Spinal Stenosis

Background 

Spinal Stenosis commonly known as narrowing of the spinal canal mostly occurs in lower back or neck. With the age, there are spine changes leading to degeneration of bones, disc, ligaments and muscles that together makes up the Spinal Column.  This also leads to narrowing of the spaces within your spine which can put pressure on the nerves that travel through the spine. 

Some people with Spinal Stenosis may not experience any symptoms while others may experience pain, numbness, tingling and muscle weakness. When the symptoms worsen surgery will be required to create additional space for spinal cord or nerves to relieve the pressure on nerves and alleviate the chronic symptoms causing pain. 

Causes of Spinal Stenosis

The cause of Spinal Stenosis is mostly associated with aging. Though rare but it is possible for younger people to have spine stenosis due to some injury or have a curvature of spinal canal. Various other causes for spinal stenosis are:

Herniated Disc

The soft cushions that act as shock absorbers between your vertebrae which gets accidentally displaced after heavy work, accidental fall or injuries. 

Tumours

Abnormal growth inside spinal cord.

Spinal Injuries

Accidents or other trauma injury can cause dislocation or fractures in one or more vertebrae.

Overgrowth of Bone

Wear and tear damage caused by Osteoarthritis can lead to formation of bones spurs. 

Thickened Ligaments

The cord that hold the bones of your spine can become stiff and thickened over time. 

Symptoms of Spinal Stenosis

The symptoms often start gradually and worsen over time. Symptoms usually depend upon which area is affected. Many people may not experience symptoms and condition may appear after an MRI or CT scan. 

In Neck

  • Problem with walking and balance
  • Neck Pain
  • Numbness or tingling in arm, foot or leg
  • Weakness in arm, foot or leg
  • Bowel or bladder dysfunction (In severe cases)

In Lower Back

  • Weakness in foot or leg
  • Numbness or tingling in foot or leg
  • Back pain
  • Pain or cramping in one or both leg when you stand for long period or when you walk

Diagnosis of Spinal Stenosis

Diagnosis is mainly done by a Neurosurgeon based on history, symptoms, physical examination and test results.

Physical examination alone does not yield a conclusive spinal stenosis diagnosis. Final diagnosis is done based on results magnetic resonance imaging ( MRI) or or Contrast enhanced computerised tomography ( CECT)Scan to assess the degree of change, compression of nerves and bony changes. 

Treatment of Spinal Stenosis

  • Treatment for Spinal Stenosis depends on the location and severity of its sign and symptoms. 
  • Initially a combination of pain killer medicines, time, posture management and some stretching exercises may be advised to relieve the pain or symptoms. 
  • Anti-inflammatory medicines and epidural injections may be prescribed to reduce swelling.   
  • Physical therapy may also help to increase flexibility, stabilise and protect the spine and build endurance. A therapy of 4 to 6 weeks is encouraged and this may help patient to resume a normal lifestyle.
  • If nonsurgical treatment as above does not improve symptoms then different types of spine surgery are suggested. The neurosurgeon will help determine which procedure is suitable for a particular case.
  • Surgical procedures are as follows
  • Laminectomy: This procedure removes the back part of affected Vertebrae. 
  • Laminotomy: This procedure removes only a portion of the lamina.
  • Laminoplasty: This procedure is performed only on the vertebrae in the neck.
  • Minimally Invasive Surgery: This procedure removes bone or lamina in a way that it reduces damage to nearby healthy tissue. 

The best way to manage Spinal Stenosis is by keeping your lower back as healthy as possible by maintaining a healthy weight, practicing good body mechanics, and getting regular exercise.

To consult with best team of Neuro and spine surgeons available at The Surgeons House (SHL) in different global locations, please click this link for more details. 

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