In Ancient Greek 'stenosis' means literally a 'narrowing' and spinal stenosis is exactly this, where the channel through the individual vertebrae where the spinal cord sits becomes narrower.
Spinal stenosis can affect different parts of the spine and so is referred to as 'cervical spinal stenosis' where it affects the upper section and the neck, and 'lumbar spinal stenosis' where it affects the lumbar region, i.e. the lower back.
This narrowing of the channel can exert pressure on the spinal cord and / or nerves and in turn cause a range of other conditions which are a result of nerve compression, such as myelopathy.
Lumbar spinal stenosis is more common than cervical spinal stenosis, although cervical stenosis is a more serious condition.
Spinal stenosis is sometimes referred to by other names, which include 'pseudo claudication' and 'central spinal stenosis'.
The most common cause of spinal stenosis is simply the process of ageing and degeneration in all components of the spine, as bony overgrowth can make the central canal narrower over time.
Other causes include…
- Narrow spinal canal (this is generally an inherited condition).
- Spinal curvature ('scoliosis').
- Bone disease (Paget's disease where there is abnormal bone growth).
- Bone tumours.
- Arthritis of the spinal column.
Symptoms are almost identical to other conditions caused by nerve compression. In some cases, there are no symptoms at all, however common symptoms include…
- Pain affecting the area/s of the body supplied by the affected section of the spinal cord and the affected nerve/s; this is commonly the lower back, the buttocks and the legs, or the neck, arms and shoulders; the pain commonly 'radiates' down the limb.
- Weakness in affected muscles.
- Numbness or tingling in affected areas.
- Difficulties with balance.
- Difficulties with sexual function.
These symptoms can often be aggravated by physical activity.
In rare cases more serious symptoms may appear, in which case immediate medical assistance should be sought. These symptoms are…
- Loss of bladder / bowel function.
- Paralysis (this is a medical emergency).
Tests / Diagnosis
The correct diagnosis of spinal stenosis can be challenging due to the similarity of symptoms with other conditions, e.g. sciatica. A physical examination and review of medical history is the first step. A diagnosis is generally confirmed with one or more of the following tests…
- CT or MRI scan.
- Electromyogram ('EMG') to check the function of muscles and nerves.