SPINAL STENOSIS

Cervical Spinal Stenosis

Cervical spinal stenosis refers to a narrowing of the spinal canal in the cervical (neck) region, often resulting in compression of the spinal cord and nerve roots. This condition can develop due to various factors, including age-related degeneration, herniated discs, or congenital abnormalities. As the spinal canal becomes narrower, it can lead to symptoms such as neck pain, stiffness, numbness, weakness, and tingling sensations that radiate down the arms. Severe cases of cervical spinal stenosis may result in difficulty walking, loss of bladder or bowel control, and even paralysis if left untreated.

Lumbar Spinal Stenosis

The narrowing of the spinal canal or the tunnels via which nerves and other tissues connect with it refers to lumbar canal stenosis. Narrowing of the spinal canal usually occurs by aging-related changes that reduce the canal’s size, such as the misalignment of one of the vertebrae. The nerve root of the spinal cord usually gets pinched when the spinal canal or side canals that protect the nerves narrow. As the canal’s diameter narrows, the nerves get progressively inflamed. The legs, groin, hips, buttocks, and lower back can all become affected by lumbar canal stenosis, which causes discomfort, numbness, and weakness. Walking or standing causes symptoms to increase, whereas laying down, sitting, or leaning forward causes symptoms to improve.

Who Gets Spinal Stenosis?

Spine stenosis can affect anybody, although it occurs most frequently in people over 50. This condition can also affect young persons who were born with a small spinal canal. The causes of spine stenosis link to a variety of disorders affecting the spine, such as scoliosis or damage to the spine.

Risk Factors:

Several factors can increase the risk of developing spinal stenosis, including age-related degeneration of the spine, genetics, previous spine injuries or surgeries, and certain medical conditions such as arthritis and scoliosis.

What Causes Spinal Stenosis?

There are several reasons for spine stenosis. What they all have in common is that they alter the shape of your spine, limiting the area surrounding your spinal cord and nerve roots that escape through it. Compression or pinching of the spinal cord and/or nerve roots produces symptoms such as low back pain and sciatica. The following are some of the causes of spine stenosis:

Bone overgrowth/arthritic spurs:

Osteoarthritis is a “wear and tear” disease that causes the cartilage in your joints, including your spine, to break down. The protective coating for joints is cartilage. The bones start to rub against one other when cartilage goes down. Your body reacts by producing more bone. As doctors, we see the overgrowth of bone, or bone spurs, as a typical occurrence. Bone spurs on the vertebrae expand into the spinal canal, narrowing it and squeezing nerves. Paget’s disease of the bone can lead to an overgrowth of bone in the spine, squeezing nerves.

Bulging discs/herniated discs: 

A flat, spherical cushioning pad (vertebral disc) sits between each vertebra and works as a stress absorber along the spine. The gel-like interior of these discs breaks through a weak or torn outer layer due to age-related drying out and flattening of vertebral discs, as well as breaking in the outside border of the discs. The nerves around the disc are then compressed by the bulging disc.

Thickened ligaments:

Ligaments are the fiber bands that connect the vertebrae of the spine. Ligaments can enlarge and protrude into the spinal canal space as a result of arthritis.

Spinal fractures and injuries:

Broken or dislocated bones, as well as inflammation caused by injury to the spine, can limit the canal space and put pressure on spinal nerves.

Spinal cord cysts or tumors:

Growths within the spinal cord or between the spinal cord and vertebrae can restrict the space between the vertebrae, putting pressure on the spinal cord and its nerves.

Congenital spinal stenosis:

A person who is born with a tiny spinal canal is said to have this ailment. Scoliosis is another congenital spinal condition that can cause spine stenosis (an abnormally shaped spine).

Symptoms of Lumbar Spinal Stenosis

When spinal stenosis first appears, you may or may not have symptoms. As time goes by, the narrowing of the spinal canal is generally a gradual and progressive process that becomes worse over time. Although spine stenosis can occur anywhere along the spinal column, doctors usually locate it in the lower back (the most frequent location) and neck. Hence, symptoms differ from person to person and might appear and disappear at any time. The following identifies some of the signs and symptoms of lumbar spine stenosis:

• Lower back pain. Pain can range from a subtle aching or discomfort to an electric or searing feeling.
• This is discomfort that starts in your buttocks and spreads down your leg, maybe into your foot.
• Leg cramps in one or both legs due to a heavy feeling in the legs.
• The buttocks, leg, or foot are numb or tingling.
• Leg or foot sluggishness (as the stenosis worsens).
• Standing for lengthy periods, walking, or walking downhill causes pain.
• When leaning, bending forward slightly, walking uphill, or sitting, the pain subsides.
• The inability to control one’s urine or bowels (in severe cases).

Symptoms of Cervical Spinal Stenosis 

• Neck pain.
• Arm, hand, leg, or foot numbness or tingling
• Weakness or clumsiness in the arm, hand, leg, or foot
• Balance issues.
• Hand loss, such as difficulty writing or buttoning shirts
• The inability to control one’s urine or bowels (in severe cases).
• The following are some of the signs and symptoms of thoracic (abdominal) spine stenosis:
• At or below the level of the abdomen, pain, numbness, tingling, or weakness may exist.
• Balance issues.

Is it possible for Spinal Stenosis to Result in Permanent Paralysis?

While spinal constriction might cause discomfort, it typically does not result in paralysis. Permanent numbness and/or paralysis can occur if a spinal nerve or the spinal cord is crushed for an extended length of time. This is why, if you have numbness or weakness in your arms or legs, you should contact your doctor as soon as possible.

Spinal Stenosis Diagnosis

A physical exam will take place after your medical history is reviewed and questions about your symptoms are answered. During your physical exam, your healthcare provider may feel your spine and push on different regions to see whether it causes discomfort. Usually, your doctor may ask you to bend in different directions to examine whether different postures of your spine cause pain or other symptoms. Finally, your doctor will evaluate the patient’s balance, mobility, and walking patterns, as well as their arm and leg strength. Imaging tests will take place on the spine to establish the precise location, nature, and degree of the disease. Imaging investigations may involve the following:

• X-rays: X-rays emit a limited quantity of radiation and can reveal changes in a bone structure such as disc height reduction and the formation of bone spurs that narrow the spine’s space.
• MRI: Magnetic resonance imaging (MRI) creates cross-sectional pictures of the spine using radio waves and a strong magnet. The nerves, discs, spinal cord, and the presence of any malignancies are all seen in exquisite clarity on MRI images.
• CT or CT myelogram: A computed tomography (CT) scan uses a series of X-rays to produce cross-sectional pictures of the spine. In a CT myelogram, a contrast dye is utilized to assist reveal the spinal cord and nerves more clearly.

Treatments for Spinal Stenosis

Treatment options for stenosis are determined by the cause of your symptoms, the location of the issue, and the severity of your symptoms. If your symptoms are minor, your doctor may advise you to try some self-care methods first. If they don’t help and your symptoms continue to worsen, your doctor may suggest physical therapy, medication, and eventually surgery.

Preparing for Spinal Stenosis Surgery?

If you smoke, consult with your doctor about stopping smoking immediately to speed up your recovery. Furthermore, consult with your doctor about stopping any non-essential drugs, vitamins, or herbal therapies that may interact with anesthesia. Finally, ask our doctors any questions or express any concerns you may have.

Non-Surgical Treatment Options:

Treatment for spinal stenosis aims to alleviate symptoms, improve mobility, and prevent further deterioration of the spine. Several approaches include:

• Medications: Pain management medications such as NSAIDs, muscle relaxants, anti-seizure drugs, and opioids will alleviate pain and discomfort associated with spinal stenosis.
• Corticosteroid Injections: These injections can help reduce inflammation and provide temporary relief from pain and swelling.
• Nerve Blocks: Nerve blocks involve injecting local anesthetics or steroids directly into the affected nerves to block pain signals.
• Physical Therapy: Physical therapy focuses on strengthening the muscles surrounding the spine, improving flexibility, and enhancing overall mobility.
• Surgery: In severe cases or when conservative treatments fail to provide relief, surgical interventions using the following procedures can occur:

Surgical Treatment Options

Laminectomy:

• Laminectomy, also known as decompressive laminectomy, involves the removal of a portion of the lamina, the bony arch of the vertebra, to create more space within the spinal canal. This relieves pressure on the spinal cord and nerves, reducing pain and other symptoms associated with spinal stenosis.

Laminoplasty:

• Laminoplasty is a surgical procedure designed to address spinal stenosis while preserving the stability of the spine. Unlike laminectomy, which involves removing a portion of the lamina, laminoplasty involves creating a hinge on one side of the lamina, allowing it to lift and opened like a door. This expands the spinal canal while maintaining the integrity of the spine’s bony structure.

Laminotomy:

• Laminotomy is a minimally invasive surgical procedure that involves removing a small portion of the lamina to relieve pressure on the spinal cord and nerves. Unlike laminectomy, which removes the entire lamina, laminotomy preserves more of the bony structure of the spine, reducing the risk of instability.

Minimally Invasive Spine Surgery:

• Minimally invasive spine surgery (MISS) encompasses a variety of techniques and procedures aimed at addressing spinal conditions with minimal disruption to surrounding tissues. These techniques often involve smaller incisions, reduced blood loss, and faster recovery times compared to traditional open surgery. Surgeons use MISS to perform laminectomy, laminoplasty, laminotomy, or other decompression procedures.

Decompression Procedures:

• Decompression procedures are surgical interventions aimed at relieving pressure on the spinal cord and nerves caused by spinal stenosis. These procedures may involve removing bone or tissue that is compressing the spinal canal, such as the lamina, ligaments, or bulging discs.

Spinal Fusion:

• Spinal fusion is a surgical procedure that aims to stabilize the spine by joining two or more vertebrae together using bone grafts, screws, and rods. While not primarily used to address spinal stenosis, Surgeons use spinal fusion in conjunction with decompression procedures to improve spinal stability and prevent further degeneration.

Newest Treatments:

• Emerging treatments like interspinous spacers, which are inserted between the spinous processes to help maintain proper spinal alignment and reduce pressure on the nerves, show promising results in relieving symptoms of spinal stenosis.

Home Remedies:

In addition to medical treatments, individuals with spinal stenosis can benefit from home remedies such as maintaining a healthy weight, practicing good posture, using supportive devices like braces or canes, and engaging in low-impact exercises like swimming or walking.

Complications:

Complications of spinal stenosis may include progressive neurological deficits, chronic pain, decreased mobility, and reduced quality of life. It’s essential to monitor symptoms closely and seek prompt medical attention if complications arise.

Living with Spinal Stenosis:

Living with spinal stenosis may require lifestyle adjustments to manage symptoms effectively. It’s essential to avoid activities that exacerbate pain or discomfort, maintain a balanced diet, stay physically active within limits, and practice stress-reducing techniques such as meditation or yoga.

Why Choose the Southwest Scoliosis and Spine Institute for Your Treatment

Patients with spinal stenosis can benefit from choosing the Southwest Scoliosis and Spine Institute for their treatment for several reasons:

Specialized Expertise

The Southwest Scoliosis and Spine Institute specializes in the diagnosis and treatment of various spine conditions, including spinal stenosis. The institute is staffed with highly skilled and experienced spine specialists, including spine surgeons and other healthcare professionals who have extensive knowledge and expertise in managing spinal stenosis. Their specialized training and experience ensure that patients receive the most accurate diagnosis and effective treatment options for their specific conditions.

Comprehensive Care

The institute offers comprehensive and patient-centered care for spinal stenosis. For example, this includes a multidisciplinary approach, where a team of experts collaborates to develop individualized treatment plans tailored to each patient’s unique needs. The team may include spine surgeons, physical therapists, pain management specialists, and other professionals who work together to address the various aspects of spinal stenosis, including pain management, functional restoration, and improving quality of life.

Advanced Treatment Options

The Southwest Scoliosis and Spine Institute is equipped with state-of-the-art technology and advanced treatment options for spinal stenosis. Interestingly, they stay updated with the latest advancements in minimally invasive techniques, such as decompression surgeries, which can effectively relieve pressure on the nerves while minimizing surgical invasiveness and promoting faster recovery. Also, the institute also offers non-surgical treatment options, including physical therapy, medication management, and lifestyle modifications, providing a comprehensive range of choices to address spinal stenosis.

Patient-Centered Approach

The institute prioritizes patient-centered care, ensuring that patients are actively involved in their treatment decisions. They emphasize open communication, providing patients with a thorough understanding of their condition, treatment options, and expected outcomes. The team at the Southwest Scoliosis and Spine Institute takes the time to address any concerns or questions patients may have, guiding them through every step of their treatment journey.

Track Record of Success

The Southwest Scoliosis and Spine Institute, with offices in Dallas, Plano, and Frisco, Texas, has a track record of successful outcomes in treating spinal stenosis. Besides their expertise, they utilize advanced technology and a patient-centered approach to find solutions for their patients.  Thus, patient testimonials and success stories attest to the institute’s commitment to providing high-quality care for spinal stenosis. More importantly, choosing the Southwest Scoliosis and Spine Institute for spinal stenosis treatment ensures access to specialized expertise and comprehensive care.  Furthermore, it provides advanced treatment options, a patient-centered approach, and a track record of successful outcomes. In conclusion, patients need to consult with their doctor about all aspects of their condition. Notably, the discussions should also determine the most suitable treatment path to stop the pain of spinal stenosis.

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Footnote:

American Association of Neurological Surgeons: Lumbar Spinal Stenosis