Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. It constricts the spinal canal resulting in a neurological deficit. The location of the stenosis determines which area of the body is affected. There are several types of spinal stenosis: lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina. Spinal stenosis occurs most often in the neck and lower back. While some people have no signs or symptoms, spinal stenosis can cause pain, numbness, muscle weakness, and problems with bladder or bowel function. Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to aging. In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves. While some people are born with a small spinal canal, most spinal stenosis occurs when something happens to reduce the amount of space available within the spine.
Spinal stenosis can be difficult to diagnose because its signs and symptoms resemble those of many age-related conditions. Imaging tests may be needed to help pinpoint the true cause of your signs and symptoms (See Tech & Procedures).
The type of treatment you receive for spinal stenosis may vary, depending on the location of the stenosis and the severity of your signs and symptoms.To reduce inflammation and control pain associated with spinal stenosis, your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs). Some NSAIDs, such as ibuprofen and naproxen are available without prescription. They may also prescribe muscle relaxants, which tend to calm the muscle spasms that sometimes occur with spinal stenosis. In some cases antidepressant and anti-seizure drugs too might be required. In addition to medicines, a physical therapist can teach you exercises that may help: Build up your strength and endurance, maintain the flexibility and stability of your spine and improve your balance.
Surgery: Surgery may be considered if a) more conservative treatments haven’t helped; b) you’re disabled by your symptoms and c) you’re in good health otherwise. The goal is to relieve the pressure on your spinal cord or nerve roots. For example, a laminectomy removes the back part (lamina) of the affected vertebra to create more room within the spinal canal. In some cases, vertebrae also may need to be fused together to maintain the spine’s strength. In most cases, surgery helps reduce spinal stenosis symptoms.
X-rays: Although an X-ray isn’t likely to confirm that you have spinal stenosis, it can help rule out other problems that cause similar symptoms.
Magnetic resonance imaging (MRI): In most cases, this is the imaging test of choice for diagnosing spinal stenosis. Instead of X-rays, an MRI uses a powerful magnet and radio waves to produce cross-sectional images of your spine. The test can detect damage to your disks and ligaments, as well as the presence of tumors. Most important, it can show pressure on the spinal cord or spinal nerves.
CT myelogram: Computerized tomography (CT) combines X-ray images taken from many different angles to produce detailed, cross-sectional images of your body — including the shape and size of your spinal canal. In a CT myelogram, the CT scan is conducted after a contrast dye is injected. The dye outlines the spinal cord and nerves, and it can reveal herniated disks, bone spurs and tumors.