Spinal Stenosis: Types, Symptoms, Treatment

Overview

Spinal stenosis refers to narrowing of one
or more areas of the spine. It is a common result of osteoarthritis. It occurs
when the small spinal canal, which contains the nerve roots and spinal cord,
becomes compressed. The condition mostly affects your lower back and the neck.
Some people with spinal stenosis may be symptom-free, while others may experience
pain and muscle weakness.

Spinal stenosis occurs mostly in people
older than 50. Younger people with spine injuries or small spinal canals are
also at risk. Diseases such as arthritis and scoliosis can cause spinal
stenosis too.

Types

Based on the affected area, there are two
types of spinal stenosis:

  • Cervical spinal stenosis

This type of spinal stenosis often occurs
at some part of the spine in your neck.

  • Lumbar stenosis

In this condition, the narrowing occurs in
the part of the spine in your lower back. It’s the most common form of spinal
stenosis.

Causes

The spine is the backbone running from your neck to your lower back. The bones of your spine form a spinal canal to protect your spinal nerves. Some people are born with a small spinal canal. But most spinal stenosis occurs when something happens to narrow the open space within the spine. Risk factors for this disease include:

  • Age

If you are 50 years old or older, you are
at higher risk.

  • Gene

Your spinal canal may be small at birth and
structural deformities of the vertebrae may cause narrowing of the spinal canal.
They are both congenital factors.

  • Gender

Women are more likely to develop spinal stenosis.

  • Medical conditions

Osteoarthritis, spinal tumors or Paget’s
Disease can cause overgrowth of bone, which may narrow the spinal canal.

  • Trauma

Previous injury or surgery of the spine can
cause dislocations or fractures of one or more vertebrae and may damage the
contents of the spinal canal.

  • Tumors

Soft tissues may irregularly grow into the spinal
canal and cause press on nerves, the sac of nerves, or the spinal cord.

Symptoms

Most people with spinal stenosis may not
have symptoms. If signs and symptoms do occur, general ones include:

  • Pain in your neck or back
  • Numbness, weakness, cramping, or pain in your hands, arms, legs or
    feet
  • Worsening balance
  • Loss of control of the bowel and/or bladder in severe cases
  • Loss of sexual function

Diagnosis

To diagnose spinal stenosis, your doctor
may ask about your symptoms and medical history, then he or she will conduct a
physical examination to look for typical signs associated with the disorder. The
doctor may order several imaging tests to help pinpoint the cause of your signs
and symptoms. These tests include:

  • An X-ray of the spine to check for osteoarthritis, bone spurs and
    narrowing of the spinal canal
  • A computed tomography (CT) scan, which takes more detailed images of
    the back and spinal canal
  • A magnetic resonance imaging (MRI) scan of the spine to detect
    damage to your disks and ligaments, as well as the presence of tumors
  • An EMG (electromyogram) to check the nerves going to your legs

Doctors may also arrange X-rays of the hips
or knees, blood tests, as well as tests to check the circulation in your legs
and to rule out other diseases with similar symptoms.

Treatment

There are various treatment options
available for spinal stenosis depending on how severe the patient’s symptoms
are and what are the underlying medical conditions.

Non-surgical
options
that can be used to treat spinal stenosis
are:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Anaprox), and acetaminophen (Tylenol) to relieve pain
  • Corticosteroid injections to provide temporary and occasional permanent relief
  • Exercise to maintain or achieve overall good health by improving your balance, ability to walk, bend and move about, as well as control pain
  • Weight loss to relieve symptoms and slow progression of the stenosis
  • Physical therapy to support self-care

If other treatments don’t work or the patient is disabled by the symptoms, a surgery called decompression laminectomy is needed. This surgery removes the bony spurs and buildup of bone in the spinal canal, giving space for the nerves and spinal cord.

Afterwards, doctors often perform a spinal fusion to connect two or more vertebrae and better support for the spine.

Keyword: spinal stenosis.

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