It's new to me, but looks intriguing. Seems like it would only be good for certain kinds of stenosis. One site said that pain has to go down into legs (can't be just in back) and that the pain must be relieved by bending forward.
that i what info i get also.my husband has pain in legs.doctor wants to do a laminectomy..we going to see another doctor as this dr.was rude and told us to look on internet 4 the procedure(laminectomy).thats how i found this x stop info.thanks 4 your interest.
There is normal alignment within lumber vertebral bodies with no evidence of fracture or dislocation.There is disc desiccation at L3,L4,L5,and L5-s1.There is significant loss of disc height L5-S1 with fatty endplate changes. The conus medullaris ends at L1 and is unremarkable. The patient has congenitally short pedicles,which creates a congenitally narrowed central canal.L1,L2 and L2,L3;no evidence of disc bulge,central canal stenosis,or neural foraminal narrowing.L3,L4;There is mid central canal stenosis due to congenitally short pedicles,a posterior broad-based bulging disc, facet degenerative changes,and mild posterior epidural lipomatosis.Mild bilateral inferior neural foraminal narrowing is noted.L4,L5;There is severe central canal stenosis with effacement of CSF.The nerve roots are all clumped centrally,This is due to posterior broad-based bulging disc and severe facet and ligamentum flavum hypertropy. Moderate to severe bilateral neural forminal narrowing is identified.L5-S1;There is no definite central canal stenosis.There is a posterior broad-based bilging disc with osseous ridging,this extends into the left neural foramen.Mild to moderate facet degenerative changes are noted.There is moderate right and moderate to severe left neural foraminal narrowing. SORRY this is so long.Thanks 4 the interest.We really don't know what to do next.We are nervous about surgery,but think we are heading in that direction.
My amateur opinion is also that you are heading toward surgery. The thing is, at the worst level - L4-5 - his spinal cord is getting it from all sides: the disk in front, the facets on the sides, and the ligamentum flavum in back. Even if none of those three problems rose to the level of "severe", put together they could have a severe effect on the canal and cord. As it is, the radiologist didn't say the disk bulge was severe, but did apply that adjective to the facets and the ligamentum flavum.
A laminectomy would certainly solve the ligamentum problem (it would be removed, as far as I know), and I suppose the surgeon could trim the facets back to normal size while he's in. Wouldn't do anything about the disk bulge, but would create space for the canal and cord to move backward, away from the disk.
Surgery, yes, but what kind I can't say. I'd be very shy of a cervical laminectomy, because of instability problems, but I suppose that might not apply at all to the lumbar area. Also, there may be a variety of other surgeries that could be done. Keep in mind that doing two lesser surgeries a little while apart might be better than a laminectomy, but I really don't know.
Whatever surgery you do should not only address the canal stenosis at L4-5, but definitely also the foraminal narrowing - on BOTH sides - at L5-S1. Actually, those may be the actual cause of his leg problems, rather than the canal narrowing at L4-5. I would be concerned, in particular, that a laminectomy might not do anything about the disk protrusion into the left foramen. Definitely something to clear up with the docs.
You might want to create a new thread and head it something like "lumbar laminectomy", and that may draw the interest of someone here with more knowledge and experience than I have.
Good luck, and I hope you will post your progress, as I for one would like to learn more about lumbar problems and solutions.
You both could wander over to the Back board and read through threads there to learn more about lumbar issues. Most lumbar and some thoracic spineys post on that part of the board.
I'm sorry your surgeon was so rude. I would suggest looking for a spine specialist that will take the time to explain things to you, in detail if necessary.
I'm almost certain that your husband's spine problems are too complex for the X-stop procedure. It only works in very specific situations, and usually when there is a problem at only one level. Your husband has some degenerative issues between L3 and S1.
Central canal stenosis is mentioned at the L4-5 segment. Be advised that the spinal cord terminates at around the L1 level. After this point the spinal nerves collect and feed into the spinal canal, twisting together and forming what is called the "cauda equina." When something presses into the spinal canal at this level, it can cause nerve pain, but you do not run the risk of paralysis that you might if it were happening in the cervical or thoracic areas of the spine.
Of concern is the mention that the nerve roots are all clumping together at this level.
There are also stenotic and degenerative changes at the L5-S1 level.
My suggestion is to find an experienced fellowship-trained spine specialist who will be able to explain thoroughly what all is going on in your husband's spine and what type of treatments are possible. This could be a neurosurgeon or an orthopedic spine surgeon.. Just be sure either one limits his/her practice to issues of the neck and back.
Hope to see you posting on the Back board...and I hope you can find a more patient spine specialist!