A Look at Spinal Stenosis

Stenosis means narrowing.  In spinal stenosis, the canal through which the spinal cord and nerve roots run becomes narrow.  This results in abnormal pressure on the spinal cord and nerves causing a myriad of symptoms including pain, leg cramping, numbness, tingling and weakness.  Often the pain starts and is made worse with walking and is relieved when you stop walking or sit down.  When the spinal cord is being compressed symptoms may include imbalance, or difficulty with fine movements of your hands.  In severe case you may experience abnormalities with your bowel or bladder function.  These symptoms from spinal cord compression are referred to as myelopathy and can be irreversible.

Spinal stenosis or narrowing of the spinal canal can be asymptomatic or symptomatic.  The canal may be narrowed from bulging/herniated discs, a shift two adjacent vertebrae (spondylolisthesis), bone spurs, enlarging of the facet joints, or buckling/enlarging of the spinal canal ligament (ligamentum flavum hypertrophy).  Any one or a combination of these things can contribute to spinal stenosis.

Anti-inflammatories and small amount of local epidural steroid injection are often used to help decrease inflammation of the nerves to reduce pain.  Physical therapy can be used to increase core strength to stabilize the spine so there is less micro-motion through the spine, less irritation of the nerve and therefore less pain.  When these treatments fail, minimally invasive surgery can be performed through a small 3 to 15 mm incision.  A small tubular retractor is gently placed in between the muscle fibers.  Special instruments and magnification is used to relieve the pressure off the nerves by making more space for them.  This is an outpatient procedure with a tiny suture-less incision.

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