Spinal stenosis

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Stenosis is narrowing of the spinal canal, through which the spinal cord and nerves run.

It is a very common condition and most people do not have any symptoms with it. However, symptoms may develop when there is severe pressure on the nerve structures. Depending on the region of the spine, where stenosis occurs, people may experience different symptoms.

Symptoms

In the neck (cervical spine) and mid-back (thoracic spine) the canal contains the spinal cord. Stenosis at those levels may cause symptoms of spinal cord dysfunction called myelopathy. This may include difficulties with hand function, pain running down the arm, poor balance and sensation of electric shocks running through the entire body.

In the lower back (lumbar spine) only spinal nerves run through the spinal canal. Stenosis here may cause pressure on the nerves and cause either pain down the leg or difficulties with walking.

In severe cases, stenosis may cause significant neurological abnormalities, including weakness in the arms and legs and abnormal function of the bladder and bowels.

Diagnosis

Even though certain symptoms may suggest presence of spinal stenosis, final diagnosis is usually established with advanced imaging: CT (computed tomography) and/or MRI (magnetic resonance imaging).

Treatment

While in most cases spinal stenosis does not cause any symptoms, some people may require specialized treatment including physical therapy, medications and injections.

In cases of severe stenosis, when symptoms do not respond to less invasive treatments or when there is rapid progression of neurological abnormalities, surgery may be necessary.

Surgery typically involves removal of spine structures causing pressure in order to free up compressed nerves: bones called lamina (hence name of procedure, laminectomy) and soft tissues called ligaments. If there is instability in the spine, a fusion procedure may also be necessary.

Red flags are indicators that a more serious condition may exist and should prompt you to seek qualified medical help sooner. They are:

  • history of high-energy trauma
  • weakness in the legs
  • inability to control bowel or bladder function
  • pain increasing over the course of several days
  • increasing pain at night
  • unexplained fever and chills
  • history of poor bone quality (osteoporosis)
  • history of cancer in other body parts
  • history of IV drug use

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