What Is Spinal Stenosis?
Spinal stenosis is a condition that describes a narrowing of the spinal canal. The spinal canal is the space surrounded by the bones and discs of the spine. It is where the spinal cord and the roots of the spinal nerves are housed.
Where does Spinal Stenosis Occur?
Spinal stenosis can occur anywhere in the spine, but occurs most commonly in the low back (known as lumbar canal stenosis) and in the neck (known as cervical spine stenosis).
What are the causes of Spinal Stenosis?
A common cause of spinal stenosis is age-related. Spinal stenosis is common is both men and women over the age of 50. As we age, degenerative changes can take place in the spine. These degenerative changes are known as arthritic changes and can cause the bones to grow into the spinal canal as well as into the space through which the nerve travel from the spinal cord and out to the body. When the degenerative changes create a narrowing of the spinal nerve space, it is called foraminal stenosis.
What Symptoms can occur with Spinal Stenosis?
The degenerative changes to the spinal canal space can compress the spinal cord. The degenerative changes to the spinal nerve space can cause compression spinal nerve. Symptoms include back pain or neck pain, tingling, numbness, and in more severe cases, cramping and weakness in the arms and/or legs. When these symptoms occur in the leg it is known as sciatica.
Treatment for Spinal Stenosis
Treatments for Spinal Stenosis can include medications, physical therapy, injection therapies, and surgery. When spinal stenosis creates more severe symptoms such as weakness, surgery may be an option if conservative treatments have not been effective. The goal of any type of spinal stenosis surgery is to provide more space for the spinal nerves and/or the spinal cord to function without compression.
How to Diagnose Spinal Stenosis
In most cases X-rays are used initially. X-rays often can show changes in the spine vertebrae as well as how degenerative changes may have affected the spinal disc spaces. From here assumptions can be made to relate your symptoms to the changes seen on x-ray.
Magnetic Resonance Imaging (MRI) is a more conclusive diagnostic technique as it can show much more than an x-ray can. An MRI provides very good details of the bones, ligaments, discs, and nerves.
Computed Tomography (CT) is another form of imaging that uses a combination of x-rays from different angles and positions.
When does a surgeon consider spinal stenosis surgery?
After all other treatment options have been ineffective, a surgeon will consider spinal stenosis surgery. There are several types of surgical options for spinal stenosis.
Decompression is the general term to describe the surgical techniques geared toward removing pressure from spinal nerves or the spinal cord.
Laminectomy is one type of decompressive surgery and is in fact the most common type of surgical procedure for spinal stenosis. During an laminectomy, the surgeon removes the part of the vertebrae called the lamina and the spinal process. The surgeon may also remove a small portion of the ligaments or bone spurs in order to open the space for the nerves and/or spinal cord.
If the disc has degenerated or severe disc herniation has compromised the spinal canal space or spinal nerve space to cause spinal stenosis, the surgeon may need to remove the spinal disc. This is called a discectomy and is sometimes performed along with the laminectomy.
There are different techniques that can remove the disc. The most common to remove the disc in the neck is called an anterior cervical discectomy and fusion (ACDF.)
If there is a combination of spinal stenosis with instability in the spine, surgeons may perform a surgery called a spinal fusion that will both open up the space to allow the spinal cord and spinal nerves to flow without pressure as well as stabilizing the spine.
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