In medical terms, Stenosis signifies a ‘narrowing’ of any tubular vessel or structural passageway in the body. Axial Spinal Stenosis refers to a condition where this narrowing reduces the space within the spinal canal. The cause may be due to arthritic overgrowth of the Facet Joints, degeneration of the disc with a subsequent loss of disc height, slackening of surrounding ligaments which then bulge into the spinal canal, and bulging of the disc. This loss of space can result in the squeezing or pinching of the nerve roots as they navigate within the spinal canal.
Symptoms of Axial Stenosis
Many individuals with this condition experience escalating back pain, often over several years. Pain is commonly triggered by physical activity, and there’s an increasing preference for the back to be flexed. This implies that standing straight or extending the back can intensify pain and gradually exacerbate symptoms. As the condition progresses, patients often report heaviness in the thighs, hamstrings, or calves during walking. The condition can reduce walking distance in a phenomenon known as ‘Claudication,’ resulting from inadequate blood supply to the nerves. Symptoms subside when the individual stops the activity, crouches, or leans forward. Over time, there may be a swift decline in function, and the individual might find it hard to stand. It’s crucial to intervene before reaching this stage for the best outcomes.
Challenges with Conventional Diagnosis
Diagnosing Axial Stenosis can be complex. One significant challenge is the over-diagnosis of the condition. Pathology evident on MRI and CAT scans might be present for years without manifesting symptoms. Moreover, there are difficulties in distinguishing between Axial Stenosis and Lateral Recess Stenosis. From the perspective of The Spinal Foundation, Axial Stenosis, while visible on scans, might be less of a pain contributor than Lateral Recess Stenosis.
Is a Precise Diagnosis Feasible?
Axial Stenosis is closely related to Lateral Recess Stenosis. The key to an accurate diagnosis lies in distinguishing between the two and identifying if both conditions are present and causing symptoms.
Confirming the Diagnosis
Modern techniques, such as spinal probing and hydraulic discography, can confirm the diagnosis. These techniques can identify the specific segment causing symptoms without needing extensive surgery.
Issues with Conventional Surgical Procedures
There are several conventional surgical treatments available. However, each has its limitations and may not always provide the desired relief.
Aware State Diagnosis
Aware state diagnosis is a contemporary approach that focuses on ‘live’ diagnosis. This method provides more accurate results compared to traditional techniques that rely heavily on X-rays, MRI scans, and CAT scans.
Treatment for Axial Stenosis
Endoscopic Transforaminal Endoscopic Lumbar Decompression & Foraminoplasty (ELDF) is a treatment method that addresses the specific causes of the condition.
Why is Endoscopic Minimally Invasive Spine Surgery Superior?
This technique is precise, causes minimal tissue damage, and offers a better long-term outcome compared to conventional surgery.
Evidence of Successful Treatment
Aware State Diagnosis and ELDF Surgery have shown promising results, with over 80% success rate when reviewed 2-4 years post-surgery and 70% after 10 years.