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Spinal Stenosis
What is spinal stenosis?
The spinal cord and nerve roots run through an opening in the vertebral column called the spinal canal. Because of the natural process of aging and spinal degeneration, the spinal canal may narrow, compressing the spinal cord and nerves in a process called central stenosis. The keyholes (intervertebral foramina) where the nerve roots exit the spine at their respective levels can also become narrowed, and this is referred to as foraminal stenosis.
Click the image to enlarge.
What causes spinal stenosis?
Spinal stenosis may occur anywhere along the spine but most commonly in the cervical or lumbar spine. Causes for the stenosis include:
- Calcification of the posterior longitudinal ligament (common in cervical spinal stenosis)
- Facet joint arthritis
- Spondylolisthesis
- Degenerative disc disease or protrusions
What are the symptoms for spinal stenosis?
Cervical spinal stenosis:
- Abnormal gait
- Upper extremity numbness
- Weakness in upper extremity, lower extremity, or both
- Pain radiating to the upper extremities
- Sphincter disturbances (difficulty with bowel and bladder control)
- Muscle wasting
- Neurological changes
Lumbar spinal stenosis:
- Pain in the buttocks, thighs, and legs brought on by either prolonged standing or by exercising in the erect posture
- Weakness, tingling, and loss of deep tendon reflexes
- Pain worsens while walking
- Pain decreases after sitting down
- Pain is usually less intense while you are leaning forward
- Pain is worse with extension of the back at the hips
- Low back pain may or may not be present
How is spinal stenosis diagnosed?
- Through history and physical exam
- Through imaging such as MRI
How is spinal stenosis treated?
Treatment for spinal stenosis will vary depending on the severity of the problem. It can include:
- Physical therapy
- Activity modification
- Epidural Steroid Injections
- Surgical procedures such as laminectomy, foraminotomy, or decompression and fusion