Your spine comprises a series of bones called vertebrae and shock-absorbing discs, which provide stability and support for your upper body. It helps you with movements like turning and twisting. Spinal nerves travel through the vertebral column, and the surrounding bones and tissues protect these nerves. These nerves carry signals from the brain to the rest of your body. If they get damaged in any way, then the functions like walking, balance, and sensation get affected.
What is spinal stenosis?
Spinal stenosis is a condition that occurs when the bony openings within the spine become narrow, reduce nerve space, and start to compress the nerves. The compressed or pinched nerves become irritated, which can lead to back pain and sciatica type claudication.
Usually, spinal stenosis occurs slowly over time. Mostly it is caused due to osteoarthritis or “wear and tear” effects that occur naturally in your spine with increasing age.
For this reason, the symptoms may not appear for a long time even though the condition persists. The changes might be noticed on regular imaging tests or taken for another reason. Depending on the spinal stenosis condition’s location and severity, you may feel pain, numbness, tingling sensation, or weakness in some body parts like the neck, back, legs, and hands.
Spinal stenosis can occur anywhere along your spinal column, but most commonly, they appear on the cervical and lumbar spine area and classified as.
Cervical stenosis: This is a condition where the narrowing of the spinal canal occurs in the part of your neck. It is also termed cervical spinal stenosis.This leads to more serious situations like cervical myelopathy.
Lumbar stenosis: This is a condition where the narrowing spinal canal occurs in the part of your lower back. It is the most prevalent form of this spinal stenosis condition.
You may be affected by one or both the spinal stenosis conditions. If the condition is left untreated, it becomes severe, and you may face serious permanent health problems like numbness, weakness & balance problems.
Symptoms Of Spinal Stenosis
In some people, symptoms might not appear in initial stages but progress over time, when the nerves become compressed more. The symptoms vary from person to person and they might come and go. The symptoms of cervical spinal stenosis vary slightly compared to the symptoms of lumbar spinal stenosis.
Symptoms of cervical spinal stenosis:
- Neck pain
- Numbness or tingling sensation in one hand or leg and sometimes both
- Balance and coordination problems like walking difficulties often termed as cervical myelopathy
- Cervical radiculopathy – affect the sensation and functions of different parts in the upper body
- Weakness in your shoulders, hand, arm or leg
- Loss of control over bladder or bowel functions in severe cases.
Symptoms of lumbar spinal stenosis:
- lower back pain
- A heavy feeling in your legs, which may cause cramps in one or both legs.
- lumbar radiculopathy – Numbing or tingling sensation in your buttocks, leg, or foot.
- Foot drop – weakness in your legs in case of severe spinal stenosis
- Worsening of pain when you stand or walk for longer distance
- Radicular pain – Pain that radiates from the spine into your lower body parts.
- Cauda equina syndrome
- Loss of sexual ability
Causes of spinal stenosis
There were several causes that lead to spinal stenosis. Subsequently, most of the reasons result in narrowing the space around the spinal canal and reducing the nerve space. Some of the causes that lead to spinal stenosis include:
- Overgrowth of bone or bone spurs (osteophytes)
- Bulging disks/herniated disk
- Thickens the ligaments over time and bulge into your spinal canal
- Spinal trauma or injuries
- cysts or tumours to the spinal cord
- Congenital spinal stenosis
- Scoliosis (an abnormally shaped spine)
- Often your bones may grow unusually large and become brittle, called Paget’s disease
- Wear and tear conditions of your spine due to increasing age
Some people may have spinal stenosis or other conditions that lead to it at the time of birth. The condition starts creating problems for them between 30 to 50 years of age. Adults above the age of 50 are at more risk of this condition.
Treatment for spinal stenosis
The treatment options depend on the stenosis location and the severity of signs and symptoms you are experiencing.
A spine specialist will examine the condition thoroughly and suggest the best treatment for your situation. If you are experiencing mild symptoms nor any, your condition may be monitored with regular follow-up checkups. The doctor recommends some self-care tips, and if this doesn’t help, medications or physical therapy is recommended. When other treatments don’t help, surgery might be the only option.
- Over the counter(OTC) pain medication such as aspirin, acetaminophen, ibuprofen, etc. for short-term relief
- Antidepressants to ease chronic pain
- Anti-seizure drugs to reduce pain caused due to damaged nerves
- Opioids – these drugs might have serious side effects, so never use them without prescription
- Muscle relaxants to relieve from muscle spasms
Corticosteroid injections to reduce inflammation and relieve from pain. However, they are suitable for everyone with spinal stenosis, and moreover, repeated steroid injections weaken bones and tissue nearby.
Surgery for spinal stenosis
In case of severe spinal stenosis, the doctor recommends surgery to create space for the nerves so that inflammation and pain can go down. Below are the surgical procedures for spinal stenosis condition:
- Laminectomy – This procedure involves removing the lamina(back part) from the damaged vertebra. Sometimes laminectomy is also termed as decompression surgery as it reduces the pressure on your nerves by creating space for them. In some cases, spinal fusion is performed to the adjacent vertebrae to maintain the spine’s strength.
- Laminoplasty – This type of surgery is performed only on your cervical spine. The surgery creates some space inside your spinal canal by forming a hinge on the lamina. Metal hardware is placed in your neck vertebrae to bridge the open gap in the spine.
- Laminotomy – In this procedure, the surgeon removes a small portion of the damaged lamina, typically carves a hole just big enough, and relieves pressure in that particular spot.
- Minimally invasive surgery – This is a procedure where the bone or lamina from the vertebrae is removed completely to reduce the damage caused to nearby healthy tissues. This surgery avoids spinal fusion.
- Decompression procedure – This is a different procedure in which the surgeon uses needle-like instruments to remove a thickened portion of your ligaments in your spinal column. This decompression procedure is suggested only if you have lumbar spinal stenosis caused due to thickened ligaments. Medically it is termed as percutaneous image-guided lumbar decompression (PILD).
In maximum cases, the space creating procedures help to minimize the symptoms of spinal stenosis. These surgeries might carry some risks, as well. To know more information or if you are suffering from any spine problems, consult Dr. Surya Prakash, one of the best spine surgeons in Hyderabad. He has more than two decades of experience in treating various spinal problems.