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 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. It can be caused by bulging or herniated discs.
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.
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. Relief is felt 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.
Treatment for spinal stenosis depends on each patient’s severity and duration of symptoms. In many cases, lumbar spinal stenosis can be treated 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.
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.
If you have questions about spinal stenosis or would like to set up an appointment with a physician specializing in spinal stenosis diagnosis and treatment, please contact the ONS Spine Center.
Art Source: American Association of Orthopaedic Surgeons