Spinal Stenosis

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

Spinal stenosis 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
• Paget disease of the bone
• Achondroplastic dwarfism
• Acromegaly—too much growth hormone

Symptoms

Spinal stenosis symptoms can happen anywhere along the spinal cord. It is most common in the low back (lumbar) region.

Problems may be:

• 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 symptoms and past health. A physical exam will be done.

Pictures may be taken of the spinal canal. This can be done with:

• MRI scan
• CT scan

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

Treatment

There is no cure, but symptoms can be managed with:

• 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 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 current guidelines to prevent spinal stenosis.