Spinal Stenosis

 

Spinal stenosis describes the progressive narrowing of the central part of the spinal canal that protects the spinal cord.

 

What causes spinal stenosis? 

Spinal stenosis may be congenital or acquired.  Congenital means you're born with it.  Acquired spinal stenosis arises as a result of arthritis, disc bulges or part of the natural aging process. As the canal narrowing progresses, the nerves begin to become compressed.

 

How is spinal stenosis diagnosed?

Cervical, thoracic, and lumbar spinal stenosis are all diagnosed with an MRI scan.  In certain circumstances, a CAT scan can be used.   A simple X-ray is almost never good enough to make this diagnosis.

 

Lumbar spinal stenosis can cause pain that is typically in the buttocks and legs, and is commonly described as numbness and tingling in the legs that is often better when sitting down and resting. This is termed as neurogenic claudication. However there are other conditions that may mimic this symptom and it is important to get a thorough neurologic exam by a physician trained in treating these disorders in order differentiate among other causes.

 

Cervical spinal stenosis can cause pain, numbness, and tingling in the neck and down the arms.  In severe cases, compression on the spinal cord can occur.  This may lead to gait ataxia (poor walking coordination) and weakness in the legs.  

 

What are the treatment options?  There are many treatment options ranging from conservative to advanced depending on the severity and limitations in function. Conservative treatments include proper spinal mechanics, maintaining a healthy weight, exercise, smoking cessation and physical therapy. Certain medications may be helpful; these include anti-inflammatory medications (NSAIDs), analgesics (Tylenol) or neuropathic medications specifically for nerve pain. If these options fail to provide relief, steroid injections may be a reasonable treatment. For others with severe stenosis who have failed other treatments or if there is neurologic weakness, surgery may be a more effective approach to decompress the pressures on the spinal cord or nerves.