Spinal Stenosis

Spinal stenosis (or narrowing) is a common condition that occurs when the spinal canal, which contains the nerve roots and spinal cord, becomes compressed. Usually, this narrowing is caused by osteoarthritis of the spinal column and discs between the vertebrae (the bones of the back). It may also be caused by a thickening of the ligaments in the back, as well as by a bulging of the discs that separate the vertebrae.

Symptoms

Depending on where the narrowing occurs, you may experience symptoms in the lower back and legs, neck, shoulder or arms. Symptoms of spinal stenosis often start slowly and get worse over time. Symptoms include:

• Loss of feeling (numbness) in the arms or legs
• Pain in the neck or back
• Leg, foot or arm weakness
• Problems with walking (gait disturbance)
• Pain or cramping going down the arm or leg
• Problems with bladder and bowel function.

Diagnosis

Your doctor will order one or more tests to investigate the degree of compression in your spine.

• X-rays
• Magnetic resonance imaging (MRI)
• Computerized axial tomography (CAT)
• Bone scan – SPECT CT

Treatment

There are a number of treatment options that may provide relief for spinal stenosis, and avoid the necessity of surgery. In some cases, surgery may be the only option after all other treatment options have been exhausted.

• Exercise – Physiotherapy
  Regular exercise can help you build and maintain strength in the muscles of your arms and upper legs. This will improve your balance, ability to walk, bend and move about, as well as control pain. Swimming, Pilates and core strengthening exercises are excellent options.
• Medications
  Nonsteroidal anti-inflammatories (commonly called NSAIDS) may also relieve pain. In addition, your doctor may prescribe other medications to help with pain and/or muscle spasm.
• Acupuncture
  Acupuncture may provide relief if symptoms are mild.
• Steroid injections (corticosteroid injections)
  Injections directly into the area around the spinal cord (known as epidural injections) may provide a good temporary and occasional permanent relief.
• Surgery
  Some patients with severe or worsening symptoms may need surgery. If you have problems with bowel or bladder function or problems with walking, then surgery will likely be recommended. Two common surgical options are:
  • Laminectomy: This procedure involves removal of the bone, bone spurs, and ligaments that compress the nerves.
  • Spinal fusion: In this procedure, two or more vertebrae are permanently fused together.