Spinal Stenosis

Spinal Stenosis

The term stenosis means narrowing, and spinal stenosis refers to narrowing of the diameter or hole of the spinal canal where the spinal cord and nerves are protected, and the foramen (hole where the nerve exits). As we age the spinal discs degenerate, lose height, and may bulge into the spinal canal. Bone spurs or osteophytes develop on the vertebral bodies and facet joints; the spinal ligaments may hypertrophy (overgrow). All of these factors contribute to spinal stenosis, and the disease process continues to slowly worsen over time. Some individuals are born with smaller spinal canals (congenital spinal stenosis), and may develop symptoms at an earlier age. Genetics play an additional role in that direct family members frequently developDegenerative Disc Disease and spinal stenosis at an earlier age. Obesity, repetitive injury, sports, occupation, and smoking are also contributing factors.

Symptoms of spinal stenosis are quite variable including minor pain and stiffness in the neck or lower back that worsens slowly over time. The disease usually affects the neck (cervical spine) and lower back (lumbar spine) more than the thoracic spine.Radiculopathy and Sciatica may develop with arm or leg pain, numbness, and weakness. It is not uncommon for individuals to have very few symptoms until an accident or injury occurs, even though the pathology was already there. Cervical spinal stenosis may cause compression of the cervical spinal cord with no pain, but progressive spinal cord dysfunction or Myelopathy. (Cervical Spondylitic Myelopathy) . Lumbar spinal stenosis may mimic vascular problems causing bilateral leg pain, numbness, and weakness with standing and walking (Neurogenic Pseudoclaudication) or may progress to sudden lower extremity weakness with bowel and bladder incontinence (Cauda Equina Syndrome)

Evaluation and Diagnosis

During your initial office evaluation one of our physicians will complete your History and Physical examination, review any available diagnostic studies, decide what further tests need to be performed including office x-rays, and we will discuss possible treatment options with you regarding your individual diagnosis.

Treatment Options

Spinal stenosis gradually worsens over time and surgery may eventually be required. Activity adjustment, anti-inflammatory medications, and injections including epidural steroids can help reduce pain symptoms. Surgical treatment options includeACDF (Anterior Cervical Discectomy With Fusion), Corpectomy,Foraminotomy, Laminectomy, Laminoplasty, and the various types of Lumbar Fusion. Lumbar spinal stenosis patients may be candidates for the minimally invasive X-STOP procedure.


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