What Is Spine?
The spine is the column of bones known as vertebrae, which provides stability and support to the body’s upper part. It is useful in turning and twisting actions. The spinal nerves pass through the openings of vertebrae and help in the conduction of signals from the central nervous system or brain to the periphery or the other parts of the body. Any condition affecting these nerves or bones can lead to malfunctioning of walking, balancing, and/or sensation.
What Is Spinal Stenosis?
A condition where there is a narrowing of spaces within the spine is known as spinal stenosis. This can put pressure on the spinal cord and spinal nerves that have the route through the spine. It is usually seen in the lower back portion of the body in the lumbosacral region and in the neck known as the cervical region.
It can be either symptomatic or asymptomatic. When it is symptomatic, it can be experienced as pain, numb feeling, weakness in the muscle, and/or tingling sensation. It is also possible that the symptoms can worsen in the future. The other names for spinal stenosis are neurogenic claudication, central spinal stenosis, and foraminal spinal stenosis.
What Are the Types?
Depending on the affected location on the spine, it can be classified into the following (sometimes a person may experience more than one type):
1. Cervical stenosis: In this type, the narrowing is seen in the part of the spine situated in the neck.
2. Lumbar stenosis: In this type, the narrowing is witnessed in the spine portion located in the lower back. It has to be noted that, this is the most common type.
What Are the Symptoms?
Most of the people remain asymptomatic and the diagnosis is done only after imaging like X-rays, CT, etc. But, when a person has symptoms, it usually starts as mild, and then with time, it worsens.
The symptoms seen in the cervical spine or neck are as follows:
1. A sensation of numbness or tingling in the hands, feet, arms, or legs.
2. Weakness in the limbs.
3. Walking and balancing issues.
4. Pain in the neck.
5. When it is severe, dysfunction Ing of bowel or bladder can be seen as urinary urgency and incontinence.
The symptoms seen in the lower back or lumbar spine are as follows:
1. Numbness or tingling sensation in lower limbs.
2. Weakness felt in lower limbs.
3. Presence of pain or cramps in the legs while standing for a long duration or while walking. This discomfort eases while bending forward or sitting.
4. Pain in the back.
How Often Does Spinal Stenosis Occur?
Spinal stenosis occurs frequently. By the time they are 50 years old, up to 95 % of persons have degenerative spinal abnormalities. One of those modifications is spinal stenosis. Lumbar spinal stenosis is most frequently diagnosed as the reason for spine surgery in patients over 65.
How Does the Pain Associated With Spinal Stenosis Feel?
Individuals with spinal stenosis may experience numerous types of pain. Some individuals characterize it as tenderness or a dull aching. Some individuals characterize it as scorching or electric-like. The discomfort is not constant.
What Are the Acquired Causes of Spinal Stenosis?
The extension of the spine also called the backbone runs from the neck to the lower back. The bones of the spine form the spinal canal, which acts as a protective layer for the spinal cord (the nerve passing through the spinal canal).
The causes of spinal stenosis are as follows:
1. Bone overgrowth due to damage caused by wear and tear in osteoarthritis patients.
2. Disk herniation.
3. Thickening of the ligaments.
4. Tumors within the spinal cord.
5. Injuries to the spine due to vehicle accidents.
What Are the Congenital Causes of Spinal Stenosis?
Children and babies are affected by congenital spinal stenosis. It may occur as a result of:
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Problems with the fetal development of the spine.
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Disorders affecting bone development that are genetic (inherited). These result from mutations (changes) in the DNA.
The following are a few congenital causes of spinal stenosis:
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Achondroplasia: A genetic abnormality causes a bone growth condition that causes dwarfism.
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Spinal Dysraphism: An abnormality in the development of the spine, spinal cord, or nerve roots throughout fetal life. Examples of neural tube abnormalities include spina bifida.
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Congenital Kyphosis: An excessively outward curvature of the spine in children.
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Osteopetrosis: An uncommon hereditary disorder that triggers the child's bones to grow improperly and become extremely thick.
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Morquio Syndrome: An uncommon inheritable condition that impacts the kid's bones, spine, and other organ systems.
What Are the Risk Factors?
The following are the risk factors of spinal stenosis:
1. People who are above 50 years of age.
2. In young people, trauma, certain genetic defects, congenital abnormalities, etc., may increase the risk.
Are There Any Complications?
If severe spinal stenosis is not treated, it can lead to the following complications:
1. Numbness in the affected part.
2. A weakness of limbs.
3. Problems in balancing the body.
4. Incontinence.
5. Paralysis.
What Are the Ways to Diagnose It?
Initially, when one visit their physician, he or she will ask personal history, medical history, and complete details about the signs and symptoms being experienced by them. Following that, a physical examination will be conducted along with many imaging tests to assist in confirming the diagnosis.
The imaging tests may include the following:
1. X-rays of the back or neck.
2. MRI of the spine.
3. CT or CT myelogram.
The imaging studies help to read the spine and pathologies associated with it. An electromyogram can be useful in checking the spine health.
How Can Spinal Stenosis Be Treated?
The treatment is mainly dependent on the location and severity of stenosis. Initially, medications can be given to manage the symptoms, they are as follows:
1. Painkillers or analgesics like Ibuprofen, Paracetamol.
2. Muscle relaxants like Chlorzoxazone, Thiocolchicoside.
3. Certain antidepressants like Amitriptyline.
4. Anti-epileptic or anti-seizure drugs like Gabapentin, Pregabalin.
5. Opioid analgesics in refractory pain.
It is very important to consult the physician before taking any of these medications.
Next, physical therapy can be done like doing exercises that can improve the balance and strengthen the muscles. Steroid injections and decompression of the nerve are other procedures that can be done.
In severe cases, surgery is advisable which can be laminectomy (this includes removal of part of vertebrae so that the nerves can get more space and is the most common procedure), laminotomy, laminoplasty, and bone or lamina removal using minimally invasive surgery. Another procedure carried out are diskectomy and foraminotomy which helps in widening the part of the spine where the nerve exits.
In very severe cases, spinal fusion is carried out in which spines are involved in multiple levels and thus helps in preventing instability. Also, bone grafts and/or metal implants can be used to attach the affected bones together.
Are There Any Other Specific Ways to Manage Spinal Stenosis?
Pain is the most severe problem faced by individuals in such situations. Hence, other options available apart from surgery include ice or heat packs, acupuncture, massaging. Also, cognitive behavioral therapy will prove to be helpful in managing pain as it provides education and coping mechanisms.
Spinal stenosis can affect the daily routine if not treated at the right time. Consult a physician to get all the details cleared regarding spinal stenosis which can also be done using online medical platforms.
Conclusion:
An excessively narrow space within the backbone results in spinal stenosis. The most frequent cause of spinal stenosis is arthritic wear-and-tear alterations in the spine. Individuals with severe spinal stenosis can require surgery. More room inside the spine can be created via surgery. Spinal stenosis can affect the daily routine if not treated at the right time. Consult a physician to get all the details cleared regarding spinal stenosis which can also be done using online medical platforms.
