Re: OT: Guitar Hero/Rock Band vs. real guitar.

On May 17, 7:16 am, Mitch@xxx wrote:

That really sucks! Have you considered Mayo Clinic? They're the top
of the top. When other doctors told us nothing could be done for my
wife, we went there and they had tons more ideas to try.

It seems to be pretty common in older folks, it's just hitting me
because of a defect in my spine. Mayo Clinic says:

http://www.mayoclinic.com/health/spinal-stenosis/DS00515/DSECTION=8

Treatment

Many people with spinal stenosis are effectively treated with
conservative measures. But if you have disabling pain or your ability
to walk is severely impaired, your doctor may recommend spinal
surgery. Acute loss of bowel or bladder function is usually considered
a medical emergency and requires immediate surgical intervention.

Nonsurgical treatments
Before considering surgery, your doctor is likely to recommend trying
one or more of the following for at least three months:

* Physical therapy. Working with a physical therapist can build up
your strength and endurance and help maintain the flexibility and
stability of your spine.

* Nonsteroidal anti-inflammatory drugs (NSAIDs). These include
over-the-counter and prescription medications, such as aspirin,
ibuprofen (Advil, Motrin, others) or indomethacin (Indocin), to reduce
inflammation and pain. Although they can provide real relief, NSAIDs
have a "ceiling effect" — that is, there's a limit to how much pain
they can control.

If you have moderate to severe pain, exceeding the recommended
dosage won't provide additional benefits. What's more, NSAIDs can
cause serious side effects, including stomach ulcers that may bleed.
If you take these medications, talk to your doctor so that you can be
monitored for problems.

* Analgesics. This group of pain relievers includes acetaminophen
(Tylenol, others). Analgesics don't reduce inflammation, but they can
effectively treat pain. Yet chronic overuse of acetaminophen can cause
kidney and liver damage. Drinking alcohol increases your risk of
serious side effects.

* Chondroitin sulfate and glucosamine. These nonprescription
supplements, used either alone or in combination, have shown positive
effects on osteoarthritis. But it's not yet known whether they're
effective at treating or preventing osteoarthritis of the spine. Talk
to your doctor if you're interested in these supplements — they may
interfere with other medications you're taking, especially warfarin
(Coumadin).

* Rest or restricted activity. Moderate rest followed by a gradual
return to activity may improve symptoms. Walking is usually the best
exercise, especially for people with neurogenic claudication, but
biking also is recommended because it keeps your back in a flexed
position rather than in an extended one.

* A back brace or corset. This helps provide support and may
especially benefit people who have weak abdominal muscles or
degeneration in more than one area of the spine.

* Epidural steroid injections. In some cases, your doctor may
inject a corticosteroid medication into the spinal fluid around your
spinal cord and nerve roots.

Corticosteroids suppress inflammation and can be especially
helpful in treating pain that radiates down the back of your leg — in
fact, a single dose may provide significant relief. But because
corticosteroids can cause a number of serious side effects, the number
of injections you can receive is limited, usually to no more than
three in one year.

Surgery
The goal of surgery is twofold: to relieve pressure on the spinal cord
or nerves and to maintain the integrity and strength of your spine.
This can be accomplished in several ways, depending on the cause of
the problem. The most common surgical procedures include:

* Decompressive laminectomy. In this procedure, your surgeon
removes all of the lamina — the back part of the bone over the spinal
canal — to create more space for the nerves and to allow access to
bone spurs or ruptured disks that may also be removed. A laminectomy
is often performed through a single incision in your back (open
surgery), although in some cases, your surgeon may use a laparoscopic
technique. In that case, a tiny camera and surgical instruments are
inserted through several small incisions, and your surgeon views the
operation on a video monitor.

Laparoscopic back surgery is complex and requires great skill
and is not appropriate for many people with spinal stenosis. When done
properly, however, you're likely to have less pain and to recover from
surgery more quickly with this technique. Risks of laminectomy include
infection, a tear in the membrane that covers the spinal cord at the
site of the surgery, bleeding, a blood clot in a leg vein, decreased
intestinal function (paralytic ileus) and neurological deterioration.

* Laminotomy. In this procedure, just a portion of the lamina is
removed to relieve pressure or to allow access to a disk or bone spur
that's pressing on a nerve. The risks are the same as for laminectomy.

* Fusion. This procedure may be performed on its own or at the
same time as laminectomy. It's used to permanently connect (fuse) two
or more vertebral bones in your spine and may be especially indicated
when one vertebra slips over another. To fuse the spine, small pieces
of extra bone are needed to fill the space between two vertebrae. This
may come from a bone bank or from your own body, usually your pelvic
bone. Wires, rods, screws, metal cages or plates also may be used,
especially if your spine is unstable or the operation takes place to
correct a deformity.

Back surgery can relieve pressure in your spine, but it's not a cure-
all spinal stenosis treatment. You may have considerable pain
immediately after the operation, and you might continue to have pain
for a period of time. For some people, recovery can take weeks or
months and may require long-term physical therapy. What's more,
surgery won't stop the degenerative process, and symptoms may return —
sometimes within just a few years.
.

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