Description
Stenosis is a narrowing of the spinal canal or the foramen, the opening through which nerve roots pass. Stenosis can develop in any area of the spine.
Degenerative changes in the spine, a collapsed disc, bone spurs, or cysts can cause the spinal canal to narrow. This narrowing places pressure on the nerve roots and/or spinal cord, often resulting in pain.
Symptoms and Signs
Cervical
- Stiffness in neck
- Weakness in arms causing difficulty using the hands
- Pain and Numbness in hands and/or arms
Lumbar
- Tired, heavy feeling in back, buttocks, and legs while walking or standing
- Cramping sensation in these areas
- Decreased walking due to weakness, numbness or pain in legs
Causes
Cervical
- Arthritic changes in neck
- Bone spurs push on nerves and spinal cord
- Compression can be caused by large disc herniations
Lumbar
- TDegenerative changes limit nerve space; lack of blood supply induces symptoms
Possible Treatment Options
Non Operative Treatment
Medications, physical therapy or spinal cortisone injections are indicated for pain relief. Surgery can be considered for those who do not improve.
Cervical Laminectomy
Spinous process and lamina are removed to decrease pressure on spinal cord. Instrumentation can be used to ensure stability.
Lumbar Decompression
This procedure involves removing all or portions of the lamina, removing bone spurs and/or enlarging foramen to relieve pressure or compression on the nerve roots or spinal cord. This pressure often is the cause of the pain.
Decompression & Posterolateral Fusion
Often times, in addition to a decompression, your surgeon will perform an instrumented posterolateral fusion by inserting a series of screws and rods coupled with the placement of a bone graft. This fusion provides increased spinal stability.
Anterior Lumbar Interbody Fusion (ALIF)
The surgical approach is from the front of the abdomen. Once the exposure is made, surgical instruments are used to remove the disc material causing the nerve compression. Once this material is removed, an interbody cage or bone spacer is placed at the disc site filled with bone graft. The vertebral bodies above and below are frequently put under compression to aid in the subsequent spinal fusion.
Posterior Transforaminal Interbody Fusion
The same procedure as the ALIF but the approach and exposure are performed from the back. Just as in an ALIF, the disc material is removed and an interbody device is inserted. Compression through the use of pedicle screws is frequently achieved to aid in fusion.
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