Without treatment, spinal stenosis can significantly impact your mobility and quality of life. At Virginia Spine Institute in Reston, Virginia, the neurological surgery team provides evidence-based solutions for spinal stenosis, including spinal stenosis surgery. To schedule an appointment with the team, call Virginia Spine Institute or book a visit online today.
The spinal cord is a long, tubular structure that connects the brain to the peripheral nervous system, allowing you to move your body, feel your surroundings, and experience pain.
The spinal column protects our spinal cord and is made up of bones, joints, discs, soft tissues, and nerves. The spinal cord is housed in the cervical and thoracic spine and normally terminates at the upper lumbar spine, where the nerves then spread out and travel freely through the canal.
Cervical spinal stenosis causes pressure on the spinal cord and exiting spinal nerves. Lumbar spinal stenosis causes pressure on the freely traveling and exiting lumbar spinal nerves. That can be caused by several factors including degenerative changes such as disc herniations, disc height collapse, enlargement of facet joints, arthritis, or thickening of the ligamentous structures.
If the central spinal canal or the foramen through which the spinal nerves exit narrows, you have spinal stenosis.
Spinal stenosis is a narrowing of the spinal canal to a degree where the spinal cord or nerve roots become compromised. Spinal stenosis may occur throughout the spine, but it is most common in the lumbar spine. However, spinal stenosis is most dangerous in the cervical spine due to its proximity to the spinal cord.
There are several causes of spinal stenosis; however, degenerative changes are typically the most common. These changes include:
Finally, bone spur formation, called spondylosis, is also a common cause.
Symptoms depend on whether the narrowing affects the spinal nerves, spinal cord, or both. If only the spinal nerve roots are involved, you may experience pain, numbness, tingling, or weakness in the arms or legs, called radiculopathy.
In cervical or thoracic spinal stenosis, people may or may not experience pain or symptoms of radiculopathy. Often, they present with symptoms of myelopathy, which is the term used to describe neurologic symptoms related to the spinal cord. Myelopathy may cause permanent spinal cord injury. Without spinal stenosis treatment, damage may lead to paralysis or death. Symptoms of myelopathy include:
Other symptoms include clumsiness or difficulty with fine motor skills, such as typing or writing.
Lumbar spinal stenosis may cause pain and radiculopathy or symptoms of neurogenic claudication. Symptoms of neurogenic claudication include pain, numbness, weakness, tingling, or heaviness in the legs that often worsen with prolonged standing or walking.
Pain often is improved with sitting or bending forward. If lumbar spinal stenosis is severe enough, it can result in cauda equina syndrome. That is when the bundle of nerves below the spinal cord is compromised, causing loss of sensation in the genital area, bowel or bladder incontinence, urinary urgency, leg pain or weakness, numbness, or heaviness in the legs.
Cauda equina syndrome is a spinal emergency and requires emergent evaluation as it can lead to permanent paralysis and incontinence.
If you experience any of the symptoms above or suspect you may be experiencing spinal stenosis, make an appointment to be evaluated by a spinal specialist at Virginia Spine Institute in Reston, VA.
Your initial evaluation will involve discussing your full medical history, a comprehensive physical exam, and diagnostic imaging such as x-rays and MRI. Spinal stenosis is medically diagnosed by MRI.
For people with mild spinal stenosis and not at risk for permanent neurologic deficit, conservative treatments often are the initial treatment of choice. These non-surgical treatments include spine specialized physical therapy in conjunction with medications.
Physical therapy gently stretches the joints and muscles in the spine to provide relief. Chiropractic manipulation should never be performed with spinal stenosis. When medications and therapy fail to improve symptoms, steroid injections can reduce inflammation but spinal stenosis surgery may also be discussed.
If non-surgical treatments fail to improve your symptoms or the degree of stenosis is too severe, cervical spinal stenosis surgery is often discussed. The goal of spinal stenosis treatment with surgery is to improve pain and stop progressive neurologic damage.
Multiple surgical procedures and approaches exist to treat stenosis. Our spinal specialists at Virginia Spine Institute will review these options with you. Each surgical plan is specifically tailored to the patient and their spinal needs to provide the best care possible and optimal spinal stenosis recovery.
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Reviewed by: Dr. Christopher Good, MD, FACS.