What Is Advanced Spinal Stenosis?

Advanced spinal stenosis is condition where the spinal canal has narrowed and pressure is placed on the spinal cord. Spinal stenosis can occur anywhere on the spine. However, it is most commonly seen in the upper or lower regions of the spine. If the spinal narrowing, or stenosis, is located in the upper area of the spine, it is called cervical spinal stenosis. If it is located in the lower area of the spine, it is called lumbar spinal stenosis.

Causes

• While some people are born with spinal stenosis, it most commonly manifests in people who are older than 50 years of age. It is a result of the aging process and the normal wear and tear that takes place on the spine throughout life. The aging process also causes calcification of the ligaments of the spine. This produces harder, thicker ligaments. Bones can also enlarge and bone spurs may form. All of this can lead to spinal stenosis. Spondylolisthesis can lead to spinal compression. This is when one vertebra has slipped and is resting on another vertebra. It should be noted that the experts at Spine Universe state that some people may be genetically predisposed to the condition as only a small minority of patients develop advanced spinal stenosis.

Symptoms

• Advanced spinal stenosis in the lumbar region produces pain, numbness and weakness in the legs and buttocks. Symptoms generally increase when walking and decrease when sitting, lying in bed or bending forward. Advanced spinal stenosis in the cervical region produces pain in the legs, arms and shoulders, balance disturbances and hand clumsiness. Advanced spinal stenosis can cause bowel and bladder problems. Loss of body movement and paraplegia can occur, but it is rare.

Diagnosis

• A diagnosis of advanced spinal stenosis is given after a physician has done a complete medical history, physical exam and testing that confirms the condition. These tests can include X-rays that show the vertebrae and any calcification which may be present, an MRI which gives the physician a three-dimensional view of the spine and shows nerve roots, spaces between the vertebra, if tumors or infection is present, bone degeneration and enlargement of the bones, a CAT scan which shows the size and shape of the spinal canal, a myelogram which involves injecting a dye into the spinal column which enables the physician to see where pressure is on the spinal cord and a bone scan. A bone scan involves injecting a material that attaches to bones. This material enables a physician to see if the bone has any fractures, infections, arthritis or tumors.

Treatment

• Advanced spinal stenosis generally does not respond to non-surgical treatments, such as physical therapy and medications. Surgery is often the only way to relieve the pressure on the spinal cord. However, most surgeons will not consider the surgery until patients have tried the non-surgical route first. During surgery, the narrowed vertebra are trimmed, realigned or completely removed. The surgery often requires the placement of rods or screws in the spine to increase stability and strength.

Surgery Considerations

• People opting for surgery to treat advanced spinal stenosis should know there is a risk that nerves will be damaged during the procedure. This can mean that numbness and pain may still be a problem after surgery. In addition, the surgery itself may not relieve the symptoms of the condition as the degenerative process generally continues. According to Spine Universe, most symptoms reappear 5 or more years after the procedure.