Spinal Stenosis

Spinal Stenosis

Spinal Stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. It is also somtimes called a stricture.

The vertebrae are the bones that make up the lower back. The spinal canal runs through the vertebrae and contains the nerves supplying sensation and strength to the legs. Between the vertebrae are the intervertebral discs and the spinal facet joints

The discs become less spongy and less fluid filled with age. This can result in reduced disc height and bulging of the hardened disc into the spinal canal. The bones and ligaments of the spinal facet joints can thicken and enlarge, due to arthritis, also pushing into the spinal canal. These changes cause narrowing of the lumbar spinal canal which is known as spinal stenosis (figure).

Spinal stenosis is like the lime build-up on the inside of a garden hose. Over time, it narrows the diameter of the hose, just as spinal stenosis narrows the spinal canal.

Spinal Stenosis Symptoms

Patients with stenosis may have few or no sypmtoms at all. When presant they are usually pain or numbness in the legs or back.

Narrowing of the spinal canal does not usually cause symptoms. When he nerves are inflammed patients begin to experience problems. Patients with lumbar spinal stenosis may feel pain, weakness, or even numbness in the legs, calves or perhaps the buttocks. Lumbar spine symptoms often start when walking small distances and decrease when the patient sits, bends forward or lies down. Cervical spinal stenosis can cause similar symptoms in the shoulders, arms, and legs. Hand fumbleing and gait and balance disturbances migh also occur. Some patients experience pain starting in the legs and moveing upward to the buttocks. Other patients experience pain in the upper body and moves downward. This is often referred to as a “sensory march”. Sometimes the pain radiates much like sciatica or it could be a cramp type pain. The pain can be constantin severe instances. Severe cases of stenosis can also cause bladder and bowel problems. 

Spinal Stenosis Diagnosis

The doctor will usually have either xrays or MRI's or both that will reveal the extent of the stenosis.

Treatment

Initial treatment will probably include anti-inflammatory drugs & physical therapy. On occassion spinal injections will be ordered. Surgery is reserver for patients whose pain cannot be abated.