Spinal Stenosis

A pre-existing spinal condition may put you at high risk for spinal stenosis. Tumors and infections in the spine increase this risk as well.

Spinal stenosis refers to the narrowing of the spinal canal in your back. With this condition, pressure is placed on the spinal cord and spinal nerves, which are housed in the canal. Spinal stenosis occurs most often in the lower back (lumbar) area, and is more common among older people.

Causes
Spinal stenosis usually occurs gradually, with age, as a result of bony spur formation. It may also result from the following:

• injury, such as a sporting accident or car wreck
• disease, such as osteoarthritis
• disc herniation
• crack or break in a bone of the spine (vertebra)
• congenital defect
• infection
• tumor

Symptoms
The symptoms of spinal stenosis can range from mild to severe, depending on the level of constriction in the spinal canal. Pain and numbness may develop in the legs and buttocks. You may have muscle weakness, with walking and standing endurance greatly reduced. Bowel and bladder function can also be affected. However, stenosis does not cause back pain.

Diagnosis
Your doctor will discuss your symptoms and the history of your condition. X-rays will be used to check the alignment of your spine and to look for broken bones. Detailed images of your back may be obtained by CT (computed tomography) scan, MRI (magnetic resonance imaging), and myelography.

Treatment
Treatment options will vary according to your condition. Conservative treatment works in most cases and usually includes:

• anti-inflammatory medications
• epidural steroid injection (usually cortisone) to decrease inflammation and relieve pain
• physical and/or occupational therapy for specialized treatments and to guide your rehabilitation program

Surgery is considered when conservative measures do not provide an acceptable level of relief. The goal of surgery is to remove bone and tissue to widen the space in the spinal canal. With some cases, a spinal fusion may also be completed to connect the vertebral bones in the affected area. Spinal fusions are aimed at eliminating movement between some of the vertebrae where motion is causing pain.

Outlook
Recovery from spinal stenosis depends on several factors. Your age, overall health and the extent of your condition will play a significant role in determining the rate of recovery. Conservative treatment may offer relief within a few months. Surgical patients may need 6 months to a year for a complete recovery. It is important to follow the instructions given by your healthcare providers to help you return to your regular activities as soon as possible.