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:
- Conservative Treatment
- 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.
