Spinal stenosis
Definition
Spinal stenosis is a narrowing of the lumbar (back) or cervical (neck) spinal canal, which causes compression of the nerve roots.
Causes
Spinal stenosis mainly affects middle-aged or elderly people. It may be caused by osteoarthritis or Paget's disease or by an injury that causes pressure on the nerve roots or the spinal cord itself.
Symptoms
- Pain in the buttocks, thighs or calves that is worse with walking or exercise
- Numbness in the buttocks, thighs or calves, that is worse with standing, walking or exercise
- Back pain that radiates to the legs
- Weakness of the legs
- Neck pain
- Leg pain
- Difficulty or imbalance when walking
Exams and Tests
An examination of reflexes of lower legs reveals asymmetry. Neurologic examination confirms leg weakness and decreased sensation in the legs.
- X-ray of the spine shows degenerative changes and narrowed spinal canal.
- Spinal MRI or spinal CT scan shows spinal stenosis.
- EMG may show active and chronic neurological changes.
Treatment
Generally, conservative management is encouraged. This involves the use of anti-inflammatory medications, other pain relievers, and possibly steroid injections. If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves.
Surgery is performed on the neck or lower back, depending on the site of the nerve compression.
Outlook (Prognosis)
If the nerve roots can be successfully relieved of pressure, the symptoms will not worsen and may improve.
Possible Complications
Injury can occur to the legs or feet due to lack of sensation; infections may progress because pain related to them may not be felt. Changes caused by nerve compression may be permanent, even if the pressure is relieved.
When to Contact a Medical Professional
Call your health care provider if symptoms suggestive of spinal stenosis develop.
Reviewed By: Kevin B. Freedman, MD, MSCE, Sports Medicine, Orthopaedic Specialists, Bryn Mawr, PA. Review provided by VeriMed Healthcare Network.
