Spinal stenosis is a condition that affects many individuals, especially those who have reached or exceeded middle age. Simply stated, spinal stenosis occurs when the spinal column (which houses the spinal cord) becomes constricted. A number of factors can lead to a narrowing of the spinal canal, chief among them the degenerative changes that occur as a person ages.

Degenerative Changes

As we grow older, we all anticipate that our skin will become wrinkled, our hair will gray, and our eyesight will become less acute. Just as these degenerative changes can occur later in life, so too can changes that affect the spine. This area of the body is not only relied upon for protecting the spinal cord, which sends and receives sensory and motor signals to and from the brain, but it is also tasked with supporting the weight of the body and facilitating movement. Over time, these responsibilities can begin to take their toll, causing some of the spine’s anatomical components to break down, such as the vertebrae, facet joints, and intervertebral discs.

Vertebrae are the bone structures that house and protect the spinal cord. Most people have 24 articulating vertebrae that run from their necks to their lower backs and nine fused vertebrae that make up the sacrum and the coccyx. Each articulating vertebra contains a passageway – called the vertebral foramen, which is more commonly known as the spinal canal – through which the spinal cord travels. Between each vertebral pair is a passageway called the intervertebral foramen that provides space for nerve roots to branch from the spinal cord and travel throughout the body to deliver sensory and motor messages. There are a variety of degenerative changes that can occur throughout the spinal column that can potentially lead to spinal stenosis:

– As an individual ages, the ligaments in the neck and back can lose elasticity, leading to a shortening of the spine. This can lead to the development of canal stenosis (when the vertebral foramina become narrowed), and foraminal stenosis (when the intervertebral foramina are constricted). Both conditions can cause a pinched spinal nerve or nerve root

– The facet joints are responsible for connecting adjacent, articulating vertebrae. These joints afford us the ability to bend, twist, and otherwise move our necks and backs. A thin layer of cartilage lines the joints and provides lubrication to prevent them from painfully grinding against one another. Over time, the joints’ cartilaginous lining can begin to wear away, leading to facet disease, or spinal arthritis. The body may produce smooth bony growths called bone spurs to stabilize an arthritic spine. These nodules can protrude into the spinal column, leading to neural compression.

– Intervertebral discs, or the saucer-shaped “shock absorbers” that separate articulating vertebrae, are composed of two parts: an outer shell called the annulus fibrosus, and an inner jelly-like filling called the nucleus pulposus. The annulus fibrosus is not only tasked with keeping the highly pressurized nucleus pulposus contained, but is also responsible for giving the discs their ability to “bounce back” after weight and pressure are applied to them. The nucleus pulposus is relied on to ensure that the pressure that is applied to the disc is evenly dispersed in all directions. During the natural aging process, the annulus fibrosus can harden and lose elasticity, while the nucleus pulposus can lose water content. This degeneration can lead to herniated or bulging discs, each of which are conditions that can directly lead to spinal stenosis. Herniated discs occur when the annulus fibrosus develops a crack or tear, allowing the annulus fibrosus to escape and enter the spinal canal. Bulging discs, on the other hand, occur when the annulus fibrosus weakens to the point that it can no longer contain the nucleus pulposus within its normal boundaries, which allows the disc’s inner contents it to shift and causes the disc to balloon to one side.

Symptoms

Regardless of which degenerative spinal condition is causing neural compression, most patients with spinal stenosis will experience similar symptoms. This typically includes pain, numbness, tingling, and muscle weakness that extends into the limbs. When neural compression occurs in the cervical spine, patients can experience symptoms in the neck, upper back, shoulders, and/or arms. A pinched nerve in the lumbar spine can cause discomfort in the lower back, hips, buttocks, and/or legs.

Nonsurgical Treatments

Most patients who are diagnosed with spinal stenosis are able to relieve their symptoms through the use of conservative, nonsurgical treatments. This typically includes the use of medication, such as over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, muscle relaxants, or narcotic pain relievers. May patients also benefit from working with a physical therapist to build strength in the neck, back, and abdomen. Strengthened musculature can provide the spine with added support and can potentially help in relieving some of the pressure from the compressed spinal nerve. In addition to strength building exercises, physical therapy may also include transcutaneous electrical nerve stimulation (TENS), cryotherapy, thermotherapy, and posture modification exercises, among others.

Some patients who suffer from spinal stenosis benefit from the use of alternative therapies, either in lieu of conservative treatments or as a complement to them. Popular alternative therapies for relieving chronic neck and back pain include:

– Acupuncture

– Restorative yoga

– Herbal supplements

– Deep tissue massage

– Hypnotism

– And others

Patients should consult their physicians before using alternative therapies, especially if they are being used in addition to conservative treatments. This can prevent the occurrence of harmful and potentially serious side effects and/or interactions.

Surgical Treatment

Those who are unable to relieve their spinal stenosis symptoms through the use of nonsurgical treatments may be advised to consider surgery. In the past, this often meant the patient would undergo open spine surgery that required a long incision, the dissection of muscles, the complete removal of one or more spinal component, and the installation of hardware and bone grafts to fuse a portion of the spine. Thanks to advances in medical technology, many patients who require surgical treatment for spinal stenosis can undergo a minimally invasive procedure in lieu of open spine surgery. These procedures are performed on an outpatient basis and utilize an endoscope to access the spine. Spinal components are not removed in their entirety, which means patients are not resigned to spinal fusion. Many patients recover within a matter of weeks, and some even experience immediate relief.

Before consenting to any type of surgical treatment, patients should research all of the options that are available to them. It may also prove beneficial to receive a second or third opinion to ensure surgical treatment is warranted. Those who wish to learn more about spinal stenosis and the various treatments that are available to them should schedule an appointment with their primary care physician or a specialist.

Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for spinal stenosis and several other spinal conditions.

Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for spinal stenosis and other spinal conditions. http://www.laserspineinstitute.com/back_problems/spinal_stenosis

Author Bio: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for spinal stenosis and several other spinal conditions.

Category: Advice
Keywords: Spinal Stenosis