Cervical and lumbar stenosis

Spinal stenosis is a narrowing of the spinal canal. Some people are born with some degree of stenosis, but more commonly it is the result of degenerative changes that occur during the aging process. These can include disc herniation, bony growths, facet (small joint) enlargement and other changes. As this degeneration progresses, the spinal canal that houses the nerve roots and spinal cord narrows, exerting pressure on the spinal cord or local nerves. This results in pain, numbness, weakness, bowel or bladder incontinence, or problems with sexual function.

Spinal stenosis most commonly occurs in the cervical (neck) or lumbar (lower back) spine. Spinal stenosis of the neck or back frequently causes symptoms with activities that require extension (bending backward). This usually causes the greatest amount of canal narrowing and leads to symptoms.

Your doctor will evaluate your medical history and perform an examination. You may also be advised to undergo an appropriate imaging procedure to help confirm your diagnosis. These imaging procedures may include: X-ray, magnetic resonance imaging (MRI), computerized tomography (CT scan), myelogram (a dye that is used before an X-ray), or a bone density test.

Not all cases of confirmed spinal stenosis cause symptoms. Your doctor will determine if the stenosis identified is causing your problem.

Whenever possible, spine center physicians recommend conservative, non-surgical options for their patients. In cases of mild stenosis, exercise, physical therapy, bracing and treatment with anti-inflammatory or nerve-stabilizing drugs may help to alleviate symptoms. Epidural corticosteroid injections may be used in some cases to bring temporary pain relief.

In cases where stenosis is more severe, surgery may be recommended to widen the spinal canal or the space around the nerves. Surgical procedures — including some minimally invasive techniques — either enlarge the space around the nerves or create more space in the spinal canal. Sometimes it is necessary to fuse two or more vertebral bones, especially when there is significant intervertebral disc disease or undesired movement between vertebrae.

Your spine center doctor will conduct a thorough evaluation and discuss all appropriate treatment options and procedures with you. Together, you will determine the approach that is best for you.