Spinal Stenosis

Introduction

Spinal stenosis is a medical condition characterized by the narrowing of the spinal canal that occurs when excessive growth of bone and/or tissue reduces the size of the openings in the spinal bones. The process eventually leads to the compression of the nerve roots.

This condition occurs mostly in the lower back (lumbar) area. Spinal stenosis commonly affects middle-aged or elderly people. Younger people born with a narrow spinal canal or who damage their spines may also get spinal stenosis.

Symptoms

The main symptoms of spinals stenosis include:

Pain in the buttocks, thighs or calves that worsens with walking or exercise

Numbness in the buttocks, thighs or calves that worsens with standing

Radiating back and hip pain

Cramping and weakness in the legs

Neck and shoulder pain

Foot and leg pain

Difficulty or imbalance when walking

Loss of bowel or bladder function (cauda equine syndrome)

Causative Factors

Spinal stenosis most often occurs because of the natural process of spinal degeneration that occurs with aging. Here we list some of the other main causes that might lead to spinal stenosis:

Herniated disk

Ligament changes

Spinal tumors

Injury (such as from car accidents)

Paget’s disease of bone

Achondroplasia

Arthritis is also considered as one of the frequent causes of spinal stenosis.

Diagnosis

Spinal stenosis is usually diagnosed by a combination of interview about the medical history and a physical examination along with some essential tests. Here we list some of the main tests involved:

X rays

Spinal magnetic resonance imaging (MRI)

Computerized axial tomography (CAT)

Bone scan

Treatment Modalities

There are two major lines of treatment followed for relief from spinal stenosis, including conservative treatment and surgical remedies. Here we briefly explain each one of them:

  1. Conservative Treatment

  2. Non-steroidal anti-inflammatory drugs (NSAIDs)

Analgesics (Tylenol)

Epidural steroid injections

Physical therapy

Restricted therapy

Support devices

Surgical Options

Before understanding the different surgical procedures available, it is important to know that surgery is considered only if the patient meets the following conditions:

There is weakness or numbness in the legs

It is difficult to stand or walk

Medication and physical therapy have not produced the desired effect

The patient’s health is stable

Leg pain limits normal activity, affecting quality of life

Various surgical options include:

Laminectomy

Laminotomy

Foraminotomy

Spinal Fusion

If left untreated the infections may progress because the pain related to them may not be felt. The changes caused by the nerve compression can also be permanent, even if the pressure is relieved.