Spinal Stenosis

Overview

Definition

Spinal stenosis is a narrowing of the spinal canal. This can put pressure on the nerves or spinal cord.

Spinal Stenosis
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Causes

Some people are born with a small spinal canal. It can also happen with aging. Other things that may cause it are:

  • Osteoarthritis and osteophytes (bony spurs) from aging
  • Rheumatoid arthritis
  • Spinal tumors
  • Trauma
  • Paget disease of the bone

Risk Factors

It is most common in people over 60 years of age. Things that may raise the risk are:

  • Defects in the spine
  • Prior injury or surgery of the spine
  • Having Paget disease of the bone
  • Achondroplastic dwarfism
  • Acromegaly—too much growth hormone

SymptomsandDiagnosis

Symptoms

causes pain and other symptoms. Stenosis can occur anywhere along the spinal cord. It is most common in the low back (lumbar) region.

Spinal stenosis may cause:

  • Spreading pain in the lower back, buttock, or lower limb
  • Burning
  • Problems walking
  • Numbness, tingling, or loss of feeling in the feet
  • Weak muscles

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Images may be taken of your spinal canal. This can be done with:

  • MRI scan
  • CT scan

The electrical activity of your nerves, nerve roots, and muscle tissue may be measured. This can be done with electromyography.

Treatments

Treatment

There is no cure. The goal of treatment is to ease symptoms. Options may be:

  • Medicine to ease pain and swelling
  • A corset or brace to keep the spine stable
  • Exercises to keep the spine stable and promote strength and motion

Surgery

Some people with severe symptoms may need surgery to take pressure off of the nerves or spinal cord. Options are:

  • Decompression laminectomy to remove part of the vertebra, ligaments, and/or bone spurs to make room for the nerves and spinal cord
  • Spinal fusion to fuse two vertebrae together to support the spine. This is almost always done after decompression laminectomy.

Prevention

There are no guidelines to prevent spinal stenosis.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

Arthritis Foundation http://www.arthritis.org 

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org 

CANADIAN RESOURCES

The Arthritis Society http://www.arthritis.ca 

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

References

Delitto A, Piva SR, Moore CG, et al. Surgery versus nonsurgical treatment of lumbar spinal stenosis: A randomized trial. Ann Intern Med. 2015;162(7):465-473.

Kreiner DS, Shaffer WO, et al; North American Spine Society. Evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). Spine J. 2013 Jul;13(7):734-743.

Lumbar spinal stenosis. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/lumbar-spinal-stenosis  . Updated January 24, 2019. Accessed September 30, 2019.

Spinal stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Spinal%5FStenosis/default.asp. Updated August 2016. Accessed September 30, 2019.