Spinal Stenosis

Overview

Definition

Spinal stenosis is a narrowing of the spinal canal. The spinal canal is located in the backbone. It is a small space that holds the nerve roots and spinal cord. If this space becomes smaller, it can squeeze the nerves and the spinal cord. This 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
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Causes

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

  • Osteoarthritis and osteophytes (bony spurs) associated with aging
  • Rheumatoid arthritis
  • Spinal tumors
  • Trauma
  • Paget's disease of the bone
  • Previous surgery

Risk Factors

Spinal stenosis is more common in people aged 50 years and older. Other factors that may increase the chance of spinal stenosis include:

  • Being born with a narrow spinal canal
  • Previous injury or surgery of the spine

SymptomsandDiagnosis

Symptoms

Spinal stenosis may cause:

  • 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

You will be asked about your symptoms and medical history. A physical exam will be done.

Imaging tests that evaluate your spine and surrounding structures may include:

  • Ultrasound
  • X-ray
  • CT scan
  • MRI scan

Treatments

Treatment

Treatments include:

Medication

Medications that relieve pain and inflammation include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroid injections

Physical Therapy

Special exercises can help stabilize the spinal cord. Exercise can increase muscle endurance and mobility of the spine. This can relieve some pain. Sometimes exercises are ineffective against spinal stenosis.

Support Devices

Wearing a corset or lumbar brace can help stabilize the spine. This may relieve pain.

Surgery

Surgery is reserved for severe cases.

  • Decompression laminectomy—This is the removal of bony spurs or increased bone mass in the spinal canal. This can free up space for the nerves and the spinal cord.
  • Spinal fusion—This is when 2 vertebrae (back bones) are fused together. This will provide stronger support for the spine. This is almost always done after decompression laminectomy.

Prevention

There are no guidelines for preventing 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.

Kovacs FM, Urrutia G, Alarcon JD. Surgery versus conservative treatment for symptomatic lumbar stenosis: A systematic review of randomized controlled trials. Spine. 2011;36(20):E1335-E1351.

Lumbar spinal stenosis. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114133/Lumbar-spinal-stenosis . Updated October 26, 2015. Accessed September 1, 2017.

Snyder DL, Doggett D, et al. Treatment of degenerative lumbar spinal stenosis. Am Fam Physician. 2004;70(3):517-520.

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 1, 2017.

12/17/2013 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114133/Lumbar-spinal-stenosis : de Schepper El, Overdevest GM, et al. Diagnosis of lumbar spinal stenosis: an updated systematic review of the accuracy of diagnostic tests. Spine (Phila Pa 1976). 2013 Apr 15;38(8):E469-81.