What Is Spinal Stenosis?
Spinal stenosis is a narrowing of the spinal canal, which houses nerve roots and the spinal cord. This condition most often occurs in the neck (cervical spine) or the lower back (lumbar spine). The narrowing of the spinal canal puts pressure on the spinal cord or the nerves and can cause pain and other symptoms.
There are a number of risk factors that make a person more likely to develop spinal stenosis, as well as conditions that cause the narrowing.
Risk factors include:
- Age 50 years or older
- Female gender
- Injury to or surgery on the spine
- Narrow spinal canal since birth (congenital)
Some conditions that may cause spinal stenosis are:
- Ankylosing spondylitis
- Facet cyst
- Herniated disc
- Osteoarthritis, the most common cause
- Spinal tumors
Spinal stenosis will have different symptoms depending on whether the narrowing is in the cervical spine or the lumbar spine. Spinal stenosis is rarely seen in the mid-back region, which is the thoracic spine.
Symptoms of cervical spinal stenosis can include:
- Arm or hand pain
- Dexterity issues
- Numbness, tingling or weakness in a hand, arm, foot or leg
- Trouble walking
- Urinary or bowel incontinence in severe cases
Lumbar spinal stenosis symptoms can include:
- Back pain
- Numbness, tingling or weakness in a foot or leg
- Pain or cramping in one or both legs after standing for long periods or after walking
Diagnosing spinal stenosis usually starts with a medical history and physical exam. Doctors will be looking for the presence of numbness, weakness and pain in the legs or feet, as well as a history of conditions like arthritis that may cause stenosis.
A number of imaging studies and other tests are useful in diagnosing stenosis. An X-ray can determine the presence of osteoarthritis or bone spurs causing pressure on the nerves or spinal cord, while a computed tomography (CT) or magnetic resonance imaging (MRI) scan can show the spinal cord and where it is being compressed. An electromyogram (EMG) can check for nerve damage by measuring how long it takes a signal to travel down the nerve.
Some conservative measures can help reduce or eliminate the symptoms of spinal stenosis. These include anti-inflammatory medications, painkillers and steroid injections.
A surgery called decompression laminectomy can widen the spinal canal and remove whatever is causing the nerve compression. The surgeon removes bone spurs that are pressing on the spinal cord or nerves, and occasionally also fuses two or more vertebrae to better support the spinal cord.
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