What is

Spinal Stenosis?

Spinal Stenosis refers to a narrowing of the spinal canal. Stenosis is when there is compression of the spinal cord in the neck area, called the Cervical Spine, or of the spinal roots in the lower back, referred to as the Lumbar Spine. Stenosis can be a result of age, however, some are born with congenital canal stenosis.

Types of Stenosis

Stenosis can affect the anatomy in different ways. There are three main classifications of Stenosis: Foraminal Stenosis, Central Stenosis, and Lateral Stenosis. However, in general, all forms of Spinal Stenosis are referred to as simply “Stenosis”.

Foraminal Stenosis

The most common of lumbar spinal stenosis is Foraminal Stenosis. The nerve root exits out of a side hole in the back of the spine, referred to as the neuroforamen. In conditions of degenerating disc or arthritic facet joint, a bone spur can develop and then press on the nerve root as it is leaving the neuroforamen. In the presence of Foraminal Stenosis, that root becomes trapped, and results in the painful pinching of the nerve.

Central Stenosis

The thecal sac is a membranous sheath of dura mater that surrounds the spinal cord and the bundle of nerves at the end of the spinal cord. Those nerves and nerve rootles in the lumbar area are called the cauda equina, Latin for “horses tail”. The spinal cord, in effect, “floats” inside the cerebrospinal fluid within the thecal sac. Central Stenosis is a narrowing of the central canal in this low back area, which can compress the thecal sac, causing pressure on the cauda equina and affecting individual nerves within the thecal sac.

Far Lateral Stenosis

Often combined with Foramina Stenosis, Far Lateral Stenosis occurs as a narrowing of the area lateral, or to the side of the neuroforamen. Similar to Foramina Stenosis, it is secondary to the formation of bone spurs from facet joints, herniated or bulging discs and ligamentum hypertrophy.

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Pinched spinal cord symptoms of Lumbar Stenosis Include:

Leg pain (sciatica)
Leg tingling
Weakness in the leg
Numbness in the leg or foot

Symptoms of Cervical Spinal Stenosis

Similar to Lumbar Stenosis, but happen in the upper extremities:
Arm pain
Neck pain
Weakness in the arm
Numbness or tingling in the arm

In circumstances of Cervical Spinal Stenosis with myelopathy, more serious conditions like difficulty with coordination, incontinence and paralysis can arise if not addressed in its early stages.

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Non-Surgical Treatments for Stenosis

If the condition is mild, treatment includes non-surgical methods like exercise, anti-inflammatory medications, injections, and limitation of activity. In severe cases, however, back surgery is recommended to prevent worsening of the condition and symptoms.

Surgical Treatments for Stenosis

Great care is taken to qualify patients spinal stenosis surgery. However, spinal stenosis surgery outcomes for decompression can be successful surgical procedures. Surgical options for Stenoisis are:

Laminectomy Surgery
ACDF: Anterior Cervical Discectomy and Fusion