What Spinal Stenosis is?
In the medical field, stenosis means the abnormal narrowing of a body channel. When combined with the word spinal, it defines a narrowing of the bone channel occupied by the spinal nerves or the spinal cord. Some people are born with a congenital form, but most develop spinal stenosis as part of the degenerative cascade. The lower back develops lumbar stenosis, while the neck develops cervical stenosis.
Lumbar Spinal Stenosis
In lumbar stenosis, the spinal nerve roots in the lower back become compressed and this can produce symptoms of sciatica—tingling, weakness or numbness that radiates from the low back and into the buttocks and legs—especially with activity.
While the narrowing may occur at different parts of the spine, the symptoms of nerve compression are often similar. That is why specialists often will perform testing to determine the cause and location of the narrowing.
Lumbar spinal stenosis often mimics symptoms of vascular insufficiency. Both conditions can cause claudication, which means leg pain with walking. If vascular studies identify normal blood flow, and there is confirmation of spinal stenosis on diagnostic testing, the symptoms are then called neurogenic claudication. In the classic description, people with spinal stenosis will describe an onset of leg pain, or weakness with walking, but with relief of symptoms with sitting. Many will also describe increased tolerance to walking when flexed forward, such as when walking while leaning forward on a shopping cart. While lumbar spinal stenosis most often occurs at the L4-L5 and L3-L4 levels, it can occur any level in the spine. The degenerative cascade may eventually effect most of the vertebral segments of the lumbar spine.
Can also occur, but is less common. The thoracic part of the spine is the middle/upper portion of the spine, and mainly consists of the vertebrae that are attached to the rib cage. This stable and strong part of the spine allows for minimal movement, which is why degenerative conditions such as spinal stenosis are less likely to develop.
Spinal stenosis is related to degeneration in the spine and usually will become significant in the 5th decade of life and extend throughout every subsequent age group. As it is a gradual process and rarely causes immediate symptoms, the subtle changes of spinal stenosis often result in a gradual decrease in physical activity, and a development of a more kyphotic or forward flexed posture.
This gradual accommodation may be evident when looking at a series of oneself in pictures—over the course of several years—after around age 50. It is typical to start stooping forward more and become less active as effects of spinal stenosis increase.
This condition means that there is potential compression of the spinal cord. Unfortunately, the spinal cord compression can lead to serious problems such as extreme weakness, or even paralysis. With cervical stenosis, anyone who develops signs of spinal cord compression (myelopathy) may need more invasive treatment, such as surgery.
The treatment of the stenosis may not require surgery. Some more conservative methods like, medication, or physical therapy may help to relieve from the symptoms. If the symptoms do not improve with time or when there is nerve damage, surgery is considered with endoscopic and minimally invasive spine surgery techniques. Our philosophy is to make the pain or the symptoms of the patient disappear “step by step”, meaning that not always is needed to undergo a major surgery when there are other ways to resolve the problem with the Endoscopic & Minimally Invasive Techniques that are used from our specialized team that is examining always the symptoms and the indications in order to use the best under guidelines technique to resolve the problem of the patient.