Diagnosis of Spinal Stenosis
With the right treatment, pain caused by spinal or cervical stenosis can be managed. Learn more here.
Table of Contents
What Is Spinal Stenosis?
Spinal stenosis is the narrowing of one or more spaces within the spine. A tight space can irritate or pinch the spinal cord or nerves, resulting in back pain and sciatica. An estimated 250,000 to 500,000 people in the US have spinal stenosis symptoms.1
Spinal stenosis typically develops gradually over time and is commonly caused by osteoarthritis-related wear and tear changes in the spine.
Impact of Spinal Stenosis
Depending on the severity of the condition, doctors may recommend surgery to create additional space for the spinal cord or nerves. The prevalence of spinal stenosis is 20% in patients under forty years old and 47.2% in patients between sixty and sixty-nine years old.2
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Some people with spinal or cervical stenosis may not show any symptoms for a long time. However, depending on the severity and where the condition is, people may experience numbing, tingling, and muscle weakness, which can worsen over time. The prevalence of cervical stenosis is 6.8% in patients fifty years old and over and 9% in patients seventy years old and over.3
Where Does Spinal Stenosis Occur?
Spinal stenosis can occur anywhere along the spine, frequently around the lower back (lumbar canal stenosis) and neck (cervical canal stenosis).
What Are the Symptoms of Spinal Stenosis?
Sometimes symptoms of spinal stenosis do not appear when the condition first develops, as the narrowing of the spine is typically a slow and progressive process. Symptoms of spinal stenosis may vary from person to person, but the most common include:
- Leg or arm weaknessÂ
- Lower back pain while standing up or walkingÂ
- Numbness in the legs
- Balance problems
What Causes Spinal Stenosis?
Several reasons may cause spinal stenosis. Nonetheless, the underlying common factor among the different causes is alterations to the structure of the spine, causing a smaller space around the spinal cord and nerve roots that exit through the spine. This small space will cause compression or pinching of the spinal cord or nerve roots, resulting in low back pain and sciatica symptoms.
Some of the causes of spinal stenosis will be detailed below.
Bone Overgrowth/Arthritic Spurs
Wear and tear damage from osteoarthritis on the spinal bones may trigger the formation of bone spurs that can grow into the spinal canal. Paget’s disease of the bone can also cause an overgrowth of bone in the spine, compressing the nerves.
Bulging Discs/Herniated Discs
A flat, round cushioning pad (vertebral disk) sits between each disc and acts as a shock absorber along the spine. The gel-like center of these disks breaks through a weak or torn-out layer due to age-related drying out, flattening, and cracking at the outer edge of the disks.
Thickened Ligaments
The powerful cord that connects the spine can become rigid and thickened over time. These thickened ligaments can protrude into the spinal canal.Â
Spinal Fractures and Injuries
Dislocation or fracture of one or more vertebrae can result from accidents or trauma. Displaced bone from a spinal fracture can cause damage to the spinal canal’s content. Inflammation of nearby tissue immediately following surgery can also stress the spinal cord or nerves.
Spinal Cord Cysts or Tumors
Irregular growths within the spine or the membranes covering it can stress the spinal cord and nerves.Â
Congenital Spinal Cord Stenosis
Congenital spinal cord stenosis is a genetic disability in which a person is born with a narrow spinal canal. Scoliosis is another congenital spinal deformity that can put a person at risk for spinal stenosis.
Spinal Stenosis Diagnosis and Tests
The following are the diagnosis and tests for spinal stenosis.
Medical History Review
To diagnose spinal stenosis, health care providers review their patients’ medical history, inquire about their symptoms, and perform a physical examination.Â
X-Ray
Doctors may order several imaging tests to help determine the causes of the signs and symptoms. X-rays, for example, use a small amount of radiation that can show changes in the bone structure, such as loss of disk height and development of bone spurs that are shrinking the space in the spine.Â
Magnetic Resonance Imaging (MRI)
An MRI uses radio waves and a powerful magnet to produce cross-sectional images of the spine. MRI tests can detect nerve disks, ligaments, the spinal cord, and the presence of any tumors.Â
Computerized Tomography (CT scan)
A computerized tomography (CT) scan combines x-ray images taken from various angles to create detailed cross-sectional images of the body. Medical professionals perform CT scans after injecting a contrast dye into the veins to see the spinal cord and nerves more clearly.Â
Spinal Stenosis Treatments
Treatment options usually depend on the severity of the symptoms and where the condition is located on the spine. For example, mild symptoms may only require self-care home remedies. However, if at-home treatments are not sufficient and pain persists or worsens, the doctor would recommend the following medications.
Medications
 Medications used in treating spinal stenosis include:
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- Antidepressants, such as amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin imipramine (Tofranil), or nortriptyline (Pamelor)Â
- Opioids, such as oxycodone (Oxycontin) or hydrocodone (Vicodin)
- Muscle relaxants, such as cyclobenzaprine (Amrix Fexmid)Â
- Anti-seizure medicationÂ
- Corticosteroid injectionsÂ
- AnestheticsÂ
Surgery
Surgery for spinal stenosis can only be performed when other treatment options have failed. Types of surgery for spinal stenosis include:
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Laminectomy: Laminectomy is the most common type of surgery for spinal stenosis. It removes the lamina, creating more room for the spinal cord and nerves.
Laminoplasty: Laminoplasty is performed only in the cervical (neck) area, and it involves the removal of the lamina to create more canal space.Â
Laminotomy: Laminotomy is a procedure that removes only a small part of the lamina that is causing the most pressure on the neck.
Minimally Invasive Surgery: Minimally invasive surgery, also known as interspinous process spacers, is conducted on people with lumbar spinal stenosis. It involves inserting spaces between the bones extending off each vertebrae’s back, called the spinous process.
- Decompression Procedures: A decompression procedure is mainly used for treating lumbar spinal stenosis caused by a thickening of the ligamentum flavum in the back of the spinal column. One study found that patients who received surgical decompression procedures reported significant pain reduction compared to those who received nonsurgical procedures.4
Assisted Devices
Doctors may recommend the use of assisted devices to relieve symptoms.
Get Help for Spinal Stenosis at J. Flowers Health
The severe or chronic pain caused by spinal or cervical stenosis can affect your quality of life. At J. Flowers Health, we provide effective treatment options that work best for you.
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Our impressive facility provides comprehensive care that begins with a diagnosis, moves on to treatment, then continues with recovery care. Contact us today and start your journey to a healthy and enjoyable life.Â
Resources
- https://emedicine.medscape.com/article/1913265-overview#:~:text=Approximately%20250%2C000%2D500%2C000%20US%20residents,persons%20older%20than%2050%20years.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775665/
- https://pubmed.ncbi.nlm.nih.gov/17272453/#:~:text=After%20correcting%20for%20increased%20body,years%20of%20age%20or%20older.
- https://amj.amegroups.com/article/view/3837/4553#treatment
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