Spinal Stenosis

What is stenosis?
Stenosis refers to a narrowing of the spinal canal, which places pressure on the cord and or spinal nerve roots. Cervical refers to the neck and lumbar to the lower back.

Cause of spinal stenosis?
Occasionally this can be “congenital” meaning you are born with this condition. More commonly, stenosis is seen in adults and due to “degeneration” every day wear and tear of the spinal column itself. As the aging process takes it toll, the supporting ligaments (hypertrophy) thicken and the bone structures reinforce causing spurring and resultant narrowing of the normal opening.

As stenotic effects occur, inflammation onsets and it is the inflammation that is directly responsible for the ensuing pain. Inflammation causes direct pressure on the spinal cord or nerve sheaths surrounding the spinal nerves.

Signs and Symptoms of spinal stenosis
Patients may experience symptoms in the upper or lower extremities, depending if the origin is cervical or lumbar stenosis. Symptoms may include pain, weakness, early fatigue, tingling or numbness. Symptoms usually onset with walking even short distances and may cause the individual to stop activities and rest. Sitting or bending forward may help alleviate symptoms and stairs/hills may intensify or ease symptoms. Cervical stenosis may be felt in the neck, shoulders or in certain regions of the arm(s) and hand(s). Lumbar stenosis may be felt in the low back, buttock(s), or in any region of the leg(s) and Feet.

Diagnosis:
Your provider will first obtain a detailed history regarding your condition. This in turn with an examination will help rule out other causes for your pain. You will obtain other tests to help aid in the diagnosis as the provider deems necessary.

X-RAY: show the vertebrae well and assess the extent of arthritic and acute changes.

MRI: A 360 degree view of the entire spine, with emphasis on the neural (nerve) structures.

BONE SCAN: A sensitive test that detects any abnormal bone activity and helps clue the provider into a specific location.

CT SCAN: another 360 view of the spinal structures with specificity for the bone rather than soft tissue.

CT MYELOGRAM: Dye within the spinal canal, that helps outline pathology and give your surgeon a more definitive picture.

Treatment:
Non surgical treatment may consist of many things. Some of these could include; anti inflammatory medication, physical therapy, bracing, corticosteroids or therapeutic injections.

Surgical treatment may be warranted if conservative means fail. The goal of surgery is to relieve the pressure by creating space for the spinal cord and or nerves. There are multiple procedures and you would need to discuss what procedure is best for you specifically.