Spinal Stenosis

Definition

Spinal stenosis is a narrowing of the spinal canal. The spinal canal is located in the backbone. It is a small space that holds the nerve roots and spinal cord. If this space becomes smaller, it can squeeze the nerves and the spinal cord. This causes pain and other symptoms. Stenosis can occur anywhere along the spinal cord. It is most common in the low back (lumbar) region.
Spinal Stenosis
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Causes

Some people are born with narrowed canals. Most often stenosis is a result of aging. Conditions that can cause spinal stenosis include:

Risk Factors

Factors that increase your chance of spinal stenosis include:
  • Being born with a narrow spinal canal
  • Age: 50 or older
  • Previous injury or surgery of the spine

Symptoms

Symptoms include:
  • Numbness, weakness, cramping, or pain in the legs and thighs
  • Radiating pain down the leg
  • Abnormal bowel and/or bladder function
  • Decreased sensation in the feet causing difficulty placing the feet when walking
  • Loss of sexual function
  • Partial or complete paralysis of legs

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
  • X-ray—a test that uses radiation to take pictures of structures inside the body; in this case, to check for abnormalities in the bones of the back including osteoarthritis, bone spurs, and obvious narrowing of the spinal canal
  • CT scan—a type of x-ray that uses a computer to make pictures of the bones of the back, which helps to evaluate the spinal canal
  • MRI scan—a test that uses magnetic waves to make pictures of soft tissue, such as the spinal cord and the spinal nerves inside the back

Treatment

Treatments include:

Medication

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)—to relieve pain and inflammation
  • Analgesics—to relieve pain
  • Corticosteroid injections—to reduce pain and inflammation

Physical Therapy

Special exercises can help stabilize the spinal cord. Exercise can increase muscle endurance and mobility of the spine. This can relieve some pain. Sometimes exercises are ineffective against spinal stenosis.

Support Devices

Wearing a corset or lumbar brace can help stabilize the spine. This may relieve pain.

Surgery

Surgery is reserved for severe cases.
  • Decompression laminectomy—This is the removal of bony spurs or increased bone mass in the spinal canal. This can free up space for the nerves and the spinal cord.
  • Spinal fusion—This is when two vertebrae (back bones) are fused together. This will provide stronger support for the spine. This is almost always done after decompression laminectomy.

Prevention

There are no guidelines for preventing spinal stenosis.

RESOURCES

American Academy of Orthopaedic Surgeons http://www.aaos.org

Arthritis Foundation http://www.arthritis.org

CANADIAN RESOURCES

The Arthritis Society http://www.arthritis.ca

Canadian Orthopaedic Association http://www.coa-aco.org

References

American Academy of Family Physicians website. Available at: http://www.aafp.org. Accessed July 7, 2009.

Arthritis Foundation website. Available at: http://www.arthritis.org. Accessed July 7, 2009.

Berkow R. The Merck Manual of Medical Information. Home Edition. New York, NY: Merck Research Laboratories; 1999.

Questions & answers about spinal stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Spinal%5FStenosis/default.asp. Published April 2009. Accessed July 7, 2009.

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