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Spinal Stenosis
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Spinal Stenosis

En Español (Spanish Version)

Definition

Spinal stenosis is a narrowing of the space called the spinal canal, which is located within the backbone. The spinal canal is a small space that holds the nerve roots and spinal cord. If for any reason this space becomes smaller, it can squeeze the nerves and the spinal cord, causing pain and other symptoms. Stenosis can occur anywhere along the spinal cord, but it is more common in the lumbar region.

Spinal Stenosis

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Causes

Some people are born with narrowed canals, but most often stenosis is a result of aging. Conditions that can cause spinal stenosis include:

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

  • Being born with a narrow spinal canal
  • Age: 50 or older
  • Previous injury or surgery of the spine

Symptoms

Symptoms include:

  • Numbness, weakness, cramping, or pain in the legs and thighs
  • Radiating pain down the leg
  • Abnormal bowel and/or bladder function
  • Decreased sensation in the feet causing difficulty placing the feet when walking
  • Loss of sexual function
  • Partial or complete paralysis of legs

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

  • X-ray—a test that uses radiation to take pictures of structures inside the body; in this case, to check for abnormalities in the bones of the back including osteoarthritis, bone spurs, and obvious narrowing of the spinal canal.
  • CT scan—a type of x-ray that uses a computer to make pictures of the bony architecture of the back, which helps to evaluate the spinal canal
  • MRI scan—a test that uses magnetic waves to make pictures of soft tissue, such as the spinal cord and the spinal nerves inside the back

Treatment

Treatments include:

Medication

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)—to relieve pain and inflammation
  • Analgesics—to relieve pain
  • Corticosteroid injections—to reduce pain and inflammation (not often used)

Physical Therapy

Special exercises can help stabilize the spinal cord by increasing muscle endurance and mobility of the spine. Exercises are, however, often ineffective in spinal stenosis.

Support Devices

Wearing a corset or lumbar brace can help stabilize the spine and alleviate pain.

Surgery

Surgery is reserved for severe cases.

  • Decompression laminectomy—the removal of a build-up of bony spurs or increased bone mass in the spinal canal, which can free up space for the nerves and the spinal cord.
  • Spinal fusion—the fusion of two vertebrae to provide stronger support for the spine, almost always done after decompression laminectomy

Prevention

There are no guidelines for preventing spinal stenosis.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

The Arthritis Society
http://www.arthritis.ca/custom%20home/default.asp?s=1

References:

Arthritis Foundation website. Available at: http://www.arthritis.org .

American Academy of Family Physicians website. Available at: http://www.aafp.org/ .

The Merck Manual of Medical Information. Home Edition. Merck Research Laboratories; 1999.

National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .



Last reviewed October 2007 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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