The human spine is a columnar structure made up of stacks of bones that provide the stability and support to the body. The entire length of the spinal column has a large central passage through which the spinal cord extends downwards and small holes at each side allow Spinal nerves to emerge out and run to different organs of the body.
Usually, there is ample space for the spinal cord and spinal nerves to move through the spinal column but with aging and degeneration of bones, the column narrows and compresses the spinal cord and spinal nerves which can result in weakness, pain, and numbness. The condition is called Spinal Stenosis.
Depending on the location in the body the Spinal Stenosis can be of two types:
Lumbar Spinal Stenosis: When the spinal nerves in the lower back become compressed that results in Lumbar stenosis. It may result in weakness and tingling that radiates from the lower back to buttocks and legs. It’s the most common form of spinal stenosis.
Cervical spinal stenosis: Cervical spinal stenosis occurs in the neck which means potential compression of the spinal cord. It can lead to serious issues like extreme weakness or even paralysis.
Causes of Spinal Stenosis-
Spinal stenosis is very much related to degeneration in the spine with age and becomes significant with the onset of the 5th decade of your life. In some cases, people are born with small spinal columns that lead to stenosis at a very early age. But most cases occur with age.
The causes are-
Overgrowth of bones- With degeneration, the tissues in your spine may start to thicken or bones get bigger which compresses the nerves. Conditions like Osteoarthritis and rheumatoid arthritis contribute to these situations.
Tumors- Abnormal growths inside the spinal cord can reduce the spaces in the spinal column leading to stenosis.
Spinal defects present at the time of birth or people born with narrow spinal columns.
Some spinal injuries and surgeries after that can lead to the swelling of the nearby tissues can put pressure on the spinal cord or nerves.
There is a gradual deterioration of the condition and many people may not feel the symptoms till very late. But there can be several symptoms of spinal stenosis. The symptoms can be determined by the location and the severity of the stenosis in the spine.
- Tingling, numbness, and weakness in the hand, arm, foot or leg.
- Neck pain and in severe cases bowel or bladder dysfunction.
- Problem with balance and walking.
- Numbness, tingling, and weakness in your foot or leg
- Pain and crampings in one or both the legs when you walk or stand for a long period of time. But you get relieved from the pain by sitting down for a few minutes or flexing forward.
- Back pain issue which again eases with rest a sitting.
The diagnosis begins with questions on your signs and symptoms and discussion on your medical history. The doctor will also observe your movements and do a physical examination. The doctor then orders imaging tests to confirm the cause and symptoms of the issue.
- X-RAY is done to detect any changes in the bone structure, any bone spurs that might be narrowing the spinal column.
- MRI is done to detect any damage to your disks or ligaments or the presence of any tumor. It can show the nerves in the spinal cord being pressured.
- If you can't have an MRI, your doctor will order a CT scan to get a detailed view of the nerves, tissues and reveal any tumor, herniated disks, etc.
Rarely untreated severe spinal stenosis my progress and cause permanent
Treatment of Spinal Stenosis
Physical treatments- If your symptoms are mild then your doctor will first prefer self-care tips, physical exercises, and some activity modification to reduce the pain and improve strength and stability of your spine.
Pain Relievers - In some cases, pain relievers can be prescribed to alleviate the pain. Your nerve roots may get swollen and you can feel irritation and pain, cortisone injections can be injected into your spinal column to reduce inflammation and pain in the short term.
Antidepressants or anti-seizure drugs can also be used to relieve chronic pain.
Decompression procedures - A portion of the thickened ligament in the back of the spinal column can be removed by a needle-like instrument to reduce the pain and increase the space in the spinal canal. But this procedure is used only in case of Lumbar Spinal Stenosis.
Surgery- If other treatments fail to provide relief, then doctors consider surgery. The goal is to decrease the pressure on your spinal cord or nerves by creating more space within the spinal column. Surgeries done by highly experienced surgeons have proven to result in fewer complications. So try to ascertain the experience of your surgeon with spinal stenosis.
The types of surgeries-
Laminectomy - The procedure removes the back part of the affected vertebra. As a result of the surgery more space is created around the nerves and hence the pressure reduces and so does the pain.
Laminotomy- The procedure just removes a small part of the posterior wall (lamina)of the vertebra to carve a hole just big enough to relieve the pressure in a particular spot.
Laminoplasty - The procedure is performed only on the vertebrae in the neck It opens up space within the spinal column by creating a hinge in the posterior wall. The gap in the opened section is bridged with metal hardware.
Minimally invasive surgery - Minimally invasive procedures remove the bone or lamina in such a way that reduces the damage to nearby healthy tissues, also the risk of post-surgical pain and inflammation and result in shorter recovery time.
Other alternative medications that can be of help in Spinal Stenosis are Massage therapies, Chiropractic treatments, and Acupuncture. People with spinal stenosis lead full lives and remain active. Although you may need to go through some modifications in the physical activities you can perform.
In many cases, people do not feel the symptoms for a very long time but untreated stenosis can result in grave issues. People above the age of 50 should go for regular checkups for any signs of degeneration, bone spurs or other issues with their spine.
Feel free to contact us at (786) 871 6854 or write to us for more help. You can also visit us at www.jvaleriomd.comto get more information about the location of our clinics in Miami.