Spinal Stenosis is a group of conditions that results in narrowing of the spinal canal. There are three types.
- Central Stenosis-This is the narrowing of the central portion of the spinal canal.
- Foraminal stenosis-This is the narrowing of the foramen which results in compression on the nerve root.
- Far lateral recess stenosis-This is the narrowing of the lateral portion of the spinal canal.
Spinal Stenosis results in back pain, dysthesias and unilateral or bilateral numbness in the buttocks, thighs, and leg. Symptoms typically start in the buttocks and radiate to the legs but can occur vice versa. The pain intensifies with walking and standing and is alleviated by sitting.
A MRI or CT scan can make a confirmative diagnosis as well as physical examination of the patient. Non-operative treatment options include rest and physical therapy. NSAID medication provides effective pain and inflammatory relief as well. In addition, facet and steroidal injections have proven to be beneficial in treating neurogenic pain.
Surgical intervention is recommended for treating spinal stenosis that has not been relieved by non-operative measures after 3-6 months of use. Laminectomy and Foraminotomy are the operative choice through which decompression is achieved from bone removal and widening of the narrowed portions of the spinal canal. In addition, adjunct fusion might be required to improve stability of the spine. These surgical interventions have a high success rate but might require lifestyle modifications to achieve maximum benefits, although long term pain relief cannot be guaranteed.