Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal or neural passageways (foramina) that can put pressure on the nerves in the spinal cord. Stenosis, which means “choking” in Greek, is a gradual result of aging and wear and tear on the spine. Spinal stenosis may affect any part of the spine.

FORAMINAL STENOSIS

Foraminal stenosis impacts the canals found on either side of a vertebra.  Nerve roots exit the spine through the narrow passageways to send sensory and motor signals to the rest of the body.  If the nerve becomes pinched, a person may experience numbness, weakness  or tingling in the arms or legs along the path of that particular nerve. Bulging or herniated discs can cause this.

LUMBAR STENOSIS

Lumbar spinal stenosis occurs when the nerves in the lower back are compressed or choked. According to estimates from the American Academy of Orthopaedic Surgery, spinal stenosis affects 8 to 11 percent of the population  in the United States with nearly 2.4 million Americans expected to be affected by 2021. It is most common in people over the age of 50.

SYMPTOMS OF LUMBAR STENOSIS 

The most common symptom of lumbar spinal stenosis is a burning pain that starts in the buttocks and radiates down the leg (sciatica) and increases while walking. You feel relief almost immediately by leaning forward and/or sitting down. The severity and duration of the symptoms can fluctuate, but will become progressively worse over time ultimately causing pain to the foot as well. For many people, the pain can become debilitating and greatly diminish the ability to perform simple activities. Tingling, weakness or numbness that radiates from the lower back to the buttocks and legs is also common.

SPINAL STENOSIS TREATMENT 

Treatment for spinal stenosis depends on each patient’s severity and duration of symptoms. In many cases, you can treat lumbar spinal stenosis non-surgically however; severe cases often require lumbar spinal stenosis surgery.

Non-operative treatments include activity modification, physical therapy, and a targeted program of spinal stenosis modified exercises. Non-steroidal anti-inflammatory medicines such as ibuprofen can be effective in reducing inflammation. Cortisone injections into the epidural space can decrease inflammation, swelling and pain however patients should not receive more than three injections over a twelve month period of time.

SURGICAL TREATMENT

Minimally invasive surgical procedures may be an option for patients whose quality of life is greatly compromised by the pain. A laminectomy procedure removes the bone, bone spurs and ligaments that are compressing the nerve. Spinal fusion can help correct spinal instability caused by arthritis and decompress the nerve. For patients with spinal stenosis, laminectomy and spinal fusion procedures may be necessary. ONS surgeons do not perform laser spine surgery because there is a lack of credible scientific evidence indicating clear benefits.

MINIMALLY INVASIVE LAMINECTOMY AND DISCECTOMY PROCEDURES

A discectomy is a procedure to remove pieces of a ruptured disc that are causing pressure on a nerve. A surgeon performs a laminectomy to remove arthritic bone from the spine to widen the spinal canal and create more space for the nerves.

Art Source: American Association of Orthopaedic Surgeons