Spinal stenosis refers to narrowing of the spinal canal that can cause severe pain.
Stenosis is like a tourniquet applied when you give blood—after a few minutes with the tourniquet applied, the arm gets swollen and your fingers get numb. When the tourniquet is released, you feel better. In the same way, lumbar stenosis squeezes your spinal nerves, especially when you stand.
Stenosis may occur in the lumbar (lower back), cervical (neck) and thoracic (upper and middle back) spine. It is most common in the lumbar and cervical areas.
Lumbar stenosis, the most common type, compresses nerves and usually results in back and leg pain when standing, but improves when sitting.
If the stenosis occurs in the cervical or thoracic spine, resulting in the spinal cord compression, this is called myelopathy and may end up being a permanent problem.
Stenosis can be accompanied by scoliosis or spondylolisthesis, which results in greater pain when you stand. This requires more extensive treatment to decompress the nerves and to stabilize the spine.
Spinal Stenosis Causes
Stenosis may be caused by:
- Thick joint ligaments (ligamentum flavum)
- Degenerated discs that have bulged into the spinal canal and become calcified
- Facet joint that has become arthritic and pinches the nerves or spinal cord in conjunction with the above
Spinal Stenosis Diagnosis
We diagnose spinal stenosis with a MRI scan or CT scan. X-rays will help determine if an instability needs to be addressed as well.
Spinal Stenosis Treatments
At Wake Forest Baptist Health’s Spine Center, we offer a full array of treatments for spinal stenosis. We develop a treatment plan specific to your symptoms and recommend an approach that offers the highest probability of success with the least risk.
Spinal stenosis treatment options include:
- Physical therapy: We usually try this first, especially if the stenosis is in the lumbar spine. This restores flexibility and mobility, and may relieve the symptoms without surgery.
- Stretching, ultrasound, and thermal treatments or massaging: May be recommended if you experience painful muscle spasms.
- Steroid injections in spine: For when the stenosis is mild but there is some inflammation of the nerves and other therapies haven’t helped.
Spinal Stenosis Surgery
If physical therapies or injections don't work, a minimally invasive surgical decompression may be effective. We remove a thickened ligament or overgrown facet or hinge joint, or removal of a bulging disc or spur, opening up the spinal canal and relieving the stenosis.
This is a great treatment option when just 1 or 2 joints or segments of the spine are involved and may be used in the cervical, thoracic and lumbar spinal stenosis.
A minimally invasive approach limits the damage or injury to the muscles and tissues around the spine and allows for a quicker recovery. Patients are discharged the same day or next day, and are expected to rapidly progress to a more active lifestyle and return to conditioning programs within a few weeks.
If the stenosis is extensive over multiple levels, then a more extensive surgical decompression is required and a minimally invasive approach may not be the best option.
A patient who undergoes a surgical decompression for severe symptomatic spinal stenosis should expect a significant reduction in pain and an improvement in their lifestyle.
At the Wake Forest Baptist Health Spine Center, initial evaluation, physical and interventional therapies and surgical evaluations are available in one facility. Our spine specialists will make every effort to match the least invasive treatment for your symptoms and diagnosis.
With state-of-the-art imaging, easily accessible clinics, and the most advanced minimally invasive techniques and surgeons, you receive personalized treatment of your spinal stenosis with the highest probability of success.