Spinal Stenosis

Narrowing of the opening spaces present in spinal cord is called spinal stenosis.

This can put pressure on spinal cord and nerves which travel from spinal cord to arms and legs.

Spinal stenosis occurs most often in lower back and neck. While spinal stenosis may cause no signs and symptoms in some people but in other people

• pain,
• tingling,
• numbness,
• muscle weakness
• and problems with normal bladder or bowel function might take place.

Most common cause of spinal stenosis is wear and tear changes occurring in the vertebral column due to osteoarthritis.

Surgery to create additional spaces for nerves to exit is recommended in severe cases.

Many people show the evidence of spinal stenosis on x- ray but may not have signs and symptoms.

Symptoms start gradually and become worse over the course of time. Depending on the location signs and symptoms may vary.

In neck

Cervical stenosis can cause numbness, weakness, or tingling in a leg, foot, arm or hand. Many people report problems with walking and balance.

Lower back

Compressed nerves in lumbar region of spinal cord can cause pain or cramping in legs. These symptoms are noticed more while walking and standing for long periods.

Some people are born with congenital defects of vertebras. Causes of spinal stenosis may include:

Overgrowth of bone

Wear and tear damage caused in osteoarthritis in vertebra can prompt the formation of bone spurs, which can grow into spinal canal and cause compression.

Paget’s disease

A disease which usually affects adults can also cause bone overgrowth in the spine.

Herniated disks

Soft cushions that act as shock absorbers between vertebrae tend to dry out with age. Any damage of vertebral discs can put pressure on nerves.

Thickened ligaments

Ligaments are tough cords which help keeping the spinal cord in position can become stiff overtime and lead to the compression of nerves and spinal cord.

Tumors

Any spinal tumor can increase the pressure on the spinal cord and nerves leading to spinal stenosis.

Spinal injuries

Car accidents major trauma can cause dislocation of vertebral column and will cause spinal stenosis due to obstruction and compression.

Spinal stenosis will be difficult to diagnose based on signs and symptoms because they resemble some other conditions and in most of the cases there are no severe signs and symptoms.

Mainly imaging tests are used to establish and prove the diagnosis of spinal stenosis.

X- rays

Using small exposure radiation x-rays can reveal changes in bones such as bone spurs that may be narrowing the space within the spinal canal.

Magnetic resonance imaging

This technique uses electromagnetic waves to produce a three dimensional image of spine. Most conditions such as tumor can be diagnosed by MRI.

CT myelogram

IF MRI is not possible then doctor recommends Computed Tomography, a test that combines multiple x-ray images to form a three dimensional image herniated disks, bone spurs and tumors can be identified in this procedure. 

Doctor might prescribe the following medications to cure symptoms of spinal stenosis:

NSAIDs

These drugs cure typical characteristic signs of inflammation whish are

• heat,
• swelling,
• pain,
• loss of function and redness.

Muscle relaxants

Cyclobenzaprine can calm the muscle spasms that occasionally occur while stenosis.

Anti-depressants

These drugs can help reduce chronic pain.

Anti-seizure drugs

Some anti-seizure drugs such as gabapentin and pergabalin are used to reduce pain caused by damaged nerves.

Opioids

Drugs which contain codeine can be habit forming.

Steroid injections

Injecting corticosteroids into the nerve will reduce the symptoms of pain.

Surgery

If conservative therapy is not helpful surgical procedures are opted.

Laminectomy

In this procedure the back part of affected vertebra id removed and in some cases this lamina is linked to a piece of metal or bone graft.

Laminotomy

This procedure involves carving a hole big enough to relieve pressure.

Laminoplasty

Performed only on the neck of vertebrae. It opens up the space within the spinal canal by creating a hinge on the lamina. Metal hardware connects the opening.  

In some cases, spinal stenosis cannot be prevented. However it's important to check in with your doctor if you have a history of related conditions.

Genetic malformations can’t be prevented but cases like osteoporosis can be prevented by taking adequate calcium in diet.

Proper posture while sitting and sleeping. Physical exercise from mild to moderate intensity must be done to keep the muscles in position.

Some of the alternative remedies used to provide symptomatic relief from spinal stenosis are as follows:

• hot or cold packs - some symptoms of cervical spine stenosis may be revealed by applying heat or ice to the affected area. 

Some lifestyle changes can be brought in to provide better relief from stenosis of spinal cord. These include:

Diet and nutrition

Losing excessive weight can reduce the pressure on vertebral bones and intervertebral disks.

Using canes or walkers

Seeking an external support will reduce the pressure on the compressed nerve. Seeking help from family members in daily house hold activities can also reduce stress. It takes some time to cope up with the disease but patients usually become fully active after their recovery.

There are several risks and complications associated with spinal stenosis.

People over the age of 50 years are more prone to develop spinal stenosis.

Is at all younger people develop bone spinal disease it is due to genetics involved in the development of bones and muscles.

Rarely, untreated spinal stenosis may progress and cause permanent problems such as:

• Numbness,
• weakness,
• balance problems,
• incontinence
• and paralysis.