Spinal Stenosis is the narrowing (or stenosis) of the spinal canal, the spaces within the spine. The stenosis occurs in the cervical (neck), thoracic (middle or upper back), and lumbar (low back) areas of the spine. When the narrowing occurs, it may cause the spinal cord and the nerve in the spinal cord to restrict resulting in a neurological deficit. The most common symptoms include: pain, numbness, paresthesia (or an abnormal tingling and prickling sensation), and loss of motor control. Spinal Stenosis is most commonly caused by the wear and tear changes in the spine that are related to osteoarthritis.
Spinal Stenosis most commonly occurs in the cervical and lumbar regions of the spine. The cervical stenosis is a condition where the narrowing occurs in the part of the spine in the neck. The lumbar stenosis is a condition where the narrowing occurs in the part of the spine in the lower back and this is most common of spinal stenosis. Both of these different types of stenosis are diagnosed because the mobility is reduced like turning and bending. The thoracic spine’s main purpose is to provide support and stabilization which can wear down over time.
Spinal stenosis typically affects people over the age of 50 years; however, there are many people who may have it but may not have any symptoms. It starts gradually and then can worsen over time. The symptoms will vary depending on the location of the stenosis and the nerves that are impacted.
The most common causes include:
Herniated Disc – A herniated disc, also called bulged, slipped or ruptured disc, is one of the most common causes of pain in the Lumbar Spine (Lower Back). The bones or vertebrae that make up the spine in the back are cushioned by spinal discs.
Overgrowth of the Bone – The normal wear and tear from osteoarthritis on the spine’s vertebrae can cause the formation of bone spurs, which can grow into the spinal canal. Paget’s disease can also cause bone overgrowth in the spine.
Thickening Ligaments – The touch cords that help to hold the spine’s bones together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal.
Tumors – Abnormal growths can form inside the spine causing the stenosis to develop.
Spinal Injuries – Traumatic events like a car accident can also cause fractures on the vertebrae. Displaced bone fragments may also damage the contents of the spinal canal leading to stenosis.
The most common symptoms of spinal stenosis are the following:
Numbness or tingling in a hand, arm, foot or leg
Weakness in a hand, arm foot, or leg
Problems walking or balancing
Bowel or bladder dysfunction
Some patients can benefit with rest and conservative treatment options. Some of the most common non-operative treatments include: pain medication, alternating heat/cold therapy, physical therapy exercises, chiropractic care, and an epidural steroids injection. If the pain persists, an endoscopic spinal stenosis decompression procedure has resulted in 90% success in relieving pain. However, when symptoms are more severe and last more than three months with no relief from the conservative treatments, patients may require further diagnostic injections and surgical procedures. Some of the treatments include: MIS Lumbar Discectomy/Laminectomy, MIS Transforaminal Lumbar Interbody Fusion (TLIF), Anterior Cervical Discectomy and Fusion (ACDF), and Cervical Artificial Disc Replacement.