A narrowing of the open spaces within the spine is called spinal stenosis. It can put pressure on the spinal cord and the nerves that travel through the spine. Symptoms of stenosis vary depending on where the narrowing or stricture occurs.
Spinal stenosis occurs most often in the neck and lower back. The narrowing may involve a small or large area of the spine. In many cases, stenosis may be treated with medication, steroid injections or physical therapy.
In extreme cases, a neurosurgeon may advise surgery. Stenosis is considered severe when it causes loss of certain functions or disabilities, or when other treatment options have failed to relieve symptoms. You should consult an expert neurosurgeon to assess your symptoms.
Treating Spinal Stenosis
Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to aging. As people age, the ligaments of the spine may thicken and calcify (i.e. harden from deposits of calcium salts). Bones and joints may also enlarge. When surfaces of the bone begin to project out from the body, these projections are called osteophytes (bone spurs).
Spinal Stenosis in Adults
While spinal stenosis may occur in younger people who are born with a narrowing of the spinal canal, or who incur an injury to the spine, spinal stenosis is most common in men and women over 50 years of age.
Symptoms of Stenosis
Some people may have no signs or symptoms of stenosis. When symptoms do occur, they depend on the location of the stenosis, including:
Pain, numbness, muscle weakness, and problems with bladder or bowel function
Stenosis in the neck: may cause numbness, weakness, tingling in one or both legs, foot, arm or hand
Stenosis in the lower back: pain, cramping in legs while standing long periods of time or when walking
Severe stenosis cases: affected nerves in bladder or bowel, leading to incontinence.
Causes of Stenosis
Two forms of arthritis that may affect the spine and cause spinal stenosis are osteoarthritis and rheumatoid arthritis.
Paget’s disease (an uncommon bone condition that results in deformity)
ossification (i.e. calcium deposits) of a ligament located inside the spinal canal.
Some people inherit a small spinal canal or have a curvature of the spine (scoliosis) that produces pressure on nerves and soft tissue and compresses or stretches ligaments.
Severe Spinal Stenosis
In rare cases, severe back pain can be a sign of cauda equina syndrome (CES), a condition that among other factors, can be caused by spinal stenosis. It is serious and usually requires urgent surgical treatment.
CES affects a bundle of nerve roots called cauda equina (Latin for horse’s tail). These nerves are located at the lower end of the spinal cord in the lumbar spine.
When Is Surgery Necessary for Spinal Stenosis?
Patients who experience severe leg pain when walking (also called lumbar stenosis and neurogenic claudication) are often candidates for surgery. The goal of surgery is to alleviate pain and allow a return to function in everyday activities.
If you’ve experienced any of the above symptoms, contact our team to talk to one of our expert neurosurgeons.