Definition of Spinal Stenosis and Symptoms

Narrowing of the vertebral channel, usually in the lower (lumbar) back, that compresses the spinal cord or the spinal nerve roots.

The narrowing may develop as a consequence of osteoarthritic changes, the formation of bone spurs, or a congenital defect in which the vertebral channel is unusually narrow to begin with.

Symptoms of spinal stenosis are weakness or numbness in the legs, along with disturbances of gait (the mechanics of walking) and balance. There may also be low back pain and pain in the legs.

Diagnosis

The diagnostic path typically includes comprehensive medical examination with full neurologic examination and diagnostic imaging procedures such as magnetic resonance imaging (mri) or computed tomography (ct) scan that can show dimensional views of the internal and external structures of the spine. Such views help the doctor determine the location and extent of the stenosis.

Treatment and Exercises

When diagnosis is early, conservative treatment such as exercises that extend the spine (bend the body forward) and medications such as nonsteroidal anti-inflammatory drugs (NSAIDS) may reduce the causes of the stenosis enough to relieve the compression of the nerves. Heat, cold, and weight loss also help.

Physical exercise that stretches and strengthens the muscles without compressing the spine, such as bicycling and swimming, improves the ability of the muscles to support the body and further relieves pressure on the spine.

When these measures do not relieve symptoms, surgery to widen the vertebral channel may be necessary to prevent permanent loss of function in the legs. Because the outcome of back surgery is less predictable than many other kinds of surgery, it is important to discuss and understand the expected benefits and potential risks of any operation the doctor proposes.

See also BONE SPURSCERVICAL SPONDYLOSISOSTEOARTHRITIS; SCIATICA; SPINAL NERVES; SURGERY BENEFIT AND RISK ASSESSMENT.

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