What Causes Spinal Stenosis?
As we age, so do the structures within our body. The spinal cord is no exception to this rule. And, age-related degeneration may manifest in a variety of different ways. One of the most common spinal cord ailments from age-related wear and tear is a condition called spinal stenosis. Spinal stenosis describes the narrowing of the spaces surrounding the spinal cord. In many cases, this causes no symptoms at all. However, more severe instances of this condition will result in uncomfortable experiences for patients.
As time goes on, spinal ligaments swell in size, become stiff, and lose their normal levels of flexibility. This structural deterioration reduces the amount of space available around the spinal canal, which may apply pressure on nearby nerve roots or even on the spinal cord itself. This is what causes painful symptoms associated with spinal stenosis. Usually, these symptoms only manifest in patients over the age of 60. But, it is certainly possible for younger patients to experience pain and discomfort from spinal stenosis.
Luckily, advancements in modern medicine have provided us with plenty of viable treatments for patients who suffer from spinal stenosis. There are plenty of conservative treatments, as well as minimally invasive surgical procedures available for patients with the condition. If you are experiencing lasting discomfort in your back, or even other areas of the body such as your extremities, consider seeking medical attention for your ailments.
Causes of Spinal Stenosis
There are a lot of different reasons why the spaces surrounding the spinal canal might narrow. Some people are more susceptible to these conditions, as they are naturally born with a smaller spinal canal. That being said, the risk for developing any condition simply increases with time as we age. The spinal canal is an open landfill ripe for age-related deterioration. To some extent, there is always going to be some level of age-related wear and tear. That being said, here are some of the most common causes of spinal stenosis:
- Disc Herniation: Spinal discs are soft cushions that function as shock absorbers between the bones of the spine. As we age, these structures tend to dry out, which may lead to problems. For instance, the soft interior of the disc may leak out of its harder outer shell and press on the spinal cord or adjacent nerves.
- Bone Overgrowth: Conditions such as osteoarthritis may cause your body to kick into overdrive by responding with excessive bone growth. This leads to the formation of bone spurs, which may press on nearby nerves in the spine.
- Tumors: These are less common, but when they do occur, they may press on nearby spinal nerves. These may form inside the spinal cord or within the spaces between the vertebrae.
- Traumatic Injuries: Injuries from contact sports or automobile collisions may lead to a variety of problems within the spine. For instance, nearby tissue may swell and press on adjacent structures, or bones may move out of alignment and cause additional damage.
- Ligament Swelling: Ligaments may become stiff and thicken as we age, which also may press on nearby structures such as nerves or the spinal cord.
How is Spinal Stenosis Diagnosed?
As with most cases, diagnosis for any medical condition usually starts with an overview of medical history and a physical examination. Your doctor may ask you questions about your family history, pre-existing medical conditions, your history of injuries, and more. This information gives your doctor a place to start when it comes to ordering diagnostic tests. For spinal stenosis, your doctor may take the following routes for determining a diagnosis:
- X-Ray Imaging: X-rays are useful because they help reveal bone abnormalities and deformities. This is especially useful in patients who have osteoarthritis or bone spurs, as it will show where these structures press on nearby nerves or the spinal cord.
- CT Scan: Usually, your doctor will order these in lieu of an MRI, as not all patients are viable candidates for magnetic resonance imaging. CT scans are interesting, as they use a series of x-ray images taken from different angles to produce more detailed images of the affected area(s). Usually, this test takes advantage of contrast dyes, which helps to outline structures and reveal abnormalities such as herniated discs and tumors.
- MRI: Not everyone is eligible for an MRI, as it uses powerful magnets and radio waves to produce highly detailed images of spinal structures. This is a very extensive test. It is even able to detect damage to the discs and ligaments. Additionally, it will also reveal the existence of tumors within the spine. Not only that, but it will also show which spinal nerves are under pressure—an invaluable diagnostic tool.
Spinal Stenosis Treatment
As with any medical condition, treatments usually diverge into conservative options and surgery. There is, however, a middle ground where minimally invasive surgeries do reside. For some, these are viable treatment routes in cases where conservative methods are not enough, but traditional open surgery is not necessary or desired. It all depends on the severity of your case and the nature of your condition.
Firstly, there are a variety of different medicines that a doctor may prescribe if the patient has spinal stenosis. Most commonly, doctors prescribe their patients pain relievers such as ibuprofen and Tylenol to help alleviate the symptoms of spinal stenosis. That being said, antidepressants, anti-seizure drugs, and opioids are also effective treatments for the condition. It is important to note, however, that opioids do carry the risk of addiction as well as serious side effects. So, you should carefully consider this fact before taking them.
Physical therapy is great for those with spinal stenosis, as many patients with the condition are less active in an attempt to avoid painful symptoms. Less activity results in muscle weakness, which may actually exacerbate the condition. To learn what exercises are right for your specific needs, consult with your doctor or ask for a specialist referral.
Steroid injections are another effective form of treatment, however, they are not permanent and don’t work for everyone. That said, they may be helpful in situations in which the nerve roots are swollen and pinched. This is because steroid injections help to reduce inflammation and, as a result, alleviate some of the condition’s painful symptoms.
Sometimes, conservative methods aren’t enough and the patient requires corrective surgery. Thankfully, there have been advancements in modern medicine that allow for more minimally invasive executions of what once were traditionally open surgeries. That said, minimally invasive procedures are not always viable, and sometimes they necessitate multiple return surgeries. Regardless of what your needs may be, here are some common surgical procedures that doctors perform for spinal stenosis:
- Laminectomy: This specific procedure involves the removal of the affected vertebra’s lamina. Doing so helps to alleviate the pressure on nearby nerves via the creation of more space through the removal of this structure.
- Laminotomy: This is similar to laminectomy, but instead of removing the entire structure, the doctor only extracts a small portion. Usually, doctors accomplish this by drilling a small hole just to relieve pressure in the affected area.
- Laminoplasty: This surgery is unique as doctors only perform it in the cervical spine. Basically, doctors create extra space in the spine by creating a hinge with the lamina. Then, the performing doctor will use hardware to close gaps in the newly opened area.
Are you experiencing lasting discomfort in your back or perhaps other regions of the body such as your extremities? If so, you may want to contact The Advanced Spine Center at (973) 538-0900. Our doctors specialize in the latest conservative treatments as well as minimally invasive surgical care. We pride ourselves on using the most innovative technologies to treat your spinal conditions in the least invasive way possible. With the Advanced Spine Center, you can rest assured that we will put you on a treatment care plan that suits the specific needs of your case. Contact us today!