Spine Archive: Stenosis

robotic spine surgery

WATCH: Active Patient Receives Robotic Spine Surgery

David was struggling with daily mobility until robotic spine surgery saved the day(s). Learn more about Minimally Invasive Spine Surgery in Dr. Anthony Leone’s Knowledge Center.

David had a severe case of spinal stenosis in which his nerves were pinching together, causing heavy bouts of leg pain. He tried everything to remedy the daily pain. His golf swing was being heavily effected by his immobility in the lower spine. Two weeks after his surgery, David was back in the gym. Less than a year later and he is back to work and back doing the things he loves, like golfing. See David’s heartwarming story and learn about his procedure as explained by his doctor.

Video courtesy Mazor Robotics via YouTube.

Spine Surgery Buffalo

Hypochondroplasia, Erie County

Spine surgery may be a solution to alleviate pain from spinal stenosis and other complications. Contact Dr. Anthony Leone today.

Hypochondroplasia is an autosomal dominant disorder with clinical features and radiographic findings similar to those associated with achondroplasia, but to a milder degree. The diagnosis is rarely apparent before age 2 years and typically results from investigation of short stature. Musculoskeletal problems that present for management in hypochondroplasia include lumbar spinal stenosis, genu varum, and short stature.¹

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

Spine Surgery Buffalo

Surgical Treatment for Radiculopathy and Myelopathy, Western New York

You can learn more about disk herniations and surgical intervention in the Knowledge Center or by contacting Dr. Anthony Leone.

Anterior decompression can be performed, as initially described in the classic study by Smith and Robinson. When there is a central disk herniation, significant uncovertebral spurring, or central canal stenosis, anterior decompression is the most direct means of decompressing the neural elements. Transverse incisions are made for one, two, or arguably three levels, and oblique incisions may be necessary for longer exposures. The level of incision can be guided by anatomic landmarks.¹

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

Spine Surgery Buffalo

Laminectomy, Buffalo NY

Consult Dr. Anthony Leone to learn more about spine surgery for spinal stenosis and other degenerative spine issues.

The standard surgical procedure for spinal stenosis is decompressive laminectomy. Because spinal stenosis is a global degenerative process, encompassing multiple levels and frequently involving nerve roots bilaterally, multilevel bilateral laminectomy commonly is required. For bilateral laminectomy the lamina and ligamentum flavum are removed on both sides of the stenotic level(s) to the lateral recess.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

Spine Surgery Buffalo

Degenerative Lumbar Disorders, Western NY

Contact Dr. Anthony Leone to learn more about the goals of spinal surgery for various spinal problems.

Surgical decompression may be necessary in those patients unresponsive to conservative treatment (which may include epidural steroid injections). Goals of surgery include central decompression, foraminotomy, and partial facetectomy for lateral recess stenosis. Fusion is recommended for those patients with spondylolisthesis.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

Spine Surgery Buffalo

Transient Radiculopathy, Buffalo New York

Learn more about ‘burners’ in Dr. Leone’s Knowledge Center.

Orthopaedic surgeons frequently are called on to evaluate athletes with transient radiculopathy, burners, or paraparesis. Measurements on plain radiographs cannot predict congenital cervical spine stenosis. Normally with width of the body and the width of the canal are equal and would give a ratio of 1. If the ratio between the spinal canal measured on the lateral radiograph and the width of the body at its midpoint is less than 0.8, cervical spinal stenosis should be suspected but MRI is needed to establish the diagnosis.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

Spine Surgery Buffalo

Lumbar Degenerative Disease: Stenosis, WNY

Learn more about the spine in the elderly in Dr. Leone’s Knowledge Center.

Aging of the spine, as with other joints of the body, can bring on bony and ligamentous changes. Narrowing of the disc spaces and hypertrophy of the ligamentum flavum and facet joints are accompanied by narrowing of the spinal canal. Compression can occur in any of the three areas: (1) central stenosis, (2) subarticular or lateral recess stenosis, or (3) foraminal stenosis.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

Spine Surgery Buffalo

Degenerative Lumbar Scoliosis

Degenerative lumbar scoliosis can result from untreated idiopathic scoliosis, but it more frequently occurs independently as a sequela of the aging process in combination with osteoporosis. Many patients with degenerative lumbar scoliosis have a combination of both mechanical back pain and spinal stenosis.

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

Spine Surgery Buffalo

Lumbar Spinal Stenosis Surgical Intervention

Patients with persistent lower extremity symptoms from lumbar spinal stenosis are generally offered surgical decompression. The physician should make clear that the aim of surgery is to relieve current disability rather than prevent future complications. There is no conclusive evidence that disability from spinal stenosis worsens over time. Less frequent indications for surgery include progressive neurologic deficit or cauda equina syndrome.

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

Spine Surgery Buffalo

Nerve Root Compression Symptoms

Symptoms of nerve root compression injuries usually occur in older patients. There is compression of the nerve roots and dorsal root ganglion in the foramen usually due to hyperextention and ipsilateral neck flexion. There is a presence of degenerative disease and stenosis. Patients usually have neck pain, decrease range of motion and a positive spurlings sign which is neck extension and ipsilateral neck flexion that compresses the neuroforamen.

¹Warner, William C. (2015). American Association of Orthopaedic Surgeons Annual Meeting Lecture.