Spinal Stenosis

Spinal Stenosis affects patients 60 years of age and older. Sometimes it affects younger patients who are born with small spinal canals. The condition denotes narrowing of the spinal canal, the hollow tube that conducts the spinal cord and cauda equina, and or narrowing of the nerve root canals, which conduct the individual spinal nerves.

It occurs as a result of the growth of bone spurs and intervertebral discs bulging into the spinal canal, which take up the space normally occupied by the spinal cord and or spinal nerves. In older patients it produces weakness and pain in the legs usually brought on by walking, and relieved by rest. Specifically sitting down and bending forward temporarily relieves the condition. The symptoms can come on slowly or rapidly. If the pain or weakness is disabling you need to have your hips checked for arthritis, and your circulation checked since hip arthritis, poor circulation, and spinal claudication (the symptoms of spinal stenosis) can often be confused.

Axial myelo-CT showing enlargement of facet joints with severe compression of dural sac.

 

The need for surgery does not depend on the MRI scan, it again depends on the severity of the pain and the distance you are able to walk. If you can only walk 1 block, and you are in good condition, consider surgery. If you have little pain and normal function, do not have surgery merely because your MRI scan is abnormal. Also symptoms of back pain alone, without leg weakness or numbness, respond poorly decompressive surgery alone.

Sagital Myelogram and CT scan of patient with severe spinal stenosis. Arrowheads show severe compression of dural sac.

 

The most successful operation for spinal stenosis in the lumbar spine is laminectomy, or removal of parts of the posterior portion of the spine, which compress the spinal nerves. This can predictably improve your ability to walk. It does not cure symptoms of back pain. It is important for you to have a general check up to make sure you are a reasonably good surgical risk. Remember this operation is reserved for patients severely disabled by leg pain and weakness, who are healthy enough to undergo a surgical procedure. If you have other severe medical conditions, or if the problem is back pain alone, this type of surgery may not be indicated.

For more information see doctorspr.blogspot.com/2011/08/spinal-stenosis-may-be-next-baby-boomer.html

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