Spinal stenosis is a medical term for narrowing of the spinal canal. This narrowing may occur in the cervical (neck), thoracic (midback), or lumbar (lower back) area. It is often a results of age related degeneration. The narrowing of the spinal canal can be the result of bone spur formation or bony overgrowth. Thickening of the spinal ligaments also is often a contributing factor. Bulging discs may contribute to the narrowing as well. Some patients may have a shifting of the spine know as spondylolisthesis. This shifting can worsen spinal stenosis and also stimulate more bone spur overgrowth or ligamentous thickening. Although often the result of age related degeneration, some patients may have what is called congenital canal stenosis. Congenital canal stenosis occurs when patients are born with a spinal canal that is relatively narrow at birth. People with this condition usually have no symptoms in youth. However, even mild age related degeneration can cause symptoms in this situation. These patients are often symptomatic at a much younger age than patients with purely are related stenosis. There can be a genetic predisposition to the development of spinal stenosis.
Spinal Stenosis Symptoms
In the neck, patients may have symptoms from pinched nerves or a compressed spinal cord. Pinched nerves cause pain in the neck and arm, weakness, numbness, and tingling among other symptoms. A compressed spinal cord can cause weakness in
the arms and legs, numbness, balance trouble, pain, difficulty with using the hands, etc. A compressed spinal cord can lead to paralysis if severe. Management of pinched nerve
s may include an initial trial of conservative care, including therapy, steroid injections, medication and time. Surgery may be required if patients do not improve. Spinal cord compression may not be appropriate to treat with conservative care, unless the symptoms are very mild. Surgery may be required to prevent further damage to the cord itself and prevent paralysis.
In the lower back, spinal stenosis symptoms may cause radiculopathy. This may result in pain in a leg with weakness, numbness and tingling. Treatment for this may be similar to treatment for a pinched nerve in the neck. The other common symptom of spinal stenosis is neurogenic claudication. Claudication generally causes patients to have trouble with standing and walking for any significant length of time. Bending over, over leaning on a shopping cart often relieves the symptoms. Sitting and lying down also often relieve the symptoms. Patients are often limited in their physical activities as a result. Surgery may be required unless the spinal stenosis symptoms are mild.
Spinal Stenosis Treatment
MRI is often required to diagnose spinal stenosis. Unfortunately, the non-operative methods of treatment only rarely reverse the spinal canal narrowing found in spinal stenosis. Also, spinal stenosis can continue to worsen over time. Therefore, non-operative treatment may only help temporarily. Surgery is often the only treatment option that gives long-term relief. The goal of surgery is to remove the pressure on the nerves of the spine. That means that the spinal canal must be surgically enlarged, and any bone spurs, bulging ligaments, or bulging discs that are pushing into the nerves must be removed. Because pressure is removed from the underlying nerve roots, the surgical procedure is referred to as a decompression of the spine.
In certain cases, spinal stenosis may be due to instability of the spine. This can be due to underlying conditions such as spondylolisthesis (shifting of one spinal vertebra over another). If this is the case, the operation may include fusion of the spine in addition to prevent future problems that could arise from spinal instability. Anterior cervical spine surgery also often includes a fusion, as surgical results are better and patient recovery faster with this technique.
Schedule a Spinal Stenosis Consultation
Spinal stenosis surgery, especially in the lumbar spine, can often be performed through a minimally invasive approach. The neurosurgeons at the Texas Spine & Neurosurgery Center have performed more minimally invasive spine surgeries than any other spine surgeons in the greater Houston area. Minimally invasive surgery allows for smaller incisions, less post-operative pain, short hospitalizations, and quicker recoveries. Schedule a consultation with our minimally invasive spine specialists today by calling (281) 313-0031.