What is Spinal Stenosis?
Stenosis may occur in the central spinal canal (central stenosis) where the spinal cord or cauda equina are located, in the tract where the nerve root exits the central canal (lateral recess stenosis) or in the lateral foramen (see section on foraminal stenosis) where the individual nerve roots exit out to the body.
The narrowing of the spinal canal, called spinal stenosis, can happen as a result of the degeneration of both the facet joints and the intervertebral discs. In this condition, bone spurs, called osteophytes, which develop because of the excessive load on the intervertebral disc, grow into the spinal canal. The facet joints also enlarge as they become arthritic, which contributes to a decrease in the space available for the nerve roots. The ligaments of the spinal column, especially the ligamentum flavum, become stiff, less flexible and thicker with age, which also contributes to spinal stenosis. These processes narrow the spinal canal and may begin to impinge and put pressure on the nerves roots and spinal cord, creating the symptoms of spinal stenosis.
What Are The Symptoms Of Spinal Stenosis?
The presentation and severity of the symptoms of spinal stenosis depends on the several factors, including the original width of the spinal canal, the susceptibility of the nerves involved, and the unique functional demands of the patient and the pain tolerance of each individual.
Patients who have significant spinal stenosis typically will begin to notice pain in the buttocks, thigh or leg that develops with standing or walking, and improves with rest. In some cases, a patient will complain of leg pain and weakness without having any back pain. More severe symptoms of the disorder include numbness, a tingling sensation and/or weakness in the lower extremities.
Certain positions, such as leaning forward, can alleviate the symptoms of spinal stenosis by increasing the amount of space available for the nerves. For instance, most patients with spinal stenosis can ride a bike and walk up an incline or flight of stairs without any pain. They can also often walk for extended distances if they have something to lean on, like a shopping cart.
Mildly symptomatic stenosis may benefit from Non-steroidal anti-inflammaory medications, physical therapy and or rest. However, if stenosis has caused a patient significant discomfort or neurologic deficit, surgical options are available. The main goal of surgery to treat spinal stenosis is to decompress, or widen the affected region of the spine.
- Minimally Invasive Lumbar Decompression
- Minimally Invasive Lumbar Laminectomy
- Minimally Invasive Lumbar Foraminotomy