Spinal StenosisSpinal stenosis is the medical term used to describe narrowing of the spinal canal. The spinal canal is the space through which the spinal cord and spinal nerve roots pass. As the spine degenerates, debris builds up around the central canal, limiting the space available for the spinal cord and/or spinal nerves. This material is often the result of the typical age-related changes in the spine. Stenosis can also occur due to a congenital narrowing, a soft tissue pathology or a traumatic injury.Nerves are ultra sensitive to compression and require adequate space in order to function properly. Severe stenosis can cause nerves to lose full signal ability, sometimes resulting in painful symptoms and a diversity of possible neurological effects. There are 3 main types of stenosis which occur in the human spine. Central canal stenosis affects the main passageway which contains the spinal cord in the cervical and thoracic levels and the cauda equina in the lumbar and sacral regions. When the term stenosis is used to refer to the spine, this is the variety being discussed, unless otherwise noted. However, there is also 2 other types, including lateral stenosis, in which the lateral recess is narrowed, and foraminal stenosis, in which one or more of the neuroforaminal spaces are decreased in size and patency.
Spinal Stenosis Nerve EffectsSpinal nerves are extremely sensitive to impingement and might react to stenosis with pain, tingling, numbness or weakness. Stenosis is a general term that can mean crowding or effacement of the spinal cord or spinal nerve roots. While it is possible to experience nerve pain from severe stenosis, it is a rare occurrence when the narrowing is mild to moderate. Remember that stenosis is a basically normal process to experience as we age, especially in the mid to low cervical levels and lower lumbar and lumbosacral levels.Most minor to moderate stenosis conditions are asymptomatic and generally harmless to the patient, although they should be monitored by a qualified
neurologist.
Recommendation on Spinal StenosisStenosis is most common in elderly patients, usually after age 60. This is one of the reasons why some forms of stenosis might not really be considered true spinal problems. Many of the mild structural changes associated with stenosis are simply normal parts of the aging process.Of course, severe spinal stenosis is a very serious concern and may require surgical treatment to expand the canal space. In the worst scenarios, patients may suffer debilitating pain and/or may become victim to incontinence, the inability to stand or walk, and even complete physical disability. These expressions represent the extreme end of the stenosis spectrum. I always recommend that diagnosed stenosis patients seek care from a neurologist, since these physicians are specially trained to deal with the spinal nerve structures. Trusting your exclusive care to any other type of health professional might be a risky endeavor. Likewise, if surgery is indicated, I advise using a neurosurgeon, as opposed to a general orthopedic surgeon. Statistically, the chance for a better result and a more functional recovery are in your favor if your consider this path to treatment. Stenosis, in its mild forms, is also a common back pain scapegoat which is blamed for symptoms which may actually be sourced by another structural concern or even a psychosomatic back pain condition. If you have longterm unresolved stenosis pain, despite what may be considered "normal" canal narrowing for your age, make sure to consider this possibility as a plausible explanation for why your symptoms have not responded to appropriate treatment. Back Pain 5/26/06 Revised 2/18/12 |
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