spinal stenosis
Spinal stenosis is a condition where for a variety of reasons the spinal canal becomes more narrow. This narrowing can put additional pressure and compression on the spinal cord and can cause a pinching of the nerve roots. If the narrowing is in the lower part of spinal cord it is referred to as lumbar spinal stenosis and if the narrowing is in the upper part of the spinal cord then it is referred to as cervical spinal stenosis. While stenosis can also occur in the thoracic or upper back region, the lumbar and cervical areas are the most common.
Who Gets Spinal Stenosis?
While some people are born with stenosis, most of the time spinal stenosis is seen in people over the age of 50 who already have some disc degeneration just as a consequence of getting older as well as the gradual wearing down on the spine from normal activities. As we get older, our spinal ligaments can calcify, bone spurs may form, and we can get herniated or ruptured discs. All these conditions can lead to a narrowing of the spinal canal which can compress and pinch the spinal nerves.
Spinal Stenosis Symptoms
Symptoms of spinal stenosis can include back pain radiating to the legs, numbness or pain in the buttocks that worsen when walking or exercising, leg weakness, decreased physical endurance, loss of balance, and leg and neck pain.
Spinal Stenosis Treatments
In general doctors tend to take a conservative approach when initially treating spinal stenosis. Drug therapy such as pain relievers and anti-inflammatory medications to reduce swelling are usually prescribed first, along with bed rest and reduced physical activity. Steroid injections can also be use to help reduce swelling although the pain relief is normally temporary.
Traction and spinal decompression may be prescribed, along with physical therapy which can be used to help increase flexibility as well as build endurance.
If the pain is acute, then surgery may be needed in order to widen the spinal canal and to correct the conditions that are contributing to the nerve compression.
Some of the surgical procedures used to treat spinal stenosis are:
Decompressive laminectomy. This is used for treating lumbar spinal stenosis and involves removing the top of the vertebra to create more space for the nerves.
Laminotomy. This is a partial removal of the lamina which can be done to widen the spinal canal and relieve compression on the nerve roots.
Foraminotomy. Removal of bone, scar tissue, or other obstructions that are compressing the nerve root exiting the spinal canal.
Due to the risks involved, many doctors will resort to surgical treatments only after non-surgical treatments have been tried first.
This article is not meant to replace the sound advice of a personal physician. Patients should discuss with their doctor all their treatment options before taking any medical course of action.
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