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Spinal Stenosis : An Overview
The Normal Spinal Canal
The spinal canal is a
tube-like space protected by the vertebral bones, extending from the base of the neck to
the
lower back. The spinal cord and spinal nerves travel through this space from the brain
to
reach their destination in the upper and lower limbs. The typical spinal canal has
adequate
free space around the spinal cord and nerves filled with Cerebrospinal Fluid (CSF). This
free space is essential for the normal functioning of the spinal cord and nerves.
Spinal Stenosis
Spinal Stenosis results from
inadequate space inside the backbone, which eventually puts pressure on the delicate
spinal
cord and nerves. Spinal Stenosis refers explicitly to narrowing the spinal canal in the
lower back or the lumbar area. However, it can also occur in other parts of the spinal
canal. Although spinal Stenosis can affect anyone, it's predominantly observed in
individuals over 50.
Spinal Stenosis is commonly
caused by long-term spinal wear and tear due to arthritis, eventually resulting in
‘progressive’ nerve root compression and symptoms. Although some people undergo surgery
for
spinal Stenosis, it may not cure their arthritic pain.
Spine specialist hospital in Delhi, we recommend non-surgical treatments, medication, and therapy to rectify this spinal condition. Kindly consult our orthopaedic experts to diagnose and treat lumbar canal stenosis.
Spine specialist hospital in Delhi, we recommend non-surgical treatments, medication, and therapy to rectify this spinal condition. Kindly consult our orthopaedic experts to diagnose and treat lumbar canal stenosis.
Spinal Stenosis: Risk Factors
Spinal Stenosis: Causes, Symptoms & Warnings
Causes
- Connective tissues - ligaments (ligamentum flavum ) get thicker
- Facet hypertrophy (over growth of joints in the spine)
- Spondylolisthesis – Slippage of one vertebrae over another with displacement of disc (pseudo disc bulge) compressing the nerves
- Degenerative scoliosis – deformed curvature of spine as a consequence of degeneration of spine
- Previous lumbar surgery (post-surgical scaring)
- Infection – Uncommon cause
Symptoms
- Pain in the buttocks, hips and legs or ROOT BLOCK: PAIN MANAGEMENT FOR SCIATIC PAIN AND SLIP DISC - Less pain with leaning forward or sitting or lying, pain aggravates on bending backwards (unilateral or bilateral)
- Difficulty in walking – Neurogenic claudication – Cramping in the calf with walking, requiring frequent multiple short rests to walk a distance
- Pain in the legs at rest
- Numbness or tingling in legs
- Loss of sensation in the feet
- Weakness in Legs
- Weakness in the foot that causes the foot to slap down when walking
- Sexual dysfunction
Spinal Stenosis: Tests & Diagnosis
Our specialists will conduct a physical examination to evaluate your symptoms and your medical history before recommending the most appropriate diagnostic tests like:
MRI is a noninvasive imaging method of choice to justify the presence of anatomic narrowing of the spinal canal or the presence of nerve root impingement.
X-rays to identify any spur growths that may be compressing your spinal nerves or narrowing the spinal canal.
CT scan taken after injecting a contrast dye
Spinal Stenosis: Surgical Treatments
A patient may be considered a candidate for surgery if:
- Back and leg pain limits normal activity or impairs quality of life
- Progressive neurological deficits develop (leg weakness, foot drop, numbness in the limb)
- Loss of normal bowel and/or bladder functions
- Difficulty standing or walking
- Failed medical therapy
The primary goal of surgery is to create space for the
nerve to pass
through and relieve compression on the nerve and can in the form of
decompression and fusion which is performed in a minimal invasive
fashion.
Decompression
Laminectomy and Foraminotomy – removal part of bone, soft
tissue and
ligaments – for patients with predominant leg pain without instability.
This can be done minimally invasively, using either a tube or an
endoscope.
Spinal fusion
In case of dominant back pain coupled with leg pain and
spine
instability. Here an artificial graft/ cage is placed in between the
two vertebral bones and stabilised with screws and rod to achieve
fusion between the two adjacent bones.
- In both cases you are made to walk on next day morning
- Immediate relief of leg pain is felt
- Minimal operative site pain and back pain as a result of surgery is expected with numbness in leg at times
- Benefits of surgery appear to last for many years (long term relief)