- Spinal stenosis results
from narrowing of the canal in which the spinal cord travels,
or the openings through which nerves leave the spinal cord or
both.
- The appearance of the compressed
spinal cord or nerves has been likened to an hour glass
- The most common cause of spinal
stenosis is degenerative arthritis. Spondylosis is a term used to
describe degenerative changes in the spine. Pinching of the spinal
cord and nerves results from deterioration of discs, formation of
bone spurs, joint enlargement, and thickening and calcification of
ligaments.
- Other causes of spinal stenosis
include rheumatoid arthritis, changes following trauma, and cancer.
Scoliosis can also result in spinal stenosis. Less common causes
include infection, abnormal blood vessels (vascular malformations)
and Paget's Disease (a metabolic condition which produces thickened
bone).
-
Some people are born with a small spinal canal. If they develop
stenosis it is called congenital stenosis.
- With degenerative disease as its
most common cause, spinal stenosis is most often seen in people over
50 years old. Men and women are equally affected.
- The symptoms of spinal stenosis
present slowly sometimes over many years. The most common symptoms
of cervical stenosis are arm pain weakness and numbness. Patients
sometimes present with weakness or clumsiness in their hands. They
may have noticed difficulty writing or buttoning a shirt. The
complex of signs and symptoms, which result from compression of the
spinal cord in the neck are referred to as cervical myelopathy.
- A thorough neurological physical
examination is important to assess the severity of cervical
myelopathy.
- To evaluate the cause of spinal
cord and nerve compression an MRI scan is usually obtained. In some circumstances,
a myelogram, (injection of dye through a needle) followed by a CT
scan is indicated. Regular x-rays taken with the neck bent forward
and backward (flexion/ extension) can be useful if abnormal motion
or instability of the cervical spine is suspected. To further assess
nerve function, your physician may request electrical studies such
as an EMG (Electromyogram), NCV (Nerve Conduction Velocity),
or SSEP ( Somatosenory Evoked Potentials) test.
- Symptomatic spinal stenosis rarely responds
to conservative treatment (rest, exercise, traction, therapy,
medication, etc.). Most of the time surgery is required to relieve
pressure on the spinal cord and nerves. Surgery normally includes
removal of whatever is pinching the spinal cord and nerves
(decompression) combined with fusion. A fusion is a procedure which creates a
bridge of bone connected above and below the decompressed area, to
maintain the decompression preventing movement or instability.
Rapid improvement and relief
of symptoms usually follow surgery.
- To view a case of cervical spinal
stenosis click
here or on the images above.
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