The Who, What, When and Where of Spinal Stenosis

What is Spinal Stenosis?

There are spaces in the spinal cord and in between the vertebrae that allow for fluid movement of the bones against each other. When there is restriction in these spaces due to inflammation of soft tissue around the vertebrae, wearing away of the bones or disc erosion, the tightening of the spinal column causes pressure on the nerves, which results in pain and discomfort for the patient. This is referred to as spinal stenosis.

Spinal stenosis most often occurs in the cervical vertebrae in the neck and lumbar vertebrae in the lower back.

Underlying Causes

  • Herniated disc: the discs between the cervical or lumbar vertebrae could rupture, causing inflammation that presses on the nerves.
  • The most common cause of spinal stenosis is osteoarthritis and the formation of bone spurs due to the condition. These extraneous growths constrict the spinal space.
  • Direct trauma to the spine can inflame the soft tissue or fracture the bone, causing spinal stenosis.
  • Tumors of the spinal cord, being unfavorable growths, cause inflammation and irritation of the nerves.
  • Older people who have lived largely sedentary lives are more at risk for the condition.

Symptoms

  • Pain in the neck or lower back (or sometimes, both)
  • Tingling and jabbing pain in the arms and legs
  • Loss of sensation in the limbs
  • Leg cramps eased by sitting
  • Complications when untreated could lead to muscle weakness, permanent loss of sensation in the limbs, and paralysis.

Treatment Options

Treatment will aim to relieve the pain associated with the condition, and treat the underlying cause to prevent relapse.

  • Pain Medication

Steroids like prednisone and corticosteroid injections and non-steroidal medication like ibuprofen and naproxen are great for treating mild to moderate pain. Where the pain is more debilitating, opioids like oxycodone can be given to the patient under strict supervision.

  • Physical Therapy

Exercise regimens designed for endurance, stretching and flexibility are encouraged-even when medication is being taken.

  • Surgery

Decompression surgery can relieve the pressure around the affected area by removing some calcified growths and ligaments. It is minimally invasive and has great success rates of recovery.

Direct surgery to relieve the inflammation, and replace the worn out discs is also recommended for serious cases. In this instance, the surgery can remove some parts of the vertebrae, replace a slipped or ruptured disc, or remove the offending bone in a way that will ease up the pressure on the nerve.

Spinal stenosis surgery is a delicate procedure best done by highly experienced surgeons who specialize in the field. When done correctly, the rate of recovery is very high.