Stenosis

Spinal stenosis refers to narrowing of the spinal canal which causes pressure on the spinal nerves or spinal cord. This condition is most commonly seen in patients over the age of 50. Although the cause of spinal stenosis is not clear, two types are recognized.

Congenital spinal stenosis is seen in individuals who are born with a narrow spinal canal. In these patients, minimal changes in the components of the spine can cause further narrowing of the spinal canal producing symptoms.

The more common is the acquired form of spinal stenosis, caused by progressive changes in different components of the spine (such as the discs, joints, ligaments, etc.) As part of a natural aging process, all these different components of the spine settle or bulge and form arthritis that narrows the spinal canal.

Patients with spinal stenosis most commonly complain of leg pain which worsens with walking or exercise. Back pain is also a common complaint. The leg pain is often improved with resting, sitting, or bending over. Progressive weakness in the legs, bowel, or bladder symptoms rarely occur. These symptoms are considered very severe and necessitate immediate attention.

Spinal stenosis can be diagnosed with Magnetic Resonance Imaging (MRI) or a CT myelogram. Regular X-rays are helpful for evaluating the general bony structure of the back. Non-surgical treatment for spinal stenosis includes anti-inflammatory medications, steroids, and analgesics. Physical therapy and steroid injections into the spine may also be helpful in relieving the symptoms of stenosis. Many times, specialized nerve or joint blocks can be helpful for diagnosing and treating this problem.

When non-surgical methods of treatment do not improve the patients’ leg/back pain surgical intervention may be considered. Surgery is a very effective means of relieving the pressure on the nerves. Surgery (decompressive laminectomy) involves the removal of the bony and ligamentous bulges which are placing pressure on the nerves. Decompressive laminectomy (opening the spinal canal) relieves the pressure on the nerves and results in significant improvement in complaints of pain.