CNY Orthopedic Sports Medicine, PC: Injury: Spinal Stenosis

Injuries and Conditions: Back & Spine: Spinal Stenosis

Spinal stenosis is a condition that results in a narrowing of the spinal canal due to a degenerative process. The spinal canal contains the spinal cord and nerve roots. As the canal narrows, the nerve roots and the spinal cord are compressed. The progressive increase of the pressure on the nerves and spinal cord result in symptoms of pain, numbness, tingling, or weakness in the extremities. Futhermore, it significantly decreases walking endurance.
  • The condition has many causes, the most common are the degenerative changes occurring in the spine as we grow older.
  • The low back (lumbar) and neck (cervical) regions of the spine are common sites of involvement. The mid-back (thoracic) is less often involved with the development of stenosis.
  • Absolute indication for surery is Cauda Equina Syndrome, which presents loss of bowel and bladder control.
  • Surgery is indicated when non-surgical measures have failed or presentation with profound neurologic deficit.
  • The surgical treatment of spinal stenosis is dependent on the underlying cause of the nerve compression.

  • Signs and Symptoms
  • A tingling sensation, numbness (paresthesia), and/or weakness in any or all of the extremities.
  • Dull to severe aching pain in the back, buttocks and thighs that develops when walking or with prolonged standing, and which may radiate into the lower legs (neurogenic claudication).
  • Clumsiness, frequent tripping or falling when walking, and/or an altered pattern of walking (gait).
  • Improvement of sympotms with sitting or bending forward. Patients often feel relief pushing a cart in a supermarket (flexing their spine) or laying in areclining position. This flexion increases the size of the canal and temporarily relieves the symptoms.
  • Contact the Doctor if ...
  • Any of the signs and symptoms are present. An evaluation by an orthopedic surgeon is recommended.
  • Symptoms persist, become increasingly severe and/or bowel and bladder function becomes impaired.
  • Medications are not providing relief or are causing unexpected side effects.

  • Common Causes of Injury
  • The most common cause of spinal stenosis is osteoarthritis, which results in bony outgrowths (bone spurs) from hypertrophied facet joints projecting into the spinal canal, compressing nerve roots and resulting in pain and dysfunction.
  • Degenerative disc disease coupled with a degeneration of the smaller joints (facet joints) connecting each vertebrae. This condition is known as spondylosis.
  • The shifting of one vertebrae on another as a result of degenerative disc disease. A condition known as spondylolisthesis.
  • Spinal stenosis can result from inherited conditions such as achondroplasia, in which the patient is born with a narrow spinal canal.

  • Expectations of Recovery
  • Recovery from spinal stenosis, when treated non-surgically is limited to control of the pain and the symptoms of nerve compression.
  • The goal of surgical treatment is to relieve pain and decompress the spinal cord by enlarging the spinal canal by removal of the narrowed or damaged sections of the spine.
  • Operative results are commonly favorable with relatively quick resolution of symptoms.

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