Spinal stenosis is a narrowing of the space around the spinal cord, called the spinal canal. This narrowing, which often is caused by development of bony growths or other degenerative changes, constricts the space for the spinal cord and nerves. Spinal stenosis occurs most often in the lower back and neck. At Neurosurgery One (formerly South Denver Neurosurgery), our neurosurgeons are experts at both surgical and non-surgical spinal stenosis treatment.
Risk Factors of Spinal Stenosis
While some people are born with a narrow spinal canal, spinal stenosis most often results when something occurs which causes the spine to narrow. One of the most common causes of spinal stenosis is the normal wear and tear associated with aging. In fact, most people who develop spinal stenosis are over the age of 50.
Common conditions that lead to spinal stenosis in older adults include:
- Overgrowth of bone. Damage over time from osteoarthritis on your spinal bones can cause bone spurs, which can grow into the spinal canal.
- Herniated disks.The soft cushions that act as shock absorbers between your vertebrae may dry out with age. Cracks in a disc's exterior may allow some of the soft inner material to escape and press on the spinal cord or nerves.
- Thickened ligaments.The tough cords that help hold the bones of your spine together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal, causing stenosis.
When spinal stenosis occurs in younger people, causes can include trauma, such as vehicle accidents, and congenital spinal deformity, such as scoliosis.
Common Symptoms of Spinal Stenosis
Many people who have spinal stenosis experience no symptoms. Among those who do, symptoms may worsen over time. Symptoms can include:
- Pain, including pain when standing for long periods or when walking
- Tingling in an arm, foot or leg
- Numbness in an arm, foot or leg
- Muscle weakness
- Back or neck pain
Non-surgical Treatment for Spinal Stenosis
Spinal stenosis typically is first treated with non-invasive therapies including:
- Steroid injections. A steroid injection can provide temporary pain relief.
- Physical therapy. Your physician may suggest physical therapy, possibly along with pain-relieving steroid injections so that exercises can be done with minimal discomfort.
- Pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol), and non-steroidal anti-inflammatory medicines such as ibuprofen or aspirin may be useful for chronic pain. Prescription pain relievers may be necessary during episodes of extreme pain but are not recommended for long-term relief.
Learn more about non-surgical treatment.
Surgery to Relieve Symptoms of Spinal Stenosis
At Neurosurgery One, our Denver spine surgeons will recommend surgery for spinal stenosis only when a patient is experiencing severe pain that is not relieved by non-surgical treatments. Spinal stenosis is usually slowly progressive, so making a decision about surgery is typically not urgent but should be considered when a patient’s activity level becomes restricted by pain to a degree that interferes with quality of life. About 10 to 15 percent of people with spinal stenosis end up needing surgery.
A correct diagnosis is essential to achieving a positive surgical outcome. Imaging studies are necessary to identify the areas of narrowing.
Depending on your symptoms and the specific nature of your spinal stenosis, your spine neurosurgeon may recommend one of the following types of surgery:
- Laminectomy. This procedure removes the back part (lamina) of the affected vertebra.
- Laminotomy. This procedure removes only a portion of the lamina, typically carving a hole just big enough to relieve the pressure in a particular spot.
- Laminoplasty. This procedure is performed only on the vertebrae in the neck (cervical spine), and creates a “hinge” on one side of the lamina so that the other side can open to increase the space around the spinal cord and reduce pressure.
- Anterior cervical discectomy and fusion (ACDF). This procedure is used to treat spinal stenosis in the cervical discs (neck). The surgeon removes the damaged disc to relieve the pressure on the spinal cord. Learn more about ACDF.