Back pain & neck pain
Spine disorders: spondylolisthesis and stenosis
Spondylolisthesis: dislocation of vertebrae vis-à-vis one another
In patients with spondylolisthesis, poor ossification has resulted in a forward or backward dislocation of two vertebrae vis-à-vis one another. Patients often suffer from an excessively hollow back. This may sometimes lead to lower back complaints. When in pain, it is best to avoid straining activities such as intensive sports.
Solution: spinal fusion or arthrodesis
In severe cases, it may be necessary to surgically fix the vertebrae using screws, rods and plates. This is called spinal fusion or arthrodesis.
This procedure is executed with live imaging on a monitor so that the screws can be inserted with the utmost precision. This can be done by making use of endoscopic devices or the O-arm. This innovative device allows to make very accurate CT-images during the actual operation. The procedure can also be executed in a minimally invasive way, for which a very small incision suffices.
Lumbar canal stenosis: narrowing of the lumbar vertebral canal
Some people are born with a lumbar spinal canal that is smaller than usual. This is not really a disorder but an anatomic variant that in time may give rise to complaints. Particularly in case of calcification or arthrosis, serious pressure may be exercised on the nerve bundle running through the vertebral canal. This may lead to radiating pain in the lower limbs when walking, forcing patients even to stop for a while. This is referred to as ‘intermittent claudication'. After a few moments of rest, the pain disappears and the patient can continue his walk. Because these symptoms also occur in the event of a reduced blood flow in the lower limbs, which is called ‘claudication', these symptoms are also referred to as ‘neurogenic claudication'.
When the complaints are pronounced and have become a real nuisance, a surgical correction may be proposed. A laminectomy restores the normal size of the canal. This can be done with open surgery, but also, as with the lumbar discectomy, in a minimally invasive way, using mini-tubes.
Cervical canal stenosis: narrowing of the cervical vertebral canal
A narrowing of the vertebral canal can also occur in the cervical vertebrae, causing pressure on the spinal cord. The most common resulting complaints are tingling sensations in hands, deterioration of fine hand skills (for instance when sowing), difficulties when walking and, finally, major signs of paralysis.
It is crucial that the diagnosis is made in an early stage. For this, an MR of the cervical spinal column is made. This allows to clearly establish the pressure on the spinal cord and even changes in the spinal cord itself.
Solution: cervical laminectomy
Surgical corrections of disorders are usually performed along the front (cf. cervical discectomy), but sometimes it is necessary to perform the operation through the back (via the neck). This is called a cervical laminectomy.
A laminectomy restores the normal size of the vertebral canal. This can be done with open surgery, but also, as with the lumbar discectomy, in a minimally invasive way, using mini-tubes.
The recovery after this surgery depends on the condition of the patient prior to the operation. If the patient already suffered from failure symptoms, it is possible that these will not recover anymore or only partially. In this case, the operation will prevent further deterioration.
Here, you can consult our brochure with recommendations after a cervical laminectomy.