vishal Kundnani is one of the Best Spine Surgeons for Lumbar Spinal stenosis surgery and
is available in various hospitals for consultation and for surgery. Dr. Vishal Kundnani is
the best spine specialist with a considerate approach to patients with an honest opinion and
ethical spine practice. Dr. Vishal Kundnani is the best microscopic and minimally invasive
surgeon for Slip Disc surgery in Goregaon, Malad, Kandivali.
What is SPINAL FUSION surgery for lumbar canal stenosis?/ Stabilization Surgery for spinal
surgery ?
Surgery
for lumbar spinal stenosis is safe and simple. Spinal fusion for spinal stenosis is
rarely required. Spinal fusion is not required in all cases of spinal stenosis. Spinal
fusion is required in patients when there is instability –painful mobility between the
vertebrae bones and the surgery is aimed at reducing the mobility at that segment. It's
especially helpful in cases where one or more vertebrae have slipped forward –
SPONDYLOLISTHESIS – slipping of one vertebra forward in relation to other, which makes
spine unstable and painful due to pinch of nerves causing pain.
Spinal
fusion may also be required if instability although not present today is imminent after
the surgery for spinal stenosis. Henceforth the fusion is added to decompression in
anticipation of instability. Spinal fusion surgery requires putting/inserting Spinal
implant (Pedicle screw and plates and cages ) in the spine after decompression surgery.
The spinal implants are an extremely safe procedure.
Spinal
fusion can be done in open conventional technique. However Minimal invasive spinal
fusion surgery is extremely safe and simple and most efficient. The best technique to do
spinal fusion is Minimal Invasive Spinal Fusion. Minimal invasive spinal fusion also
called as minimal invasive transforaminal interbody fusion or MIS-TLIF or MIS TLIF is a
extremely safe procedure with plenty of benefits of less pain , less blood loss , less
infection , smaller incisions , early return to work , early discharge from hospital ,
no need of bed rest after surgery.
Various options of spine surgery include conventional open spine surgery and minimally
invasive spine surgery or MIS surgery for spinal stenosis. These options of surgical
management of slip disc and spinal stenosis are available at Spine Clinic Mumbai – Best
Spine Clinic in Mumbai for treatment of slip disc and spinal stenosis. Dr. Vishal
Kundnani is the best spine consultant in Mumbai and is available on appointment in
Mumbai on appointment for spine specialist. Dr. Vishal Kundnani is the best spine specialist
in Mumbai and best spinal consultant in Goregaon, Kandivali and Malad