Spinal stenosis

From ArticleWorld

Spinal stenosis is a condition where a bony overgrowth or vertebral disc herniation results in a narrowing of the spinal canal and a resultant injury or pressure on the spinal cord. Generally the cervical spine or the lumbar spine can become affected.

Causes

Spinal stenosis becomes serious when it impinges on the spinal cord resulting in a dysfunction in the nerves distal to (past) the area of stenosis (narrowing). One common cause of this is called spondylolisthesis, a condition involving the slippage of one vertebral body forward as related to the vertebral body below it. The joints involving the transverse processes of the vertebra can hypertrophy (enlarge) and form bony spurs.

Degeneration of the discs between the vertebrae can result in bone-on-bone connection between the vertebral bodies with secondary arthritic changes to the affected area. A disc can bulge into the spinal canal, leading to narrowing of the canal. A condition known as DISH syndrome or “diffuse idiopathic skeletal hyperostosis” is a disease of unknown cause that results in areas of bony overgrowth in many bodily areas, including the spine. Areas that are normally ligamentous can become calcified. In DISH syndrome, the posterior longitudinal ligament of the spine becomes calcified and encroaches on the path of the spinal cord.

Symptoms

The symptoms of spinal stenosis vary according to the site of the stenosis. Cervical stenosis can yield neck pain and those symptoms resulting from the damage to the spinal cord. An individual can have a spastic gait, dysfunction and numbness in the upper extremities, difficulty with bowel and bladder function and, in extreme cases, can become quadriplegic.

The symptoms of lumbar spinal stenosis fortunately exclude involvement of the upper extremity. Lower back pain, especially with movement is common. The individual can develop severe leg pain, gait disturbances and sometimes sensory disturbances of the leg. Generally, the symptoms worsen with walking.

Treatment

Mild cases of spinal stenosis can be treated with anti-inflammatory medication, steroid injections into the back and local immobilization—all of which reduce the inflammatory component of the disease. In severe cases, surgery to remove the cause of the stenosis or to fuse the affected vertebrae together may be necessary.