Spinal stenosis refers to a narrowing of openings in the bones of the spine through which the spinal cord and nerves pass. Spinal stenosis may occur in the neck (cervical spine), mid back (thoracic spine) or the lower spine (lumbar spine). Cervical and lumbar stenosis are much more common than thoracic stenosis. Pressure on the spinal cord or nerves from stenosis may cause pain, numbness, tingling and weakness in the arms or legs and may also cause difficulty walking. Paralysis from spinal stenosis is rare.
Spinal Stenosis Diagnosis
The diagnosis of stenosis is usually made by listening to the patient’s complaints and then performing a physical exam on the patient. Regular or plain x-rays can show degeneration or wearing out of the spine though on occasion may show bones that are slipped out of alignment. The diagnosis is confirmed by obtaining an MRI which is a special study that shows the stenosis with the resultant compression or pressure that it is being placed upon the nerves and the spinal cord.
Spinal Stenosis Treatment
Treatment of spinal stenosis depends upon the severity of the symptoms. If mild, patients may be watched or given non-steroidal medication. For more severe pain, an Epidural Steroid Injection (ESI) may be done. This is a technique in which steroids are injected under x-ray control in the stenotic area of the spine with the goal of decreasing inflammation and thereby decreasing pain.
Occasionally, the pain may be severe and unresponsive to non-operative treatment. In those instances, surgery may be an option to decompress or cut away bone from the stenotic area thereby enlarging the holes in the spine through which the spinal cord and nerves pass. Fusion or stabilization of the spine is usually not necessary unless the bones of the spine are slipped out of place. This surgery is often done on an out-patient basis although a short hospital stay may be required in some cases. The surgery is successful at partially relieving the patient’s pain and returning the patient to a more normal lifestyle.
Tim E. Budorick, M.D. FAWBJ, Abbott Byrd III, M.D. FAWBJ, FACS and David M. Clifford, M.D. FAWBJ practice at the Virginia Spine and Scoliosis Center which is a division of Wisconsin Bone and Joint with offices in Norfolk, Bartlett, Buffalo Grove, and Chesapeake, Virginia.