Central Canal Stenosis

Spinal stenosis that develops in the spinal canal is known as central canal stenosis. If it progresses, this form of the condition can affect the spinal cord, potentially leading to severe complications. 

Understanding central canal stenosis and how it’s treated can help you avoid its complications. As with any spinal condition, a proactive approach is the best way to recover quickly and effectively.

Table of Contents

  • Can Central Canal Stenosis Heal?
  • Is Central Canal Stenosis Serious?
  • Mild to Moderate Central Canal Stenosis
  • Severe Central Canal Stenosis L4-L5 and Its Treatment
  • Central Canal Stenosis Surgery
  • Laminectomy for Central Canal Stenosis
  • Spinal Fusion with Laminectomy
  • Should I Have Surgery For Central Canal Stenosis?
  • Do I Have To Undergo Spinal Fusion For Severe Central Canal Stenosis?
  • Continue reading to learn more about central canal stenosis and the treatment options available to heal it. 

    Can Central Canal Stenosis Heal?

    The symptoms of central canal stenosis can heal, but the condition can’t be cured.

    Spinal stenosis surgery is the only way to open up the spinal canal after it has narrowed. Non-surgical spinal stenosis treatment focuses on alleviating the condition’s symptoms, such as back pain, stiffness, numbness, weakness, and tingling. 

    Is Central Canal Stenosis Serious?

    Though common, central canal stenosis can become serious if it’s left untreated. So, even in its early stages, it requires prompt medical treatment to slow down the narrowing process. 

    If central canal stenosis isn’t treated for an extended period, it can have serious consequences. When the spinal cord is compressed from this condition, patients may experience severe symptoms of nerve compression including:

    • Loss of bowel and/or bladder control
    • Numbness in the genital area
    • Sudden, severe back pain that won’t go away
    • Sudden numbness and/or weakness in any region of the body

    If you experience any of these symptoms with central canal stenosis, seek out emergency medical treatment. They can indicate serious complications, such as cauda equina syndrome. 

    Mild to Moderate Central Canal Stenosis

    Mild to moderate central canal stenosis may be classified as grade 1 or grade 2 stenosis. With grade 1, or mild, stenosis, all of the cauda equina are still visible in axial images. With grade 2, or moderate, stenosis, some of the cauda equina are impossible to separate.  

    Most often, mild to moderate central canal stenosis can be treated with non-surgical therapies. Although your doctor can’t open the spinal canal up again, they can offer treatment options to alleviate your symptoms and improve your spinal function. 

    Non-surgical treatment options for mild to moderate central canal stenosis include:

    • Physical therapy, which focuses on improving spinal alignment, stability, and support to prevent worsening symptoms
    • Lifestyle modifications, which typically involve adjusting your movement patterns, exercise routine, and sleeping/sitting positions to reduce pressure on the spine
    • Injections, which may include epidural or facet joint injections to temporarily alleviate pain (patients should receive no more than three to four injections per year, as they can lead to complications in excess)
    • Medications, either prescription or over the counter, to alleviate inflammation, improve circulation, and manage pain

    Severe Central Canal Stenosis L4-L5 and Its Treatment

    Treatment for severe central canal stenosis L4-L5 often involves surgery. At this stage of the condition, non-surgical therapies often fail to provide relief. Additionally, patients with severe stenosis may be at risk for serious neurological complications if the condition progresses. 

    Surgery is the only way to physically create more space in the spinal canal for patients with central canal stenosis at the L4-L5 level. 

    Central Canal Stenosis Surgery

    Central canal stenosis surgery typically involves a procedure known as a laminectomy

    Laminectomy for Central Canal Stenosis

    Laminectomy is a form of surgical spinal decompression that may be used to treat advanced cases of central canal stenosis. This procedure focuses on the lamina, which is a piece of bone that covers the back of the spinal canal. 

    By removing some or all of the lamina, your surgeon can alleviate pressure on the spinal nerves or spinal cord. This gives the damaged tissue a chance to heal and resolves neurological symptoms stemming from central canal stenosis. 

    Since laminectomy involves removing part of a spinal structure, it can lead to instability. To negate this risk, surgeons often perform spinal fusion during laminectomy (but there are more effective spinal fusion alternatives).

    Spinal Fusion with Laminectomy

    During spinal fusion, the surgeon fuses the affected vertebrae by placing bone graft material in between them. Over the course of several months, these vertebrae will become one. 

    Unfortunately, by creating a solid bone, spinal fusion eliminates the vertebrae’s ability to move. This disrupts the distribution of impact across the spine, potentially leading to adjacent segment disease. Additionally, patients may notice reduced spinal mobility after the fusion procedure. 

    Should I Have Surgery For Central Canal Stenosis?

    Generally, you should have surgery for central canal stenosis if radiculopathy or myelopathy symptoms disrupt your day-to-day activities. Central canal stenosis surgery is also typically only recommended if non-invasive treatment methods have failed to offer relief. 

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    • Radiculopathy is the term used to describe damage to the nerve roots where they exit the spine. It’s a possible complication of central canal stenosis and causes symptoms including:
      • Sharp or burning pain that travels from the back to other areas of the body
      • Tingling, numbness, and/or weakness in the extremities
      • Lost sensation
      • Diminished motor skills
    • Myelopathy refers to a spinal cord injury caused by severe compression. It can result from central canal stenosis and causes similar symptoms to radiculopathy. 

    In their severe forms, radiculopathy and myelopathy pose a serious risk for permanent nerve damage. Loss of urinary and/or bowel control, among other symptoms, can become a reality if central canal stenosis is left untreated for an extended period. 

    Your doctor can help you determine if central canal stenosis surgery is the right choice for you. 

    Do I Have To Undergo Spinal Fusion For Severe Central Canal Stenosis?

    Spinal fusion is no longer the only option to stabilize the spine for patients with severe central canal stenosis. The TOPS System is a mechanical, non-fusion implant device that restores the stability of the spine without compromising its motion in any direction. 

    TOPS is implanted into the treatment area (it can be used for the L2 through L5 segments) to replace the tissue removed during decompression surgery. It provides a much shorter recovery period than spinal fusion and allows central canal stenosis patients to safely return to their favorite activities. 

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    Reach out to a spine specialist in your area to learn more about the treatments available for central canal stenosis.