Health Library

Spinal Stenosis

Definition

Spinal stenosis is a narrowing of the spinal canal. The spinal canal is located in the backbone. It is a small space that holds the nerve roots and spinal cord. If this space becomes smaller, it can squeeze the nerves and the spinal cord. This causes pain and other symptoms. Stenosis can occur anywhere along the spinal cord. It is most common in the low back (lumbar) region.

Spinal Stenosis

Causes

Some people are born with narrowed canals. Most often stenosis is a result of aging. Conditions that can cause spinal stenosis include:

Osteoarthritis and osteophytes (bony spurs) associated with aging
Rheumatoid arthritis
Spinal tumors
Trauma
Paget's disease of the bone
Previous surgery

Risk Factors

Factors that increase your chance of spinal stenosis include:

Being born with a narrow spinal canal
Age: 50 or older
Previous injury or surgery of the spine

Symptoms

Symptoms include:

Numbness, weakness, cramping, or pain in the legs and thighs

Radiating pain down the leg

Abnormal bowel and/or bladder function

Decreased sensation in the feet causing difficulty placing the feet when walking

Loss of sexual function

Partial or complete paralysis of legs

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

X-ray—a test that uses radiation to take pictures of structures inside the body; in this case, to check for abnormalities in the bones of the back including osteoarthritis, bone spurs, and obvious narrowing of the spinal canal
CT scan—a type of x-ray that uses a computer to make pictures of the bones of the back, which helps to evaluate the spinal canal
MRI scan—a test that uses magnetic waves to make pictures of soft tissue, such as the spinal cord and the spinal nerves inside the back

Treatment

Treatments include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)—to relieve pain and inflammation
Analgesics—to relieve pain
Corticosteroid injections—to reduce pain and inflammation

Special exercises can help stabilize the spinal cord. Exercise can increase muscle endurance and mobility of the spine. This can relieve some pain. Sometimes exercises are ineffective against spinal stenosis.

Wearing a corset or lumbar brace can help stabilize the spine. This may relieve pain.

Surgery is reserved for severe cases.

Decompression laminectomy—This is the removal of bony spurs or increased bone mass in the spinal canal. This can free up space for the nerves and the spinal cord.
Spinal fusion—This is when two vertebrae (back bones) are fused together. This will provide stronger support for the spine. This is almost always done after decompression laminectomy.

Prevention

There are no guidelines for preventing spinal stenosis.

American Academy of Orthopaedic Surgeons

http://www.aaos.org

Arthritis Foundation

http://www.arthritis.org

The Arthritis Society

http://www.arthritis.ca

Canadian Orthopaedic Association

http://www.coa-aco.org

American Academy of Family Physicians website. Available at: http://www.aafp.org. Accessed July 7, 2009.

Arthritis Foundation website. Available at: http://www.arthritis.org. Accessed July 7, 2009.

Berkow R. The Merck Manual of Medical Information. Home Edition. New York, NY: Merck Research Laboratories; 1999.

Questions & answers about spinal stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Spinal_Stenosis/default.asp. Published April 2009. Accessed July 7, 2009.

Last reviewed September 2011 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.