Spinal Stenosis - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
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Spinal Stenosis - Medical Malpractice
Spinal stenosis involves a narrowing of the spinal column. Pressure is put upon the spinal cord or upon the spinal foramina or openings where the nerve rootlets pass to the rest of the body. It is a condition that usually increases as a person ages. The discs of the vertebral column become drier and begin to shrink. The bones become arthritic and the ligaments swell and enlarge to some extent so that pressure is applied to the spinal cord. Infections and birth defects can also cause this problem, and it can happen to a person of any age.
The main causes of spinal stenosis include arthritis in the middle aged person or the elderly, a herniated or "slipped" disc, a spinal injury, a spinal defect that occurred from birth (congenital defect), spinal tumours, bone diseases or Paget's disease. Achondroplasia can cause spinal stenosis as well.
Symptoms tend to come on gradually and get worse over time. The symptoms may be on both sides of the body or on only one side of the body. Some symptoms are numbness, pain or cramping in the buttocks, thighs, back or calves. In the upper body, there can be pain in the neck, arms or shoulders. Weakness of any of these body parts can occur as well and can mimic stroke symptoms.
Symptoms of spinal stenosis often worsen when you stand up or try to walk upright. Pain and weakness will be less with leaning over or with sitting. Walking for long periods of time is problematic for the person with spinal stenosis. Riding a bicycle tends to be no problem but balance is very poor when a person is trying to walk. More serious symptoms include problems with bowel or bladder control and difficulty with constipation or lack of ability to urinate.
Diagnosing a case of spinal stenosis depends on a complete history and physical examination. The doctor will assess the symptoms while standing, sitting and walking on your toes and heels. The doctor will have you bending over forward, sideways and backwards, seeing what symptoms occur. Straight leg raising will be attempted and the patient will usually have increased pain doing this when the condition is really sciatica. Reflexes are assessed and tests such as an electromyogram or EMG can be done. This is a test of the nerve and muscle function of the extremities and can tell where the problem arises. A spinal CT scan or spinal MRI can be done to show the narrowing of the spinal cord and spinal canal. Plain films of the spine may also show arthritic changes consistent with spinal stenosis.
If you have spinal stenosis, you must be careful with heavy lifting and must take care of yourself. You should not walk long distances until the problem is resolved and you should seek the attention of an orthopedic surgeon who specializes in spinal cord problems. The doctor may use tricyclic antidepressants such as amitriptyline, phenytoin, and carbamazepine to control nerve symptoms and nerve pain. Painkillers can be used to control the pain prior to surgical intervention. You should still try to stay active and, if you are having problems, consider seeking the advice and care of a physical therapist.
Doctors try to use conservative measures in cases of spinal stenosis but it may come down to having to have surgery to correct the area of stenosis. This should be done by an experienced spinal surgeon. The surgery may take several hours and the recovery time may be at least a week or more but you will have an improvement in your function that will likely not go back to the way it was. The surgeries used to treat spinal stenosis include a foraminectomy, a laminectomy and a spinal fusion surgery. These can relieve the pressure on the spinal cord on a permanent basis.
Spinal surgery will help you have at least partial or complete relief of symptoms unless there has been permanent damage to the spinal cord. There will be stress to the spinal area above and below the level of the surgery and inflammation that may last for several weeks or month to the spinal cord.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here