Spinal stenosis involves the condition in which abnormal narrowing of the spinal cavity & neural foramen occurs, which leads to development of pressure on the spinal cords & roots of the nerve.
- Cervical Spinal Stenosis
- Lumbar Spinal Stenosis
- Thoracic Spinal Stenosis
SIGNS & SYMPTOMS OF SPINAL STENOSIS
- Standing discomfort
- Discomfort/pain, in shoulder, arm, hand
- Unexplained weight loss
- Gait disturbance
- Bilateral symptoms
- Numbness at or below the level of involvement
- Weakness at or below the level of involvement
- Pain or weakness in buttock / thigh only
- Radiating pain
- Pain or weakness below the knee
- Pinched nerve.
- Cervical myelopathy
- Clumsy & numb hands
- Loss of bladder control
- Loss of bowel control
- Sexual dysfunction
- Weakness that can progress to paralysis
- Claudication, impairment in the legs
- Cauda equina syndrome
- Degenerative disc.
CAUSES LEADING TO SPINAL STENOSIS
- Thickening of the spinal ligament
- Formation of bone spurs
- Herniation of discs into the spinal canal
- Breakdown of facet joints
- Hypertrophy of facet joints
- Compression fractures of the joints
- Formation of cysts on the facet joints
- Compression of the spinal sacs.
- Degenerative disc disease
- Rheumatoid arthritis
- Congenital defects in spinal cord, like narrowing of the spinal cord at birth.
- Structural defects of the vertebra
- Accidents & injury
- Irregular growth of soft tissue
- Spinal tumors
- Paget’s Disease of the bone
- Medical history of patients are noted first, past incidence of cancer, trauma, accident, neurological damage, fever, night time disturbance and unexplained weight loss are potential red flags.
- Physical examination of areas where sensory abnormality, numbness, muscle weakness & radicular pain are seen.
- MRI is done for the accurate diagnosis & knowing the cause of spinal stenosis. Images are produced where nerve compression & muscle damage are seen.
- A radioactive dye is injected in the spinal cavity through a spinal tap, subsequently X-ray or CT scan are performed for detecting the narrowing of the spinal canal & diagnosis of spinal stenosis.
TREATMENT FOR SPINAL STENOSIS
- Medications to relieve pain as inflammation, NSAIDs.
- Severe pain can be treated with opioid medications.
- Steroid injections in the spine for treatment of severe inflammation.
- Lumbar decompressive laminectomy: Involves removing the top of the bone overlying the spinal canal and thickened ligaments in order to decompress the nerves and sac of nerves.
- Interlaminar implant: A non-fusion U-shaped device which is placed between two bones in the lower back to maintain motion in the spine and keep it stable after a lumbar decompressive surgery.
- Surgery for cervical myelopathy
- Anterior cervical discectomy and fusion: Decompressing the spinal cord and nerve roots of the cervical spine by discectomy.
- Laminoplasty, removal of the posterior parts of the spine to generate space in the spinal canal.
PREVENTION & MANAGEMENT
- Weight loss & maintaining a healthy weight
- Calcium & multivitamin rich foods & supplements
- Aerobic exercises like riding a stationary bicycle & walking