Spinal injury can occur to the bones (vertebrae) that make up the spine, or to the spinal cord, which…
What is spinal stenosis?
Spinal stenosis occurs when there is an abnormal narrowing of the spinal column. There are numerous possible causes, but essentially they lead to pressure on the spinal cord and/or the nerves that branch out from it.
What is the spinal column?
The spinal column is made up of 24 articulated and 10 fused bones (vertebrae). The vertebrae are linked by discs that act as shock absorbers for the spine.
The spinal column plays a vital role in the support of the upper body. It allows us to keep an upright posture, bend and twist. It also protects the spinal cord.
Within the spinal column is the spinal canal. Spinal stenosis occurs when there is an abnormal narrowing of this canal. The spine can narrow at one or more of the following parts:
- The space in the centre of the spine;
- The canals where the nerves branch out from the spine, or;
- The space between the vertebrae.
Spinal stenosis can occur due to a variety of causes, including the following:
- Arthritis - this is the most common cause;
- Disc herniation;
- Thickening of ligaments;
- Compression fractures - common for people who have osteoporosis;
- Injuries that dislocate the spine, or cause fractures that may cause bone fragments that penetrate the spinal canal;
- Congenital conditions in which the spinal canal is too small from birth;
- Paget's disease (which causes abnormal enlarging and weakening of bone);
- Ankylosing spondylitis;
- Acromegaly, and;
- Tumours of the spine.
The spine is made up of three regions - the cervical, thoracic and lumbosacral spine.
Lumbar stenosis is the most common, with around 75% of cases of stenosis occurring in this region. Lumbar stenosis commonly involves compression of the nerve roots of the lower back, leading to sciatica.
Cervical stenosis is less common, but is potentially more serious, as it can affect the muscles that help with breathing.
Thoracic stenosis is the least common type and can be associated with pain in the ribs.
Signs and symptoms
Methods for diagnosis
To help diagnose the cause of your symptoms, your doctor will take a detailed medical history, including your symptoms and past injuries, and ask questions about your overall health.
Your doctor will perform a physical examination to assess your strength, sensation and reflexes.
Computerised tomography (CT)
CT scans can provide detailed images of the spinal column to help better diagnose bone-related causes.
Magnetic resonance imaging (MRI)
Types of treatment
Exercise can be used to build up strength in the muscles of your arms and legs. Exercise can improve your balance, ability to walk, bend, move about and control pain.
Over-the-counter medications, such as paracetamol and ibuprofen, may provide relief from pain. Some people may be prescribed specific medication to ease muscular spasms.
Corticosteroids may be injected directly into the affected area around the spinal cord to provide temporary, or sometimes permanent, pain relief. These injections are not for regular use and are generally limited to only a few times each year.
When non-surgical treatment has not provided effective relief from symptoms, surgical treatment may be an option for some people. There are different procedures that can be used to alleviate the symptoms, including:
- Decompression laminectomy - to remove the bony spurs in the spinal canal and free up space for the nerves and spinal cord, or;
- Spinal fusion - in which additional bone is used to fuse two vertebrae together, which stops movement at the painful segment.
Surgical risks may include blood clots, infection, failure to provide relief and nerve injury.
For most people, there is good relief from symptoms without surgery. However, for others, non-surgical treatment may prove ineffective and surgery will be a good option.
You may be able to lower the likelihood of spinal stenosis by:
- Keeping your back healthy by engaging in regular exercise;
- Maintaining a healthy weight;
- Having good posture, and;
- Not smoking.