Spinal canal stenosis

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ICD codes for this diseases: M48.0

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Article overview

Overview of spinal canal stenosis

The spinal column consists of a series of smaller bones, known as vertebrae, which support and stabilise the upper body. This arrangement allows for turning and twisting movements, while also providing a channel for the spinal nerves, which carry signals to and from the brain and the rest of the body. Any damage to this structure may have an impact upon functions such as walking, balance and physical sensation.

Spinal stenosis results in a narrowing of the spinal canal (channel), which in turn causes compression of the spinal cord. The onset of spinal stenosis is typically gradual and may often produce relatively little narrowing and thus no obvious symptoms. However, excessive narrowing may cause more severe nerve compression, leading to other problems.

Aufbau der Wirbelsäule

Though stenosis most often occurs in the neck and lower back, it can also occur anywhere along the spine. How much of the spinal region is affected by this condition can vary considerably.

Other terms for spinal stenosis include:

  • foraminal spinal stenosis
  • pseudo-claudication
  • central spinal stenosis

Symptoms of spinal canal stenosis

Symptoms such as stiffness, numbness and back pain commonly develop as nerves gradually become more compressed over time. More specifically, you may experience:

  • leg or arm weakness
  • pain in your lower back while standing or walking
  • numbness in your legs or buttocks
  • sciatica (inflammation of the long sciatic nerve in your leg)
  • problems with balance
  • a loss of bladder or bowel control

Though sitting in a chair often relieves these symptoms, they return once you resume standing or walking.

Causes of spinal canal stenosis

The degenerative processes associated with ageing are the most common cause of spinal stenosis. Spinal nerves may become compressed as spinal tissues begin to thicken or as some spinal bones become enlarged. Medical conditions where inflammation is present, such as osteoarthritis, can also place increased pressure on the spinal cord.

Other causes of spinal stenosis include:

  • spinal defects present from birth
  • a naturally small spinal canal
  • scoliosis (spinal curvature)
  • Paget’s disease, which is an abnormal pattern of bone destruction and overgrowth
  • bone tumours
  • achondroplasia (a form of dwarfism)
  • spinal injuries

Diagnosis of spinal canal stenosis

An accurate diagnosis will require a complete evaluation of your spine, using some of the following tests and procedures:

  • detailing your medical history
  • conducting a physical examination
  • taking X-rays of your vertebrae
  • using MRI (magnetic resonance imaging) to create a 3D spinal image
  • using a CT (computerised tomography) scan to check your bones and soft tissues
  • using an electromyelogram to check your spinal nerves

Diagnose Spinalkanalstenose

Treatment of spinal canal stenosis

The treatment strategy for your spinal stenosis will primarily depend on its location and the relative severity of the symptoms and pain you experience. Non-surgical treatments may include:

  • physical therapy to combat muscle weakness by stretching and strengthening your body
  • limited cortisone injections to reduce swelling
  • non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief and to reduce inflammation
  • muscle relaxants to calm any muscle spasms that occur
  • anti-seizure drugs to relieve nerve pain
  • anti-depressant, pain-relieving drugs

Surgical intervention may be considered as an option, especially if your symptoms are having a disabling effect on your movement. The common types of procedure that may be appropriate for your spinal stenosis include:

  • a laminectomy, which is a common intervention to remove parts of your vertebrae in order to create more space for your spinal nerves
  • a foraminotomy, which is a procedure used to open up a space in your vertebrae to allow your spinal nerves to exit more easily
  • spinal fusion (spondylodesis), which is a technique involving the use of metal hardware and bone grafts to fuse adjacent areas of your spine together

Though surgery typically improves symptoms, some may find their condition stays the same or could even deteriorate.

Chances of recovery from spinal canal stenosis

Despite their spinal stenosis, many people continue to remain active, perhaps with some adjustments to their physical activity. Some may experience residual pain, which can often be managed by self-help treatments, such as:

  • non-prescription pain relief (e.g. ibuprofen) to combat pain and inflammation
  • heat or ice packs applied to the neck to relieve symptoms
  • diet and nutritional measures to help lose weight and ease spinal pressure
  • canes or walking aids to improve stability and relieve pain experienced during walking

Prevention of spinal canal stenosis

Because wear and tear contributes to spinal stenosis, you can reduce some of its degenerative effects by the following means:

  • stopping smoking, because smoking has been linked to back pain and decreases in bone density
  • losing weight, because excess weight increases the load on your spine, which can accelerate wear and tear
  • adopting good posture habits to limit the pressure on your spine
  • exercising to improve your flexibility and strengthen your spinal ligaments
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