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In the medical condition of spinal stenosis the spinal canal narrows and compresses the spinal cord and the nerves. The natural healing process of degeneration caused by our aging process will usually cause this back condition. Spinal disc herniation and osteoporosis are a few terms that are thrown around when talking about Spinal stenosis. Spinal stenosis may affect the cervical spine or the lumbar spine. Low back pain may be caused by lumbar spinal stenosis along with pain or abnormal sensations in the legs.
Cervical spinal stenosis: The calcification of the posterior longitudinal ligament, idopathis skeletal hyperostosis or cervical spondylosis may be contributing factors for cervical spinal stenosis. Cervical spinal stenosis is mainly discovered in the forty - sixty year old age group, and although it is found in women it is more common in the male gender.
There are multiple symptoms for cervical spinal stenosis
- Spastic gait
- Upper extremity numbness
- Upper or lower extremity weakness (sometimes both)
- Radiating pain in the upper limb
- Sphincter Disturbances
- Muscle degradation
- Sensory deficits
- Abnormal reflexes
A MRI (magnetic resonance imaging) is probably the most useful tool for diagnostic purposes, while a CT (computed tomography) scan is not very useful in this situation. Depending on the severity treatment may be as simple as a few physical therapy sessions and the use of a cervical collar. If the condition is more severe and conservative treatment measures fail surgical decompression may be advised.
Lumbar Spinal Stenosis: Lumbar spinal stenosis is mainly caused by hypertrophy of the facet joints, spondylolisthesis, diffuse idiopathic skeletal hyperostosis (DISH) and degenerative disc disease. This condition will often occur after the age of 50 and affects both male and female equally.
Neurogenic intermittent claudication resulting in leg pain, weakness, and loss of deep tendon reflexes are some of the signs of lumbar spinal stenosis. Most patient’s with lumbar spinal stenosis feel their pain more when walking and usually sitting down helps to alleviate this pain. When walking, a patient with lumbar spinal stenosis will usually be more comfortable leaning on a cane or a shopping cart.
Just like with CSS (cervical spinal stenosis) a MRI is the most reliable imaging procedure, although unlike CSS a CT scan may prove to be somewhat more useful, and may replace the MRI procedure where not available.
A few possible treatments for lumbar spinal stenosis may include; weight loss to relieve the amount of stress being placed on the lumbar segment of the spine, and activity modification, such as using a walker to help promote better posture. Epidural steroid injects to the affect area may help to relieve some of the inflammation and help to combat some of the leg pain. Just like cervical spinal stenosis, if the pain is severe enough or the patient’s lifestyle is being affected too greatly, surgical options may be advised.
X-Stop and the Walis implant are recent developments that are designed for extra-canalicular treatment of spinal stenosis. Creating slight flexion over the segment, the titanium implants act to prevent extension of the stenotic segments.
Seeing as the various forms of spinal stenosis produce symptoms that are similar in nature, diagnosing which form of spinal stenosis the patient has may not me as simple as it seems. Leg pain, low back pain, physical limitations when walking and tingling or numbness sensations in the leg are the most common symptoms of lumbar spinal stenosis.