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Spinal Stenosis

Spinal Stenosis is a narrowing of the spinal canal that results in pressure on the spinal cord or other neurological structures.

Spinal Stenosis may occur anywhere in the cervical (neck area), lumbar (lower back area), or thoracic (chest area) spine.

The narrowing in the spinal canal is the result of changes in the anatomic structures in the spine including the intervertebral discs, the facet joints, and spinal ligaments.

Symptoms:

The symptoms of spinal stenosis vary according to where in the body the stenosis is present and if there is significant pressure on the spinal cord or spinal nerves. Symptoms may be relatively mild to quite incapacitating depending on the severity of the stenosis.

Causes:

Spinal Stenosis is frequently the result of age related changes in the spine, however there are people born with narrow spinal canals. Other causes of spinal stenosis include:

  • Arthritis in the spine
  • Disc Degeneration
  • Herniated or bulging discs
  • Spondylolisthesis
  • Trauma
  • Previous surgery
  • Tumors

Symptoms of Lumbar Spinal Stenosis (Spinal Stenosis in the lower back):

  • Muscle Spasm in the lower back
  • Moderate to Severe pain in the lower back and buttocks
  • Lumbar Radiculopathy (Sciatica). The symptoms from a nerve compressed because of lumbar stenosis (pinched nerve) include pain, burning, numbness, or tingling from the lower back into the buttocks, thighs, legs and feet.
  • Neurogenic Claudication
  • Weakness may result in the muscles of the leg and feet if there is significant pressure on the nerves
  • Pain is typically brought on my walking and relieved by sitting.
The narrowing in the spinal canal is the result of changes in the anatomic structures in the spine.

Symptoms of Cervical Spinal Stenosis (Spinal Stenosis in the neck area):

  • Muscle Spasm in the neck and shoulder
  • Moderate to Severe pain in the neck and around the shoulder blades (scapula)
  • Cervical Radiculopathy. The symptoms from a nerve compressed by a disc herniation (pinched nerve) include pain, burning, numbness, or tingling from the neck into the shoulders, arms, forearms, and hands.
  • Weakness may result in the muscles of the arms and hands if there is significant pressure on the nerves
  • Cervical Myelopathy: The most serious condition that may result from cervical stenosis is myelopathy. Symptoms of myelopathy include loss of fine motor skills in the hands (difficulty buttoning a shirt, changes in handwriting, trouble putting on or taking off jewelry etc.), loss of balance, or loss of bowel or bladder control.

Treatments:

The majority of individuals with spinal stenosis do not require surgery. Common non-surgical treatment options include:

  • Physical Therapy
  • Anti-inflammatory medications
  • Epidural Injections

When pain symptoms are severe, if there is significant muscle weakness, if myelopathy is present, or if your overall condition deteriorates surgery may be necessary. The surgeons at Comprehensive Spine Care will develop a treatment plan based on your symptoms, physical exam and MRI results.

Surgery for Lumbar Stenosis typically consists of a Lumbar decompression Laminectomy, Laminomtomy). Stabilization of the spine may also be necessary (Anterior Lumbar Interbody Fusion, Posterior Lumbar Fusion, Lateral Lumbar Fusion.)

For a cervical disc stenosis the most common surgical options are Posterior Cervical Discectomy/ Foraminotomy , Anterior Cervical Discectomy and Fusion, or an Artificial Disc Replacement.