Spinal Stenosis

Spinal Stenosis Information

Spinal Stenosis is a condition that affects spinal cord. In this condition, your spinal cord areas may narrow down. You will find the problem in your upper or lower back.

As the spinal cord areas become narrower, so this condition causes extended pressure on the spinal cord and also on the nerves. As nerves are present in each and every area near the spinal cord, so they are affected by the increasing pressure.

spinal stenosis anatomy

This situation may be the base for other several problems in human body. You will have problems in the form of pain, cramp, numbness in the legs, insensitivity in neck, back, arms and shoulders etc. These may lead to other physical problems like bladder dysfunction or bowel dysfunction. You may even lose sensation in any of the body parts mentioned.

This condition may appear in any body parts. But they are mostly seen in the upper or lower part of the spinal cord. Spinal Stenosis that occurs in the upper spinal part is known as Cervical Spinal Stenosis. On the other hand, another stenosis is seen in the lower part of the spinal cord, which is called as Lumbar Spinal Stenosis.

Causes of Spinal Stenosis

There are various causes of Spinal Stenosis. Here, find out the most important ones.

Osteoarthritis– This is one type of arthritis condition, where the patient loses cartilage of bone joints. Cartilage is like a cushion in the joints of bones. When it is not there bones get affected very badly. It affects the spine and causes narrowing of the spinal cord, which is known as Spinal Stenosis.

Osteophytes– It is also known as bone spurs. Normal bones enlarge in this condition, which exert pressure on the spinal cord. It happens more with increasing age. It causes Spinal Stenosis as it affects the spinal cord and the spinal canal.

Inflammatory Spondyloarthritis– Spondyloarthritis (or spondyloarthropathy) is a condition wherein inflammation of the affected parts occurs. It affects spine, joints etc. Pain is common in this case. Stiffness or senselessness are the other problems caused by this condition.

Spinal Tumors – Tumors of the spine may be another cause of the Spinal Stenosis. The tumors are extra growth, which may hamper with the spinal canal. It may also cause problem due to inflammation. Bone displacement or bone loss may affect the vertebral framework. This exerts extra pressure on the spinal cord and its areas, which will lead to Spinal Stenosis.

Trauma – Trauma due to various reasons like accidents, mental shock may harm the spine. Spinal burst or dislocation of the spine may cause fragments of bone, which will hamper the spinal cord activities and will cause narrow spinal cord.

Previous Surgery – Previous surgery may cause problems in the spine. After surgery, many a times tissues surrounding the cut swell. This may increase the pressure on the nerves and spinal cord. This may result in Spinal Stenosis.

Paget’s Diseases of the Bone – Paget’s disease of bone is condition where the patients get deformed and enlarged bones in the body. This is a chronic condition. Due to constant breakdown and formation, the bones in the body become fragile. It is mostly seen in the spinal cord. Sometimes, spinal cord bones break down. As a result of the condition, the nerves do not get the needed blood supply. Bone breakdown also cause physical deformity, which pressurize the spinal cord and nerves and narrow down the spinal cord area.

Flurosis (Excessive level of Folroide)– Fluorosis is a condition where excess amount of fluoride is found in your body. Flurosis occurs as a result of entry of excess fluoride to your body through water, inhalation and eating. People, who live near the industrial areas where the factories emit dust or gas with fluorides, or who use fluoride contaminated water, are more prone to flurosis. Flurosis leads to excess calcium deposition in the spinal ligaments, softened bones etc. All these lead to Spinal Stenosis.

Calcium Deposits of Ligaments– This occurs at a later stage in life. People who are older than 50 years show this problem. When people age, their body parts become less active and depositions occur in the joints and parts. Ligaments in old people become hard, thick due to calcium deposition. This is another cause of Spinal Stenosis, as spinal structure is also affected by calcium deposition.

Diagnosis of Spinal Stenosis

Diagnosis of Spinal Stenosis is done through a process. First the medical history of the patient is checked, and then the doctor does a physical examination

After that other tests are carried out to confirm the results. The following are the tests carried out for diagnosis of Spinal Stenosis.

X-Ray – X-ray is used to diagnose Spinal Stenosis. X-rays are passed through your back to find out its condition. X rays can reveal the present condition of your back and the spinal cord. It will show any abnormality, signs of injury, tumor etc. The doctor can see the vertebrae and find out the problem in the patient. This is usually done before any other test. This, you can say, the preliminary test for diagnosis of Spinal Stenosis.

Computerized tomography (CT) scan – Radiation is used here again. But the results are better than X-rays. It uses more radiation. CT Scan produces detailed result about your back and any abnormality therein. A narrow beam of radiation produces cross-sectional images. It will show the doctor the shape and condition of the spinal canal. If there is any abnormality then the doctor will find out what is that.

MRI (Magnetic Resonance Imaging) – This process is used for diagnosis of Spinal Stenosis. Here the results come in a series of cross sectional images. The doctor can also see the three dimensional view of your back. This is strong and so can show clearly various small parts of the spinal cord. It can show the doctor, the ligaments, the disks in the spinal cord, nerve spots, tumors, and enlargement of the areas in the spinal canal. A magnet is used in this test where it sends a signal and a scanner catches that signal. A computer analyses the results which are seen in the report.

EMG– EMG or Needle electromyogram is a test that has been used for a long time, which started during World War II. Now again today it is becoming popular. It may be more effective than MRI. It can find out Spinal Stenosis from other problems. Doctors can use it to differentiate the Spinal Stenosis problem of your back from other such problems like arthritis, peripheral nerve disease etc. It may be more accurate than some of the other tests used for diagnosis of Spinal Stenosis.

Myelogram – This is an advance technique. In this technique a special dye is used. The dye is injected into the patient’s spinal column. X-rays cannot pass through this dye and so it shows white colors. As the dye spread through the spinal cord and nerves, so they appear white in the X ray. The doctor can find out the spinal cord and the nerves and also the tumors, abnormal growth etc by seeing the X ray plate.

Bone scan – Bone scan is itself not complete. It is done along with other tests to diagnose Spinal Stenosis. In this test a radioactive material is injected into your vein. The radioactive material attaches to the bones. When the radioactive material emits radiation a gamma camera catches it. This is used for detection of abnormalities in the bones.



Symptoms of Spinal Stenosis

Spinal Stenosis symptoms are not very prominent at the initial period. As the time passes and the problem advances the symptoms begin to appear.

When the nerves of the body are damaged due to the pressure of the Spinal Stenosis, then your body starts showing problems and symptoms. The symptoms vary and they can be described as below

Pain or cramping in the legs – Spinal Stenosis symptoms may be very dreaded and regular. Pseudoclaudication, false claudication, neurogenic intermittent claudication are some of the conditions which arise as a result of Spinal Stenosis. These conditions bring in cramp and pain of legs. When you walk for some time or when you stand for a long time, then it happens. This happens because of the compressed nerves. As the nerves get compressed more when you walk or stand, so they tend to pain more. When you sit down, then the pain reduces. So this will hamper your life by making you unable to live an active life. You will often have to sit and perform your activities.

Radiating back and hip pain – The pain starts at the buttocks or hips. Then it grows and extends to the legs. This is the result of the damaged nerves at the lower portion of the spine. The pain may be severe. It affects one side of your body. This happens more when you sit for prolong time. As the situation advances, you may find numbness, tingling in your leg. This radiating pain is very difficult to bear for most of the people who have Spinal Stenosis. The pain in your buttocks, hips and legs hampers with your activities you need to perform daily. The pain may be intermittent or continuous.

Loss of balance – All your movements are controlled by the nerves and the brain. Nerves carry the signals to the brain, which instruct the organs to move or to act. When the nerves are affected then balance of your body is sure to get affected. When there is too much of pressure on the cervical spinal cord, it may damage the nerves, which control your movement. So you may become very clumsy and senseless. You may not be able to move your body parts and that may hamper your balance. You may fall with slight provocation. See a doctor as soon as possible and if needed go for a surgery.

Loss of bowel or bladder function – Spinal Stenosis also affects the bladder and bowel function. The main cause of such problem is the damage to the nerves. Nerves control all of our activities. So when nerves are damaged, then your body may not be able to act correctly. So, if nerves leading to your bowel or bladder are affected your bladder and bowel may not listen to your brain commands. In case of any urinary or fecal problems, see the doctor as soon as possible. This problem needs time and doctor’s help. It may be a case of emergency operation.

Spinal Stenosis Risk Factors

Few risk factors increase the chance of occurrence of Spinal Stenosis. These factors are called as risk factors because they increase the chance of occurrence of the disease. Find out here which are risk factors that increase the risk of getting Spinal Stenosis.

Narrow spinal canal– Narrow spinal canal is a big risk factor. It increases the chance of Spinal Stenosis. A baby born with narrow spinal canal has more chances of being diagnosed with Spinal Stenosis. People born with normal spinal canal have lower risk of getting the disease.

But again at a later stage people may acquire Spinal Stenosis. It happens because of narrow spinal canal. Due to many reasons the spinal canal becomes narrow and then the person faces Spinal Stenosis problem.

Narrow spinal canal may be the result of many factors like tumor, extra growth of tissues, injury, abnormality etc. All these factors may cause extra bone growth or bone loss, loss of ligaments etc. Tumors and extra growths may block the spinal canal thereby making it narrow. In such cases Spinal Stenosis will appear.

Gender – Spinal Stenosis occurs in both the genders but the intensity may vary. In some places it occurs at the same intensity in both men and women. But in some other places it is seen mostly in the women. Women are more susceptible to Spinal Stenosis. In girl child the occurrence of Spinal Stenosis is high in comparison to boys.

Age –  Age is the biggest risk factor for Spinal Stenosis. In most of the cases, Spinal Stenosis occurs in older people. It generally occurs in people who are more than 50 years of age. As you become old its occurrence and intensity increases. It is an age related problem. As you become old your spine starts to degenerate. Various types of damage occur to the spine at old age, which cause Spinal Stenosis.

With age the bones, ligaments become degenerated and their loss occurs. Sometimes tumors and such extra growth also occur in the old age. In such cases, the risk of  Spinal Stenosis increases. After 50 years of age, the bones and ligaments become old and so they are not able to perform their functions properly. In such cases Spinal Stenosis may occur. The space within the spinal canal starts reducing. This reduction in the space in the spinal canal is one of the most important causes of Spinal Stenosis.

Some children born with the narrow spinal canal. Except them others acquire Spinal Stenosis during their life. As the age increases the risk factor of getting Spinal Stenosis increases.

Previous Spine Surgery – Previous Spine Surgery is another risk factor that increases the risk of getting Spinal Stenosis. If you have undergone spine surgery, and after that if you have not taken precaution, then the chance of Spinal Stenosis is more in your case. Previous surgeries may leave your bones, ligaments and spines weak. If they have not healed properly, then you are sure to get it back. Surgeries may leave some damage to the bones, spines, ligaments and nerves. In such cases the risk factor is more.



Spinal Stenosis Prevention

Exercise – Regular exercise will help in prevention of the Spinal Stenosis. Exercise makes your body more powerful. It also helps in keeping you fit and improves your immune system. So your body will be able to fight any problem caused specially to your spinal cord.

Exercise makes your spinal cord flexible. Flexible spinal cord helps in preventing the degeneration of spinal cord. It also improves flexibility in your joint, ligaments etc.

Along with free hand exercises, you can also add aerobic exercises. They are very good for the whole body. You can walk, run, hike and go for biking. Weight training is also good for your back and for your spinal cord. Weight training and other exercises will make your abdomen, muscles, arms, and legs strong. This will help your back by reducing the pressure on it.

Regular exercise will also ensure that any back related problem is removed in the initial period only. Start with less and then increase the intensity and amount of exercise.

Use good body mechanics – Your back will be fine and healthy if you maintain proper body mechanics. Your body mechanics decides whether you will suffer from any back related problem like Spinal Stenosis or not. Always be conscious of the fact that your body mechanics should be right, and follow it.

Find out the right positions to sit, lift heavy material, walk, stand, sleep. There are various sources for such information, get the needed information and follow the guidelines. While sitting try to be straight. While lifting an item don’t bend your back, instead sit and then slowly lift the item.

The seat on which you sit should be comfortable and according to the standard. You can adjust your seat accordingly. If needed add a small towel or cushion to support your back, which will save you from Spinal Stenosis. Maintain the normal curve of your body while sitting.

While driving also take care of your position and adjust the seat accordingly. It helps you to avoid any problem related to your back.

Always push items instead of pulling. Bend your knees while pushing the item. Do not push it bending your hip or back. Never lift anything overhead. Do not twist your back.

While sleeping follow the rules. Select the mattress carefully. It will ensure that you have a good sleep without any back-related problem. Use pillows if you need. While selecting pillows make sure it is not hurting your back anyway.

With such good body mechanics, you can always prevent Spinal Stenosis.

Maintain a healthy weight – One of the reasons of Spinal Stenosis is excess weight. When you have excess weight, then your joints, bones and back have to take extra pressure, which is the cause of Spinal Stenosis. So, try to maintain your body weight at an optimum level. Exercise and diet will ensure that you have a healthy weight. So exercise regularly and watch your diet. Always avoid too much weight to prevent Spinal Stenosis and to avoid other problems also.

Spinal Stenosis Treatment Options

Medical history – Spinal Stenosis treatment involves a systematic approach. In this system, first doctors check the medical history of the patient.

The medical history includes the past problems the patient faced and their treatments. It also includes any previous Spinal Stenosis problems. If the patient or his family has any previous record of the problem, then it gets another implication for the doctors.

Physical Examination – Then the doctor examines the patients physically. He asks questions and find out for the symptoms of Spinal Stenosis. He tries to find out the symptoms as well as the abnormal behavior of the patient’s body. When he finds any abnormal sign, then he sends the patient for tests to diagnose Spinal Stenosis. Even if he does not find any sign or symptoms, then also he refers the patient for tests just to ensure the patient does not have the problem.

Exercises – Exercises form a main part of the whole Spinal Stenosis treatment. It is very important to keep the patient going. It does not cure the patient of the problem. But it definitely helps him. Due to inactivity, the problem may escalate. So to check it and to keep the patient moving, exercises are very much necessary.

Lumbar Brace – A lumbar brace or corset is a support tool for the patients of Spinal Stenosis. It provides support to the patient. It helps him to walk and move again. It is necessary for the old patients or for weak patients who have weak abdominal muscles.

Medication -There are various medication used for Spinal Stenosis treatment. Anti-inflammatory medication is also used. Some of such medicines are ibuprofen, aspirin etc. These medications may be useful while treating Spinal Stenosis patients. Vitamins are also good to support the patients. You can use multiple B-complex vitamins. Take these vitamins with folic acid daily.
Analgesics medicines such as acetaminophen (Tylenol) etc are used in treatment of Spinal Stenosis. This helps to reduce the pain. Non-steroidal anti-inflammatory drugs (NSAID) are also used for treatment of Spinal Stenosis. Some of the NSAID are aspirin, naproxen (Naprosyn), ibuprofen (Motrin, Nuprin, Advil) etc. They help in two ways. First they reduce the pain and then reduce the inflammation.

Injections – Injections are used to reduce the pain and relieve the patient. Corticosteroid injections are used in the treatment. It is used near the spinal cord and nerve roots. These injections reduce the pain and also the inflammation. It reduces the radiating pain down to the leg.

Decompressive Surgery – It may be necessary as the last resort. Surgeons reduce the pressure on the spinal cord by removing the ligaments and bones.

Chiropractic treatment— This is an alternative treatment method of Spinal Stenosis. In this method, Chiropractors adjust the spine. This helps the spine becoming normal again. It is effective and many people found it effective and visit the Chiropractors regularly.

Acupuncture— Acupuncture is a well-known alternative treatment for Spinal Stenosis. In this treatment system needles are used to stimulate certain points in the body. It is effective and useful for the patients of Spinal Stenosis.

Types of Spinal Stenosis

There are various types of Spinal Stenosis present, which attack human in different time of their lives. Let’s see the major types of Spinal Stenosis.

Congenital Spinal Stenosis

Congenial Spinal Stenosis is a condition, which is found at birth. In this condition, you will see that the spinal canal of the patient is narrowing down. It affects the spinal canal of the neck. Though it is found at birth, but Congenial Spinal Stenosis is not hereditary. It increases the risk of spinal cord injury in the patient. This narrow spinal cord may be a result of the abnormal spinal parts. It is also seen in most of the short stature people. Narrow spine is a prime effect of this type of stenosis.

The symptoms of Congenital Spinal Stenosis vary depending on the affected parts. In case of problem in the upper section of the spine, pain may be seen in the torso, shoulder, arms and hands. Sometimes numbness in the organs is also found in this condition. In case of lower back or lumber Congenital Spinal Stenosis, the symptoms appear in the calves, thighs, buttocks or feet. Pain and numbness may be there in these organs.

Scoliosis means an abnormal condition of the spine. In this situation you will find a curve in the spine, which is abnormal. It may not result in pain but it can easily affect other parts of the body. It may hamper the normal workings of the organs in human body. These abnormal curves are visible from the behind of the body. This hampers the daily life of the patient.

In general it does not need treatment except check up. But if the pain is too much, then you may need to go to a doctor for surgery or you may need a brace for support.

Girls are more prone to scoliosis. It is hereditary. It is mostly found in children. Only sometimes, it may appear in the adults.

Acquired Spinal Stenosis

As the name suggests, Acquired Spinal Stenosis is acquired. It is not present at birth. It develops later as the age progresses.
It happens because of tissue destruction by any disease. It may also be caused by the immune system of the body, which sometimes attacks its own cells under the influence of a disease. According to doctors the two major causes of Acquired Spinal Stenosis are

  1. Osteoarthritis – due to osteoarthritis or joint tissue degeneration, Acquired Spinal Stenosis may develop later in the patient.
  2. Birth defects – In case of birth defects, Acquired Spinal Stenosis may happen.

Other causes of Acquired Spinal Stenosis may be

  1. Spondylolisthesis or problem in the alignment of the vertebrae
  2. Paget’s disease or such destruction of bone tissue
  3. Diffuse idiopathic skeletal hyperostosis
Cauda Equine Syndrome

This condition is the extreme condition of nerve compression and nerve inflammation. It happens when the nerves are compressed in the lower spinal canal. This is indeed a very serious condition. It can cause problem with your bladder and bowel. It may also result in paralysis of the legs. Surgical procedure is necessary to cure such condition.

Spinal Stenosis Surgery

There are various Spinal Stenosis surgeries available for the patients. They vary in their effectiveness and time needed. Know about the main surgeries for Spinal Stenosis.

Decompressive Laminectomy

It is a surgery done on the patients of Spinal Stenosis. This is the most common treatment for this problem. This surgery reduces the pressure on the spinal cord. It also reduces the pressure on the spinal nerve roots. This can help to correct the spinal injuries and damages done due to many factors. The surgery reduces the pain. After sometime the patient can resume his daily life.

Spinal canal may be narrowed down by bone and thickened tissues. They may squeeze the nerves and their roots. Decompressive Laminectomy reduces such parts and makes the spinal canal free. It is done by cutting into your back and then removing all problematic extra parts.

Spinal Fusion

Spinal Fusion is sometimes done along with Decompressive Laminectomy. In this surgery method, spine is helped to stabilize the newly Decompressive Laminectomy treated portions. Various methods are used for Spinal Fusion. In one method, one extra bone from your body or from other source is used to act as a bridge between spinal bones. It’s like grafting a new bone to help other bones grow. In another method known as Instrumented Fusion, rods, wires, screws, hooks are used to connect two spinal bones.

Laminotomy

This is a special type of Spinal Stenosis surgery. In this treatment, doctors remove a small portion of the lamina. It is easier than others. It relieves the nerve roots. The treatment reduces the pressure on the roots of the nerves.

Foraminotomy

In this type of surgery, doctors removes the foramin. The foramin is the place of the spinal canal where the nerve roots exit. When the foramin is removed, the nerve canal becomes free and so the pressure is reduced on the spinal canal. This surgery is sometimes done alone and sometimes along with laminotomy.

X Stop IPD Spinal Stenosis Decompression

In his surgery method, doctors decompress the compressed spinal nerves and help to reduce the patient’s pain. It is a small operation lasting maximum one and half hour. Doctors can perform this surgery in any hospital. Local anesthesia is enough for this surgery.

X stop implant is used to provide space between your spinous processes. It helps you to relieve your nerves when you stand and walk. The X stop takes the pressure and keep your nerves free.

The X stop is inserted to your back through a small incision. You need to bend your body for inserting the X stop. This surgery procedure offers many benefits like lesser time, lesser blood loss, and lesser complications. The X stop can also be removed whenever needed.

VAX D Spinal Decompression

VAX D is an easy treatment for the Spinal Stenosis patients. It is safe. It is also effective against the problem and the patients find the benefits soon. It needs lesser time. It offers long time benefit to the patient. It is non-invasive and so you find no problem after the surgery.

Coping with Spinal Stenosis

People with Spinal Stenosis can manage their condition and live peacefully with the problem. For living successfully with Spinal Stenosis, you need to learn about the problem, about the causes and the symptoms, the treatments, the ways of prevention, benefits of exercise and staying active. You should know the Spinal Stenosis management techniques and the role of nutrition in it.

Know the disease – First know the disease. When you know the disease it helps you to understand it and then devise the ways to live with it, if you already have it. If other family members of your family do not have it, then learning about the disease will help them to avoid it.

Know the causes– Know the factors that cause it. Then you can always avoid the causes and the risks. Once you know them, then you can avoid such causes and the factors leading to such causes. Then the risk of Spinal Stenosis occurring to you will be very less. When you know the risk factors of Spinal Stenosis, it helps you to take a closer look at yourself. If you have any of the risk factors then you should be careful enough to talk to your doctor.

Know the symptoms – Knowing the symptoms will help you to cope with Spinal Stenosis. When you know them, as they start showing up, you can consult your doctor or you can take remedial measure. Knowing the symptoms will help you to be ready for the problem. You will be able to take help from your doctor as soon as the symptoms start appearing. This will help you to correct the problem before it gets worse.

Know the Treatments– knowing the treatments will help you to save yourself in case of emergencies. You will also be able to tell your doctor what type of treatment you would like to go for, when he asks you about it.
You have to manage your Spinal Stenosis problem to cope up with it. The following measures can help you in coping up with the problem.
1.    Pain management
2.    Exercise and staying active
3.    Improved nutrition
4.    Posture and biomechanical awareness

Pain management
Pain management for Spinal Stenosis can be done by using household remedies or using medicines. Household remedies like ice-cold water bag, hot water bags etc work faster and better. You can use topical pain relieving medicines. You can take pills and pain relieving capsules. You can also take injections for relieving the pain.

Regular exercise – Regular exercise will strengthen your body and back and so you will not have much problem from Spinal Stenosis. Exercise regularly to make your back, legs, arms, hands, and abdominal muscles strong. They will support your back in case of excess weight.

Nutrition– Nutrition plays a big role in coping up with Spinal Stenosis. Drink plenty of water. Eat fruits and vegetables. Do not smoke and reduce intake of alcohol, caffeine and meat. Eat a healthy diet and see the results.

Posture and biomechanical awareness – Posture and biomechanical awareness has lots things to do with your Spinal Stenosis. If your postures are right and you know about the biomechanics then you will never have Spinal Stenosis.

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