What is spinal stenosis?
Spinal stenosis is a disorder of the spine in which the spinal chord narrows. Congenital spinal stenosis is a condition in which the spine is already narrowed at birth. Factors that can result in spinal stenosis are herniated discs, osteophytes, which are ingrown bones or bone spurs, spinal cord trauma and injuries, etc.
Spinal stenosis mostly affects the cervical spine and lumbar spine.
Back problems can affect anyone, even though young people are affected the most. Spinal stenosis affects both genders. Some people have a greater risk of having back problems and developing spinal stenosis than others.
Causes of spinal stenosis
As mentioned above, some people are born with a narrow spinal canal, which is called congenital spinal stenosis, while others develop it due to different reasons. The following conditions most frequently lead to spinal stenosis:
- Herniated disc – This applies pressure on the spine and the nerves that are rooted in the spinal chord. It is a well known fact that the vertebral column is made up of vertebrae divided by herniated discs. Intervertebral cartilage discs act as cushions and absorb the shock that would impact the spinal column. In case of any trauma or injury to the spine, discs can protrude, thus narrowing the spinal canal eventually.
- Spinal injuries – Any major trauma to the spine, especially car accidents, can cause the condition.
- Thickening of the ligaments – This narrows down the spinal canal over time.
- Bone spurs – Bone overgrowth, also known as osteophytes, develops due to osteoarthritis. These bone spurs tend to narrow the spinal column, applying pressure to the spine and nerve roots. Paget’s disease is also a common cause of bone spurs that narrows down the spinal canal.
- Tumors – Tumors located in the spine can cause narrowing of the spinal column.
Signs and symptoms of spinal stenosis
Some people do not exhibit any signs or symptoms of diagnosed spinal stenosis, even when it is checked and confirmed with an X-ray. However, others can have various signs and symptoms. In general, spinal stenosis signs and symptoms come on gradually. They tend to worsen as time goes on.
Depending on where the stenosis is occurring along the spine, symptoms will vary. As mentioned, spinal stenosis occurs more often in the regions of the cervical and lumbar areas of the spine.
You may have spinal stenosis if you are experiencing:
- A tingling sensation in the arms and hands
- Muscle weakness of the upper extremities
- Cervical pain and shoulder pain
- Bladder and bowel incontinence
- Walking problems and difficulty in maintaining balance
- Numbness, cramping and pain in the legs
The nerves that supply the bladder and the bowel can be affected, too. This results in bladder and bowel incontinence. When the nerves located at the lumbar region are affected, the lower extremities are impacted and the patient may experience walking problems and difficulty in maintaining balance. If narrowing of the spine in the lumbar region, or lumbar spinal stenosis, develops, the patient will likely experience numbness, cramping and pain in the legs, especially when walking or standing for a long period of time during the day. These symptoms tend to get better when you bend down or sit.
Diagnosis of spinal stenosis
Diagnosing spinal stenosis is not always easy, especially in its early stages since the signs take time to show. Signs and symptoms can even resemble many other age–related conditions or back problems. X-ray examinations can reveal evidence of spinal stenosis. But in many cases people are unaware of their conditions and may not even see a doctor.
Imaging tests including X–rays of the spine, MRI scans and CT scans help a doctor diagnose spinal stenosis.
If left untreated, spinal stenosis can lead to serious complications, including:
- Muscle weakness
- Bowel and bladder incontinence
- Balance problems
Treatment of spinal stenosis
The treatment of spinal stenosis depends on where it is occurring in the spine, its causes, as well as the severity of symptoms.
In general, conservative treatment is recommended at first, and, if it fails to relieve the signs and symptoms, surgical treatment might be necessary. Conservative treatment requires over-the-counter painkillers, stronger or prescription painkillers, opioids, cold and heat packs applied on the affected area to help ease the pain, physical therapy, occupational therapy, acupuncture, chiropractic therapy, etc. There are many ways that the pain can be managed and even mitigated.
Back surgery for spinal stenosis
As mentioned in previous instances, spinal stenosis surgery is the last treatment option when conservative treatment has failed to solve the problem. Your doctor will inform if you are the right candidate for a spinal stenosis surgery.
The purpose of spinal stenosis back surgery is to relieve the pressure on the spine and nerve roots. The most common types of spinal stenosis back surgery include:
- Laminoplasty – This is a surgical procedure used in treating cervical spinal stenosis. It includes opening up a space within the spinal canal by creating a hinge on the lamina of the affected vertebrae.
- Laminotomy – In this surgical procedure, a part of the lamina is removed. In general, a hole just big enough to relieve the pressure is carved in a particular spot where the narrowing occurs.
- Laminectomy – The removal of the lamina (the back part of the vertebrae) of the affected vertebrae takes place in this operation.
Like any other surgical treatment, spinal stenosis back surgery has its own risks, side effects and possible complications. The most common surgical risks include:
- Tearing of the membrane that covers the spinal cord
- Bacteria infiltration and infections
- Blood clots
- Neurological deterioration
- Nerve damage
- Tissue damage to the surrounding area
In general, spinal stenosis back surgery is a safe procedure when performed by professional surgeons. With current surgical techniques and the development of minimally invasive spine surgery techniques, the exposure and the damage to the surrounding tissues is minimal. When performing spinal stenosis back surgery, surgeons tend to preserve the facet capsules and the spine ligaments to help the patients recover faster, as well as to minimize the chances of developing degeneration issues and stenosis in the future.
While any surgery should be undergone with caution, spinal stenosis surgery may be the best solution for those who have tried less invasive forms of treatment.