Impingement

A pinched nerve from the spinal cord may occur as the result of a disc bulging or herniated pressing against the nerve in the spinal canal. The degenerative spine will form osteophytes that can press on the nerves exiting the spinal canal. Occasionally cysts may form and pinch the nerve as well. Scar tissue may form as a result of spine surgery or disc herniation. The scar may also impinge upon the exiting spinal nerve root. The patient will experience pain shooting down the nerve towards the extremity or portion of the torso that the nerve receives sensory input. Left untreated, the nerve will lose viable nutrients and begin to stop functioning. A sensory nerve will become numb, and a motor nerve will cause the muscles to atrophy. Patients have described the pain when it is acute as lanciating or laser-like projection of pain. The primary goal of therapy is to get the pressure off of the nerve. One approach is to reduce the nerve swelling by injecting steroids onto the nerve root or in the spinal canal. A multitude of minimally invasive surgical approaches are utilized including the use of lasers through flexible fiberoptic endoscopes which enter the spine at the sacrum and may treat problems of the lumbar spine. Single level endoscopic disc decompression is also performed. Open laminectomy with decompression is often used in the cervical spine.

Impingement of spinal canal due to scar tissue as seen within the spinal canal with an epiduroscope.

 

Artist’s rendition of scar in the spinal canal.

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