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spinal stenosis
Central Canal Stenosis
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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.
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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.
- 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.
Spinal Stenosis Surgery – Procedure Overview
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Whether caused by genetic factors, injury, or the aging process, spinal stenosis can disrupt your life. This common spinal condition develops when the spinal canal narrows, potentially closing in on the delicate spinal nerves and spinal cord. Back pain, reduced mobility, and neurological symptoms often accompany a spinal stenosis diagnosis.
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Usually, spinal stenosis can be resolved with non-surgical treatment. But, unfortunately, this isn’t the case for all patients. If you need surgery for spinal stenosis, understanding the ins and outs of the procedure will help build your confidence and assuage any concerns.
This article will provide an overview of spinal stenosis surgery so that you can know what to expect as a patient.
Should I Have Surgery For Spinal Stenosis?
You generally should have surgery for spinal stenosis if several months of non-surgical therapies haven’t helped, your symptoms are causing significant mobility problems, and/or if you’re experiencing severe symptoms.
Always talk to a spinal specialist before deciding whether or not to undergo spinal surgery. Many factors should be included in this decision, including your current health and medical history.
What Is the Best Surgery for Spinal Stenosis?
The best surgery for spinal stenosis is decompressive laminectomy, according to the vast majority of today’s spinal specialists.
Decompressive laminectomy is a surgical procedure that involves removing some or all of the lamina. The lamina is a portion of bone that covers the posterior side of the vertebrae. It acts like a roof to protect the spinal nerves and spinal cord.
In patients with spinal stenosis, removing the lamina creates more space in the spinal canal and can help relieve nerve compression.
Premia Spine TOPS System is a revolutionary device that helps preserve full motion in the lower back spine and recover from spinal stenosis.
How Many Hours Is Spinal Stenosis Surgery?
Spinal stenosis surgery can take two to six hours to complete, depending on the complexity of the procedure. The surgery may take longer if multiple spinal levels must be addressed or if spinal fusion is required.
Is Spinal Stenosis Surgery Done Under Anesthesia?
Spinal stenosis surgery is done under general anesthesia. This means that you’ll be asleep during the entire procedure.
Only some forms of minimally-invasive spinal surgery are done under local anesthesia. But, when minimally-invasive surgery is a viable option, it allows patients to avoid the risks of general anesthesia and leave the hospital sooner after the procedure.
Is There an Age Limit for Spinal Stenosis Surgery?
There’s no formal age limit for spinal stenosis surgery. However, the younger a patient undergoes spinal surgery, the more likely they will require reoperation.
Additionally, many elderly patients are at a high risk of complications from surgery. Nonetheless, a study published in World Neurosurgery concluded that elective spinal surgery in patients older than 90 doesn’t reduce life expectancy and provides a good outcome for well-selected candidates.
Can You Get Paralyzed From Spinal Stenosis Surgery?
You can get paralyzed from spinal stenosis surgery, but it’s a very uncommon complication of the procedure. It’s a risk of all forms of spinal surgery, given that it’s performed near the spinal nerves and spinal cord.
Can Spinal Stenosis Paralyze Your Legs?
Spinal stenosis is very unlikely to paralyze your legs. This can only happen if the spinal nerves or spinal cord in the lumbar region of the spine is left compressed for an extended period without treatment.
One study followed surgical candidates with lumbar spinal stenosis from 13 centers across the U.S. for eight years. Between the four and eight-year interval, none of the patients (whether they underwent surgery or not) experienced paralysis. This research illustrates how rare paralysis is for spinal stenosis patients.
Nonetheless, to ensure that paralysis from spinal stenosis isn’t a possibility, patients need to seek out prompt medical care from a licensed physician.
How Long Is Bed Rest After Spinal Surgery?
Bed rest after spinal surgery typically isn’t very long, given that motion is important to the healing process. Most patients can get out of bed the same day or the day after spinal surgery.
Some forms of spinal surgery, like spinal fusion, require a longer recovery time than others. After spinal fusion, patients often undergo two weeks of highly restricted activity, and it can take four to six weeks to return to their normal routines.
Nonetheless, standing up out of bed and walking around throughout your recovery process will help the spine heal faster. This is because:
- Movement prevents stiffness and muscle atrophy after surgery.
- Movement promotes blood flow to the healing spinal tissue, delivering oxygen and nutrients that the tissue needs to recover.
- By keeping the muscles strong, movement helps prevent future injury to the spine.
What Are The Risks of Spinal Stenosis Surgery?
The risks of spinal stenosis surgery include bleeding, infection, blood clots, nerve injury, and recurring pain. If spinal stenosis surgery involves a spinal fusion, patients are also at risk of bone fusion failure, lost mobility, and adjacent segment disease.
These risks are less prominent in minimally-invasive spine surgery, as the incision is smaller and less disturbance of the tissue is required.
TOPS System for Treatment of Lumbar Spinal Stenosis
The TOPS System is a revolutionary treatment for lumbar spinal stenosis. It’s a mechanical implant device that acts as an alternative to traditional spinal fusion for patients suffering from severe stenosis.
Spinal fusion is used to stabilize the spine after decompressive laminectomy. It works by fusing the affected vertebrae, eliminating all motion between them. Without the ability to move, the affected vertebrae can’t destabilize the spine or create a risk for injury.
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Unfortunately, spinal fusion can also diminish your spinal mobility. That’s why patients are turning to the TOPS System: to preserve the spine’s mobility while maintaining stability.
The TOPS System can be used between the L2 and L5 spinal segments. It restores the motion of the spine in every direction, immediately after the procedure. This allows patients to return to their favorite activities with a shorter recovery period than that of spinal fusion.
To learn more about the TOPS System for lumbar spinal stenosis, find a doctor in your area today.
What Is the Best Treatment for Spinal Stenosis?
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The best treatment for spinal stenosis can range from patient to patient. Thankfully, many patients with spinal stenosis achieve symptom relief with non-surgical treatments, like physical therapy and lifestyle adjustments. But, when these therapies aren’t sufficient, surgery may be needed to fully resolve spinal stenosis.
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This article will explore the best treatment option to cure spinal stenosis in patients who don’t respond to non-invasive treatments.
An Overview of Spinal Stenosis
Spinal stenosis is a condition characterized by limited space in the spinal canal. The patient may either be born with a narrow backbone, or it may narrow over time (most commonly due to age-related degeneration).
In its early phases, spinal stenosis may not trigger symptoms. However, as the condition progresses and the spinal canal narrows, spinal nerves can become compressed. Nerve impingement from spinal stenosis can lead to:
- Chronic back pain
- Numbness
- Tingling
- Weakness
- Pain that radiates into the extremities (a leg or foot)
- Difficulty walking, especially for prolonged periods
In the late stages of spinal stenosis, patients may experience more severe neurological symptoms, such as bladder and/or bowel dysfunction. Problems with sexual function may also occur in patients with severe spinal stenosis.
What Happens if You Let Spinal Stenosis Go Untreated?
If you let spinal stenosis go untreated, your symptoms will worsen over time and eventually impact your quality of life. Left untreated, this spinal condition leads to increased nerve compression and irritation. Eventually, failing to receive professional treatment for spinal stenosis can lead to permanent spinal cord damage.
What Is the Best Treatment for Spinal Stenosis of the Lower Back?
In many cases, the best treatment for spinal stenosis of the lower back is decompressive laminectomy. This form of spinal decompression involves removing all or some of the lamina to create more space in the spinal canal. Given that spinal stenosis is characterized by the narrowing of the spinal canal, this procedure can resolve stenosis symptoms.
What is a Laminectomy?
A laminectomy is a type of spinal decompression surgery. During the procedure, a surgeon removes the smallest possible portion of the lamina from the affected spinal segment. The lamina is a piece of bone that covers the posterior side of the backbone.
According to a study published in Surgical Neurology International, lumbar laminectomy is one of the most commonly performed lumbar procedures for spinal stenosis. It’s been a prevalent form of spinal surgery for multiple decades, with an average of 34 laminectomy discharges per 100,000 adults annually from 1998 to 2008.
What Is the Difference Between a Laminectomy and a Decompression?
The difference between a laminectomy and a decompression is that laminectomy is a specific procedure, while decompression is a treatment category. Many different procedures fall under the decompression category, including laminectomy.
Other forms of decompression surgery include:
- Laminotomy
Laminotomy involves removing only a part of the lamina, while laminectomy involves removing all (or almost all) of the lamina.
- Discectomy
Discectomy, as the name suggests, involves removing some or all of an intervertebral disc. This decompression procedure is mainly done for patients with a herniated, slipped, or bulging disc.
- Foraminotomy
During a foraminotomy, the surgeon creates more space around one of the bones in the spinal canal (known as the foramen). This area creates the opening through which nerve roots exit the spinal canal. By enlarging it, your surgeon can resolve nerve root impingement.
Decompression can also refer to non-surgical spinal treatments. Many chiropractors perform non-surgical spinal decompression, which typically involves motorized traction therapy. During this treatment, the patient lies on a decompression table, which uses medical technology to realign the spinal structures.
How Is Decompression Laminectomy Done?
Decompression laminectomy is done in the following steps:
- Administer anesthesia.
A laminectomy is performed while the patient is fully asleep. So, to start, the patient is given general anesthesia. Once the patient has fallen asleep, the incision site is cleaned and prepped.
If spinal fusion will be performed with decompression laminectomy, the surgeon may prep the hip area to acquire a bone graft. However, a donor bone graft may also be used.
- Make an incision and access the spine.
Next, the surgeon will make an incision to access the spine. The conventional approach is a posterior incision, which is made over the back. With this approach, the back muscles must be moved to the side so that the surgeon can reach the spinal canal.
- Remove the lamina with specialized tools for each affected vertebra.
With complete access to the spine, the surgeon can remove the lamina. X-ray technology may be used to confirm the affected vertebra(e). Special tools, such as bone-biting tools or drills, are then used to extract the lamina, and the process is repeated for each affected vertebra.
At this point, the surgeon may also extract bone spurs and/or thickened spinal ligaments to fully resolve the patient’s spinal stenosis symptoms.
- Complete spinal fusion, if needed.
Conventionally, surgeons perform spinal fusion with a laminectomy to reduce the risk of instability. Fusion, which would be done between steps three and four listed above, involves positioning bone graft material in between the targeted vertebrae. This graft causes the vertebrae to slowly fuse.
Today, many patients want to avoid spinal fusion due to the associated risks. These risks include lost mobility and adjacent disc degeneration. Non-fusion spinal implants can be used as an alternative to reliably stabilize the spine without these complications.
- Suture the incisions closed.
To finish the decompression laminectomy procedure, the surgeon will close the skin and muscle incisions with staples and/or sutures. The patient is then transferred to a recovery area in the hospital, with comprehensive monitoring. Patients are typically released from the hospital in one to two days after decompression laminectomy (or three to four days if spinal fusion is done).
What Is L4 L5 Decompression Surgery?
L4 L5 decompression surgery is a form of spinal surgery that’s done on the L4-L5 segment of the lumbar spine. It’s performed as a treatment for nerve compression in the lumbar spine, which can be triggered by spinal stenosis, spondylolisthesis, herniated disc, and related conditions.
The L4 L5 level is the most commonly affected and surgically treated spinal level for lumbar spinal stenosis. The lumbar spine is generally more susceptible to spinal stenosis because it has greater mobility and undergoes more strain than the rest of the spine.
Decompression Laminectomy With the TOPS System
Decompression laminectomy with the TOPS System can cure spinal stenosis and eliminate the need for spinal fusion to stabilize the spine. As a mechanical implant device intended to be used in the L2 and L5 segments, the TOPS System is an ideal option for lumbar spinal stenosis patients.
The TOPS System replaces the tissues removed during decompressive laminectomy. It moves in all directions, allowing the patient a complete yet controlled range of spinal mobility. As a result, patients can comfortably flex, bend, walk, twist, and partake in various activities after laminectomy with TOPS.
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As an alternative to spinal fusion with decompression laminectomy, the TOPS System is an advanced treatment option for patients with lumbar spinal stenosis. Reach out to a specialist in your area for more information.
Spinal Stenosis: Self-Care Rules
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If you’ve been diagnosed with spinal stenosis, self-care should be prioritized as part of your recovery. While it’s crucial to visit a physician for a treatment plan, much of the healing process will rely on your own recovery efforts.
Self-care for spinal stenosis involves paying close attention to your symptoms, following your physician’s recommendations, and working to improve your health. Read on to learn more about our spinal stenosis self-care tips.
How Do You Stop Stenosis From Progressing?
To stop stenosis from progressing, it’s crucial to follow all of your physician’s recommendations and treatment suggestions. For most patients, these recommendations include:
- Maintaining good posture
Maintaining good posture is an excellent self-care strategy for spinal stenosis. Proper posture keeps the spine in alignment, which reduces the strain on the spinal structures. It can also help lessen nerve compression, which is a key issue for patients with spinal stenosis.
- Avoiding high-impact activities
High-impact activities like running, weightlifting, and contact sports, as well as activities that involve excessive spinal extension, can worsen spinal stenosis. Avoiding these activities can help prevent further injury to the spine.
- Practicing healthy body mechanics
Similar to good posture, proper body mechanics help minimize the impact on the spine with day-to-day motion. With healthy body mechanics, the spine is in a neutral position when you stand, walk, and exercise.
- Staying active
Although it’s important to avoid high-impact physical activity with spinal stenosis, don’t write off exercise altogether. Staying active helps with the spinal stenosis healing process by promoting circulation, maintaining muscle strength, and preventing loss of mobility.
- Attending physical therapy
Physical therapy is considered a crucial component of spinal stenosis treatment. Typically, physical therapists recommend a personalized set of exercises to strengthen the abdominal muscles, as well as stretches to improve mobility. Your PT may also recommend passive therapies, such as electrical stimulation, massage therapy, and acupuncture.
- Taking breaks from sitting
If you work at a desk, you likely spend most of your day sitting down. Unfortunately, prolonged periods of sitting can be damaging to the spinal discs and back muscles.
To care for your spine, try the “20-8-2” rule. This guideline recommends that people sit for 20 minutes, stand for eight minutes, and move around for two minutes. Then, repeat.
While this rule will likely need to be adjusted to fit your needs, it’s a great place to start for spinal stenosis patients.
- Prioritizing sleep
If you’re suffering from spinal stenosis or another spinal disorder, high-quality sleep is crucial. The deep stages of sleep increase circulation to the muscles, promote stress relief, and help reduce inflammation.
Unfortunately, back pain from spinal stenosis can make it difficult to fall asleep at night. Many people find that the best sleep position for spinal stenosis is the fetal position. Additionally, investing in a top-caliber mattress, such as a latex or memory foam mattress, may help you fall asleep with spinal stenosis pain.
How Can I Help Myself With Spinal Stenosis?
To help yourself with spinal stenosis, follow the tips provided above to stop the condition’s progression. These tips, including staying active, improving your posture, and preventing activities that stress the spine will help your body heal from spinal stenosis. Additionally, curbing the progression of this spinal condition may help you avoid invasive treatments in the future.
Does Lying Down Help Spinal Stenosis?
Lying down may help reduce spinal stenosis symptoms in some patients. Most patients find that the best sleeping position for spinal stenosis is lying on the side of the body with the knees curled towards the chest in a fetal position.
Though lying down can lessen spinal stenosis pain, it’s crucial to avoid staying in one position, whether it be lying down, sitting, or standing, for too long. Except for when you’re sleeping, of course, remaining in one position for an extended period can lead to muscle tension and increased pain.
Is a Heating Pad Good for Spinal Stenosis?
A heating pad is good for spinal stenosis, especially if you’re experiencing muscle tension and tightness from the condition. Heat therapy promotes muscle relaxation and boosts circulation to the area. Circulation improves the flow of healing nutrients and oxygen to the injured spinal tissue, which promotes healing.
What is The Best Vitamin For Spinal Stenosis?
The best vitamins for spinal stenosis include vitamin B12, vitamin B9, vitamin C, vitamin D, magnesium, and omega-3 fatty acids. Vitamin supplementation can be used as part of your spinal stenosis self-care strategy, but check with your physician before starting any new supplement.
- Vitamin B12
Vitamin B12 helps the body’s nervous system function properly. This makes it a valuable supplement for anyone suffering from neurological symptoms, including weakness, tingling, and numbness that can be caused by spinal stenosis.
In a study published in the European Spine Journal, 72% of patients with spinal disorders reported improved symptoms after vitamin B12 supplementation.
- Vitamin B9
Vitamin B9 (also known as folate or folic acid) is another B vitamin. As with all B vitamins, folate promotes a healthy nervous system and helps the body turn carbohydrates into glucose for energy.
In a 2010 study funded by the NIH, researchers discovered that folate promoted healing in damaged spinal cord tissue in rats. These results indicate that folate supplementation may assist the healing process in patients with nerve-related injuries, such as nerve impingement caused by spinal stenosis.
- Vitamin C
Vitamin C plays a few critical roles in healing and recovery. For one, the body needs vitamin C to produce specific neurotransmitters, as well as collagen and L-carnitine. It’s also a key part of connective tissue, which is essential for wound healing.
Additionally, with powerful antioxidant properties, vitamin C can help fight free radical damage and cell death. This can be especially helpful for patients who are recovering from spinal stenosis surgery.
- Vitamin D
Osteoporosis is a key risk factor for spinal stenosis and other spinal injuries. Vitamin D can help ward off osteoporosis because it helps the body absorb calcium.
Sun exposure is one of the best methods of vitamin D supplementation. But, people who don’t consistently spend time in the sun can consider supplements or foods that are rich in vitamin D, such as egg yolks and fatty fish.
- Magnesium
Magnesium is an essential nutrient that plays several different roles in the body. It supports muscle function, nerve function, and energy production. Magnesium has also been found to provide neuroprotective benefits, suggesting that it may help prevent nerve damage in spinal stenosis patients.
- Omega-3 Fatty Acids
A specific omega-3 fatty acid known as docosahexaenoic acid, or DHA, can be a helpful supplement for spinal stenosis patients. As the brain’s main fatty acid, DHT is crucial for central nervous system function and helps regulate cell membrane receptor activity.
Additionally, a 2019 study found that omega-3 fatty acid supplementation may help protect against the progression of spinal disc degeneration. So, omega-3 fatty acid supplements may help patients with degenerative spinal stenosis avoid further damage to the spine.
If at-home therapies fail to improve your spinal stenosis symptoms, visit a specialist in your area to learn about the available treatment options, such as the TOPS System from Premia Spine.
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Is Spinal Stenosis Hereditary?
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With a family history of any medical condition, it’s natural to worry that you’ll eventually develop the condition. This goes for spinal conditions, including spinal stenosis, which affects an estimated 250,000 to 500,00 residents of the United States.
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But, is spinal stenosis hereditary? Can you inherit it from your parents? In this article, we’ll address these common questions to resolve concerns surrounding your risk of developing spinal stenosis.
Does Everyone Get Spinal Stenosis With Age?
Almost everyone will get spinal stenosis with age. This is because it tends to develop as a result of the natural effects of aging on the spine. However, this doesn’t mean that everyone will require spinal surgery at some point.
Spinal stenosis refers to the narrowing of the spinal canal. For many patients, this process leads to nerve compression, which triggers pain and neurological symptoms. However, if the narrowed spinal canal doesn’t cause nerve impingement, the patient may be asymptomatic.
How Does The Spine Change With Age?
The spine undergoes a variety of changes during the aging process, including:
Cartilage Degeneration
For one, the cartilage that protects the facet joints wears down over time. When this occurs, the bones rub against one another, leading to pain and inflammation.
As the cartilage degenerates with age, patients may develop bone spurs. Bone spurs are the body’s response to friction between bones, and they can take up space within the spinal canal, leading to spinal stenosis.
Disc Degeneration
Another effect of aging on the spine is disc degeneration. A cushion-like disc is located between each vertebra of the spine. This disc absorbs impact to prevent damage to the spinal structures.
Unfortunately, the aging process causes the intervertebral discs to wear down, becoming thinner and drier. Eventually, this may cause the disc to bulge, herniate, or rupture. A damaged intervertebral disc can extend into the spinal canal and cause spinal stenosis.
Thickened Ligaments
Ligaments are coarse bands of tissue that connect bone to bone. The ligaments of the spine work with tendons and muscles to keep the spine stable.
With age, the ligaments of the spine can become thicker, especially in patients with arthritis. Thickened spinal ligaments may bulge into the spinal canal and cause spinal stenosis.
Who is Prone To Spinal Stenosis?
Various factors may make certain people more prone to spinal stenosis than others. These factors include:
- Age
As discussed in the previous section, the natural aging process often leads to spinal stenosis. So, people over the age of 50 are more prone to spinal stenosis than younger individuals.
- Gender
Women are more prone to spinal stenosis than men. Though the exact reasons for this risk factor are uncertain, experts think it may be linked to pregnancy, structural pelvic differences, and female hormone levels.
- Genetic factors
Some people are born with a narrower spinal canal than others. A naturally narrow spinal canal makes you more likely to develop spinal stenosis, especially when it’s combined with other risk factors.
- Other spinal conditions
Patients with a preexisting spinal condition, such as scoliosis or a spinal injury, have a higher risk of developing spinal stenosis. Trauma to the spine triggers the body’s natural repair process, which involves inflammation. If the spinal injury isn’t properly treated, the swelling can become chronic and may compromise the space in the spinal canal, leading to stenosis.
Will I Have Spinal Stenosis If My Parents Have It?
You won’t necessarily have spinal stenosis if your parents have it. The condition isn’t thought to be inheritable, though genetic factors can influence your risk of developing spinal stenosis.
A 2015 study evaluated the influence of genetic factors compared to environmental factors for lumbar spinal stenosis. It concluded that lumbar spinal stenosis is highly genetic and disc degeneration is one way in which genetics can affect spinal stenosis.
How Long Can I Live With Spinal Stenosis?
You can live with spinal stenosis for the rest of your life. This spinal condition isn’t life-threatening, although it may be disabling in its severe forms.
With this in mind, if spinal stenosis is left untreated, it can lead to serious, potentially-permanent nerve injury. One form of nerve injury that may result from lumbar spinal stenosis is cauda equina syndrome, which occurs when all of the nerves in the lower spine become compressed. If cauda equina syndrome isn’t properly treated, it can lead to permanent paralysis in one or both legs and permanent loss of bowel or bladder control.
Seek out immediate medical attention if you’ve been diagnosed with spinal stenosis and experience any of the following signs of cauda equina syndrome:
- Severe lower back pain
- Saddle anesthesia, which is loss of sensation in the buttocks, perineum, and inner thighs
- Loss of bladder or bowel control
- Loss of sensation in both legs
- Loss of motor function in both legs
- Lost or reduced reflexes
What is The Final Outcome of Spinal Stenosis?
The final outcome of spinal stenosis depends on the severity of the condition, the treatment plan, and how soon the patient sought out treatment.
The Outcome of Spinal Stenosis With Non-Surgical Treatment
For some patients, non-surgical therapies fully resolve spinal stenosis. This is often the case when spinal stenosis is addressed in its early stages. Treatments that may help patients recover from spinal stenosis without surgery include:
- Physical therapy
- Rest and lifestyle modifications
- Anti-inflammatory medication
- Chiropractic care
- Acupuncture
- Massage therapy
- Epidural steroid injections
For patients who improve with non-invasive treatments, it’s crucial to keep up with spinal care recommendations, such as maintaining proper posture, investing in a supportive desk chair, staying active, and avoiding activities that strain the spine.
The Outcome of Spinal Stenosis With Surgical Treatment
Patients who don’t recover after six to 12 months of non-surgical spinal stenosis treatment may need surgery for symptom relief. Thankfully, decompression surgery generally provides good outcomes for spinal stenosis patients, offering long-term relief from back pain and neurological symptoms.
Decompression surgery for spinal stenosis involves alleviating nerve compression by creating more space in the spinal canal. This is most commonly achieved with a laminectomy. This form of decompression surgery involves removing a small portion of the lamina (the roof of the spinal canal) to open up the spinal canal.
Oftentimes, surgeons perform spinal fusion with decompression surgery to avoid spinal instability. Fusion involves permanently merging the affected vertebrae with bone graft material. This eradicates all motion at the targeted segment.
Unfortunately, spinal fusion can lead to mobility restrictions in spinal stenosis patients. This, combined with the risk of adjacent segment degeneration, can compromise the outcome of surgical spinal stenosis treatment.
What is The Newest Treatment For Spinal Stenosis?
The newest treatment for spinal stenosis is minimally-invasive spine surgery with the TOPS System. This device has long been used abroad to restore mobility and resolve symptoms in spinal stenosis patients. But, it’s only beginning to gain prominence in the United States as a safe, effective alternative to spinal fusion surgery.
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The TOPS System is a dynamic spinal implant that creates a controlled range of motion in the spine. It’s designed to treat lumbar spinal stenosis and spondylolisthesis. Unlike spinal fusion, the TOPS System allows patients to recover quickly after surgery and regain the ability to move the spine in all directions without the risk of instability.
Contact a specialist in your area to learn more about spinal stenosis and the latest innovations available to treat it.
What is The Best Painkiller For Spinal Stenosis?
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If you’re suffering from spinal stenosis pain, you know that it can disrupt your daily activities. Unfortunately, severe spinal stenosis pain often limits patients’ mobility, making it difficult to perform basic tasks.
Painkillers are commonly included in spinal stenosis treatment plans. In combination with physical therapy, lifestyle modifications, and other therapies, pain medications may help alleviate patients’ symptoms.
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In this article, we’ll discuss the best painkillers for spinal stenosis, as well as other treatment routes to consider.
Why is My Spinal Stenosis So Painful?
Spinal stenosis is painful because as the spinal cord narrows, it puts pressure on the spinal cord and nerve roots. When these nerves become compressed, it causes pain, cramping, weakness, and/or tingling that can radiate from the back to the buttocks and down the legs.
Additionally, spinal stenosis can become more painful with certain motions and activities. These includes:
- Long periods of walking
- Jumping
- Excessively bending and/or twisting the spine
- Contact sports, like football, basketball, and hockey
- Lifting with a rounded back
How Do You Prevent Spinal Stenosis From Getting Worse?
To prevent spinal stenosis from getting worse:
- Avoid motions and activities that strain the spine.
- Start a low-impact exercise routine to maintain mobility, flexibility, and muscle strength.
- Work on improving your posture, as proper posture alleviates strain on the spinal tissues and structures.
- Quit smoking and using nicotine products, as nicotine reduces blood flow to your spine.
- Maintain a healthy weight, as extra body weight puts extra stress on the spine.
- Practice gentle stretches to prevent muscle tension, which can worsen spinal stenosis pain.
What Helps Relieve Severe Spinal Stenosis Pain?
Medications, physical therapy, alternative treatment methods, and surgery can help relieve severe spinal stenosis pain.
Physical Therapy
Physical therapy is one of the most effective non-surgical treatment options for spinal stenosis. PT helps alleviate pressure on the spinal nerves by promoting proper spinal alignment through targeted exercises, stretches, and alternative therapies like heat/cold therapy and electrical stimulation.
The benefits of physical therapy for lumbar spinal stenosis include:
- Reduced pain and stiffness
- Relief from nerve compression
- Strengthened abdominal muscles
- Improved lumbar spine alignment
Lower Back Pain Medication
Lower back pain medication for severe spinal stenosis pain may include NSAIDs, antidepressants, anti-seizure medication, or corticosteroid shots. Medication can provide near-immediate relief from severe spinal stenosis pain, but may carry the risk of side effects and complications.
- NSAIDs
NSAIDs, or nonsteroidal anti-inflammatory drugs, are common medications used to treat pain and inflammation. They’re available over the counter in the form of Advil, Aleve, and Motrin, as well as in prescription-strength varieties.
- Antidepressants
Antidepressant medications may help with severe spinal stenosis pain by boosting levels of specific neurotransmitters in the spinal cord. These neurotransmitters lessen pain signals, leading to moderate pain relief. Unfortunately, antidepressants can take several weeks to provide significant relief from spinal stenosis pain.
- Anti-seizure medication
Certain anti-seizure medications, including gabapentin and pregabalin, can help alleviate pain stemming from nerve damage.
- Epidural steroid injections
Epidural steroid injections are commonly used for lower back pain caused by inflammation in the spinal nerves. The corticosteroid in the shot removes the proteins that cause swelling in the spinal nerves, leading to spinal stenosis pain relief.
However, physicians generally only allow patients to receive two to three injections per year. In excess, these injections can cause tissue damage.
- Muscle relaxants
Muscle relaxants can improve muscle spasms, numbness, tingling, and radiating pain caused by spinal stenosis.
What is The Best Muscle Relaxer for Spinal Stenosis?
The best muscle relaxer for spinal stenosis can vary from patient to patient. However, the best options include baclofen, cyclobenzaprine, and methocarbamol.
- Baclofen
Baclofen is an antispastic drug that’s widely used to treat muscle spasms in spinal cord conditions, including lumbar spinal stenosis. It’s FDA-approved to treat symptoms of muscle spasticity caused by spinal conditions. By influencing the spinal nerves, baclofen has been found to alleviate pain, improve muscular motion, and loosen stiff muscles.
The most common side effects of baclofen include drowsiness, weakness, dizziness, difficulty sleeping, nausea, more frequent urination, headaches, and constipation.
- Cyclobenzaprine
Cyclobenzaprine relieves muscle spasms from musculoskeletal conditions by working in the brain to reduce muscle hyperactivity. It may be used in patients with lumbar spinal stenosis to reduce pain and improve function. Unfortunately, cyclobenzaprine stops being effective after two to three weeks of use.
The most common side effects of cyclobenzaprine include clumsiness, unsteadiness, fainting, confusion, dry mouth, constipation, drowsiness, nausea, and heartburn.
- Methocarbamol
Methocarbamol blocks pain signals that enter the brain, providing relief from pain and muscle spasms. It has less of a sedating effect and lower rates of abuse when compared to other muscle relaxers.
The most common side effects of methocarbamol include drowsiness, dizziness, stomach upset, nausea, vomiting, lightheadedness, headaches, and blurred vision.
What is The Best Treatment for Spinal Stenosis at L4 and L5?
The best treatment for spinal stenosis at L4 and L5 that doesn’t improve with non-surgical methods is spinal decompression with the TOPS System.
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Spinal decompression is widely performed for spinal stenosis. It involves alleviating pressure on the spinal nerves by removing structures or tissues. Laminectomy, a common form of spinal decompression for spinal stenosis, involves removing some or all of the lamina, which is the piece of bone that covers the back of the spinal canal.
Spinal fusion has conventionally been performed after spinal decompression surgery to prevent instability. Fusion involves using bone graft material to permanently connect the affected vertebrae. Unfortunately, this process permanently limits patients’ mobility and creates the risk of adjacent segment degeneration.
The TOPS System is an excellent alternative to spinal fusion for severe spinal stenosis at L4 and L5. It’s a mechanical implant device that replaces the tissues removed during the decompression procedure. It also creates a controlled range of motion, allowing patients to bend, flex, and twist without pain after the operation.
If you’re suffering from spinal stenosis symptoms that don’t improve despite conservative therapies, find a specialist in your area to learn more about the latest treatment options.
How Do You Fix Spinal Stenosis Without Surgery?
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Spinal stenosis is a leading cause of chronic back pain among older adults. It typically results from age-related wear and tear on the spine, which causes the spinal canal to narrow. With spinal stenosis, spinal structures often press on nearby nerves, leading to pain, numbness, tingling, and related symptoms.
Patients who have received a spinal stenosis diagnosis may be concerned about requiring surgery to fix their symptoms. While severe forms of this condition generally require surgery, there are various non-surgical methods of treating spinal stenosis in its earlier stages.
This article will discuss the existing methods of treating spinal stenosis without surgery. We’ll also explore current surgical treatment options for severe spinal stenosis.
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Can Spinal Stenosis Get Better Without Surgery?
Most spinal stenosis cases can be successfully treated without surgery. In fact, an estimated 70% of patients with lumbar spinal stenosis can effectively manage their symptoms with non-surgical treatments alone. Only 10% to 15% of lumbar stenosis patients must undergo surgery for their symptoms.
Although spinal stenosis patients often don’t require surgery, prompt treatment is essential to recovering from this condition. Patients generally need a combination of conservative therapies, such as physical therapy, anti-inflammatory medications, lifestyle changes, and steroid shots, to recover.
Can You Reverse Spinal Stenosis Naturally?
Unfortunately, spinal stenosis isn’t “reversible” without surgery. Once the spinal canal has narrowed, surgery is the only way to open it back up. However, it is often possible to experience lasting relief from spinal stenosis symptoms with natural treatments alone.
To treat spinal stenosis naturally, start by scheduling prompt appointments with a spine specialist in your area. You’ll need to be monitored by a skilled medical professional and receive personalized recommendations throughout your recovery process.
With that said, physical therapy and lifestyle adjustments are among the best natural treatments for spinal stenosis.
Physical Therapy For Spinal Stenosis
Physical therapy is widely recommended for spinal stenosis patients. It can benefit patients recovering from spinal stenosis naturally, as well as those recovering from spine surgery.
In physical therapy, patients generally receive a personalized selection of exercises and stretches. These are designed to improve muscular support for the spine while promoting mobility. Additionally, your physical therapist may recommend alternative therapies, such as acupuncture, massage therapy, and electrical stimulation, to naturally encourage healing.
Lifestyle Adjustments For Spinal Stenosis
Adjusting your lifestyle can have a major impact on your spinal stenosis recovery process. Aspects of your lifestyle including your exercise routine, weight, and diet can make the difference in your ability to heal from spinal stenosis.
Your weight affects the amount of strain on your spine when you stand, walk, and exercise. Excess weight can place pressure on the intervertebral discs and spinal nerves, increasing your risk of developing neurological symptoms.
Additionally, your exercise routine can help or hinder your spinal stenosis recovery. Exercising regularly is important for spinal stenosis patients to remain mobile, retain muscle strength, and promote circulation. However, avoid activities that put the spine at risk (such as weightlifting, gymnastics, and contact sports).
What is The Newest Treatment For Spinal Stenosis?
Traditionally, spinal stenosis surgery has involved laminectomy with spinal fusion. Laminectomy alleviates nerve compression by extracting some or all of the lamina. Spinal fusion prevents instability after laminectomy by permanently fusing the affected vertebrae.
Unfortunately, spinal fusion creates the risk of adjacent segment degeneration and diminished mobility. Additionally, the rate of patients who require revision surgery after spinal fusion ranges from 9% to 45%.
With spinal fusion’s significant downsides, patients have long sought out treatment alternatives. Recent medical advancements have facilitated the release of many notable new spinal stenosis treatment options, including regenerative therapies, IDET, and non-fusion implants.
- Regenerative therapies
The use of regenerative medicine to treat pain caused by degeneration, disease, or trauma is expanding in the United States. Stem cell therapy, for example, can be used to help regenerate damaged spinal tissue in spinal stenosis patients.
Stem cells can regenerate into any cell type. By injecting stem cells (harvested from the patient or a donor) into the area affected by spinal stenosis pain, it’s possible to promote healing without surgery.
- IDET
IDET stands for intradiscal electrothermal coagulation. It can be used to treat disc degeneration in the lumbar spine without surgery.
IDET involves inserting a needle into the lumbar disc region. A catheter is moved through the needle to gently heat the tough disc exterior. This process can reinforce collagen fibers in the disc exterior, potentially offering pain relief for patients suffering from spinal stenosis caused by intervertebral disc damage.
- Non-fusion implants
Non-fusion spine implants are specialized surgical devices that can be used instead of spinal fusion for spinal stenosis. While these devices come in many forms, they generally serve the purpose of stabilizing the spine without permanently joining the affected vertebrae.
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In cases of severe spinal stenosis, non-fusion implants may be used in conjunction with spinal decompression surgery. The implant can replace the tissues removed during the decompression procedure (typically laminectomy) to prevent stability and preserve motion.
Lumbar Spinal Stenosis Surgery Without Fusion
The TOPS System is a non-fusion spinal implant that facilitates lumbar spinal stenosis surgery without fusion. It’s unique in that it restores spinal motion in all directions, including flexion, extension, axial rotation, and lateral bending. TOPS is designed specifically for patients with spinal stenosis of the lumbar region.
TOPS features internal metal stoppers that replace the natural bony elements that support the spine during axial rotation. It’s also anchored to the spine with four polyaxial pedicle screws for support. But, with a patented crossbar configuration, TOPS applies less force on the screws than fusion implants, allowing for greater longevity.
Rest assured, most spinal stenosis patients recover without the need for surgery. But, if you’re suffering from a severe form of this spinal condition, know that there are many innovative treatment options at your fingertips.
What Causes a Spinal Stenosis Flare-Up?
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Spinal stenosis causes flare-ups from a narrowed spinal canal. With this condition, the spinal cord may press on spinal nerves and/or the spinal cord, causing pain and neurological symptoms.
Flare-ups from spinal stenosis can interrupt your day-to-day life, holding you back from the activities you love the most. But, understanding these flare-ups, their causes, and how to treat them may help you better manage spinal stenosis.
This article will explore spinal stenosis flare-ups, including at-home remedies and surgical solutions that can alleviate them.
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Why Does Spinal Stenosis Come and Go?
Lumbar spinal stenosis tends to have symptoms that come and go. This is especially true when the condition is in its early stages. When spinal stenosis patients suddenly experience symptoms (or worsened symptoms), it’s known as a flare-up.
Spinal stenosis likely comes and goes due to nerve compression. Although the spinal canal is narrowed with this condition, the spinal structures may not press on spinal nerves. However, if various movements or lifestyle factors lead to nerve compression, the patient will likely experience a flare-up.
If spinal stenosis worsens, the patient is likely to experience lasting symptoms, rather than periodic flare-ups.
What Causes Spinal Stenosis Flare-Ups?
Factors that can trigger a spinal stenosis flare-up include:
- Prolonged periods of walking or standing
- Poor posture
- Excessively bending, twisting, or otherwise straining the spine
- Being inactive for prolonged periods
- Muscle spasms
Other factors, including smoking and carrying excess weight, can lead to more frequent flare-ups.
How Do You Treat a Spinal Stenosis Flare-Up?
If you’re experiencing a spinal stenosis flare-up, you can likely experience relief with at-home remedies. However, make sure that you’re scheduling regular appointments with a spine specialist, too. If spinal stenosis goes untreated, it can worsen, leading to exacerbated flare-ups.
What Helps Spinal Stenosis Pain at Home?
At-home remedies that can help curb spinal stenosis flare-ups include:
- Over-the-counter medications, such as NSAIDs. These medications offer relief for pain and inflammation, which can help you overcome spinal stenosis flare-ups. But, if over-the-counter options don’t offer adequate relief, you may want to talk to your doctor about prescription spinal stenosis medications.
- Heat and cold therapy. A heating pad can help ease muscle aches and tension, while a cold pack can help ease inflammation and pain.
- Gentle physical activity and stretching. Although it may be counterintuitive, exercise has proven to help alleviate spinal stenosis symptoms. Just make sure that your exercise choices are gentle and low-impact, such as taking short walks or swimming.
- Topical pain relievers, such as Icy Hot or Bengay. These topical medications can help ease spinal stenosis pain when you’re struggling with a flare-up.
In addition to these home remedies, spinal stenosis patients who are suffering from pain flare-ups may benefit from:
- Physical therapy can offer pain relief through muscle strengthening, stretching, and targeted exercises
- Massage therapy, which can alleviate muscle tension and release pressure on the spine
- Acupuncture can provide pain relief and greater mobility by stimulating your body’s healing response
- Chiropractic care, which improves spinal alignment through manual adjustments
What Kind of Trauma Causes Spinal Stenosis?
Spinal stenosis is most often caused by age-related spinal degeneration. Due to accumulated wear and tear over time, many adults experience spinal stenosis in their later years.
However, spinal stenosis can also be caused by sudden trauma to the spine. This may result from an auto accident, sports, or workplace injury.
A vertebral dislocation or fracture can damage the spinal canal. This can lead to displaced bone tissue, which may reduce the open space in the spinal canal. The displaced bone may press on spinal nerves or the spinal cord, leading to spinal stenosis symptoms.
Inflammation after a sudden spinal injury can also contribute to spinal stenosis pain.
What Does a Neurosurgeon Do for Spinal Stenosis?
A neurosurgeon specializes in surgery on the nervous system, namely the spinal cord and brain. Your spinal cord extends from your brain down to your lower back and is responsible for transporting nerve signals throughout your body.
Patients with spinal stenosis may see a neurosurgeon if they’re not responding to non-surgical treatment options after several months or years. A neurosurgeon can advise you on spinal stenosis surgery and whether or not it’s a good fit for you.
You may be a good candidate for spinal stenosis surgery if any of the following are true:
- You’ve tried non-surgical treatments for six to 12 months and haven’t experienced symptom improvement.
- Persistent spinal stenosis symptoms inhibit your day-to-day activities and overall quality of life.
- You’re in severe, chronic pain caused by spinal stenosis.
If you’re a good fit for spinal stenosis surgery, your neurosurgeon can perform a laminectomy with or without spinal fusion. A laminectomy is a form of spinal decompression involving part of the lamina, a bone covering the back of the spinal canal. Removing a section of this bone can relieve nerve compression caused by spinal stenosis.
Spinal fusion has conventionally been performed after spinal decompression. It prevents instability by permanently fusing the affected vertebrae using a bone graft. Unfortunately, this process also limits patients’ mobility and creates the risk of adjacent segment disease, among other complications.
Progressive and Reliable Lumbar Spinal Stenosis Surgery Options
Patients now have spinal fusion alternatives to consider for lumbar spinal stenosis surgery. A non-fusion spinal implant, like the TOPS System, is an innovative solution that stabilizes the spine without compromising the patient’s motion.
The TOPS System is specifically designed for lumbar spinal stenosis and spondylolisthesis. It’s implanted after spinal decompression to establish a controlled range of motion in the lumbar spine. In addition to greater spinal mobility, the TOPS System provides a much shorter recovery period when compared to spinal fusion.
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If you’re suffering from persistent spinal stenosis flare-ups, schedule an appointment with a spine specialist to learn more about the advanced treatment options available today.
What Causes Spinal Stenosis?
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Understanding the potential causes of various medical conditions can help protect your health for years to come. This is certainly true of back pain, which is one of the most prominent medical problems today. It affects an estimated eight out of 10 Americans at some point in life and can stem from conditions like spinal stenosis.
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Spinal stenosis is a common source of chronic back pain. It develops when the spinal canal narrows, often due to age-related changes in the spine. Working to prevent spinal stenosis can help preserve the condition of your spine so that you can remain mobile in the later stages of life.
In this article, we’ll discuss spinal stenosis and its most common causes.
How Do You Develop Spinal Stenosis?
You develop spinal stenosis either from age-related wear and tear on the spine or genetic factors. The former is known as degenerative spinal stenosis, and the latter is known as congenital spinal stenosis.
The spine undergoes significant strain over a lifetime. This accumulated wear and tear, combined with the body’s natural aging process, can lead to bone spurs, thickened spinal ligaments, herniated discs, and various other spinal injuries. All of these factors reduce the amount of space in the spinal canal, leading to spinal stenosis.
Virtually everyone develops degenerative spinal stenosis later in life. However, some people are more likely to develop symptoms of spinal stenosis that require treatment. Risk factors for spinal stenosis include:
- Previous spinal trauma
- Repeated strain on the spine, which is commonly seen in athletes
- Scoliosis
- Spinal tumors
- Other underlying spinal problems
What Is the Main Cause of Spinal Stenosis?
The main cause of spinal stenosis is age-related spinal changes. More specifically, osteoarthritis is the primary cause of this spinal condition. Osteoarthritis develops gradually as people age, causing joint inflammation from the breakdown of protective cartilage.
Osteoarthritis is also known as wear and tear arthritis. It can lead to spinal stenosis when it affects the joints located between the vertebrae of the spine. As the cartilage that cushions these joints degenerates, bone spurs can develop and narrow the spinal canal.
The ligaments in the spinal canal can also thicken as the aging process advances, potentially leading to spinal stenosis.
Can Stress Cause Spinal Stenosis?
Both physical and psychological stress can cause spinal stenosis. Physical stress gradually contributes to spinal degeneration, which can lead to spinal stenosis. However, people often overlook the fact that psychological stress can also trigger spinal stenosis, for a few different reasons.
For one, emotional stress tends to make people tense their muscles. This muscle tension can throw off the alignment of the spine, ultimately placing additional impact on the spine with day-to-day motions.
Additionally, according to a 2010 study published in the International Association for the Study of Pain, chronic stress causes spinal neuroinflammation. Spinal neuroinflammation, which is an inflammatory response in the spinal cord, can contribute to and worsen spinal stenosis symptoms.
What Are the Warning Signs of Spinal Stenosis?
The warning signs of spinal stenosis are back pain that improves when you sit or bend forward, neurological symptoms that radiate into the legs and/or feet, an abnormal gait, and difficulty walking and/or standing. Some physicians ask if patients experience symptom relief when they lean forward on a shopping cart, which is common among people with spinal stenosis.
If you experience one or multiple of the signs listed above, start with at-home care methods. If the symptoms don’t resolve within a few weeks, schedule an appointment with a spinal specialist for an evaluation.
Is Spinal Stenosis Permanent?
Yes, spinal stenosis is permanent. The only way to open the spinal canal back up is with surgical spinal decompression. However, many patients can manage and improve their symptoms with non-surgical spinal stenosis treatment.
Is Spinal Stenosis a Serious Problem?
Yes, spinal stenosis is a serious problem. Although it’s extremely common, it can cause permanent damage if it’s left untreated. Since it involves the spinal nerves and spinal cord, permanent nerve injury (including paralysis) is a legitimate risk of this condition.
Spinal stenosis can also gradually lead to disability if it’s not managed properly. The condition naturally progresses with time, potentially making it more difficult for you to work, exercise, socialize, and enjoy all of your favorite activities.
Though spinal stenosis is undoubtedly a medical condition that you need to take seriously, it can be successfully managed with professional medical treatment.
What Are The Symptoms of Spinal Stenosis?
The symptoms of spinal stenosis include:
- Persistent lower back pain
- Neurological symptoms (numbness, weakness, and tingling) stemming from the lower back to the buttocks, thighs, and legs
- Sciatica (burning pain that extends from the lower back to the buttocks and backs of the legs)
- Foot drop (weakness in the foot that causes it to slap on the group while walking)
Symptoms of severe spinal stenosis can include difficulty with bladder and bowel control, as well as sexual dysfunction. If this occurs, patients should seek out emergency medical care, as it may be an indication of cauda equina syndrome.
A significant number of spinal stenosis cases don’t cause noticeable symptoms. In these cases, the narrowing of the spinal canal doesn’t lead to nerve impingement. However, as the case progresses, patients are likely to eventually experience symptoms.
How Common is Spinal Stenosis?
Spinal stenosis is fairly common. Degenerative spinal stenosis is significantly more common than congenital spinal stenosis.
In one study, the prevalence of congenital lumbar spinal stenosis among U.S. patients was found to be 4.71% for relative stenosis and 2.62% for absolute stenosis. With relative stenosis, the anteroposterior (AP) dimension of the spinal canal shrinks to 12mm. With absolute stenosis, the AP dimension of the spinal canal shrinks to 10mm or less.
In the same study, the prevalence of relative acquired (degenerative) lumbar spinal stenosis among patients aged 60 to 69 was 47.2%. The prevalence of absolute degenerative lumbar stenosis in this age group was 19.4%.
What is The Surgery For Spinal Stenosis?
The surgery for spinal stenosis is generally a procedure known as decompression laminectomy. Spinal fusion may also be done with this procedure to stabilize the spinal structures and prevent future injury.
A laminectomy is a form of spinal decompression surgery. In this procedure, some or all of the lamina, which comprises the back of the spinal canal, is removed to alleviate nerve compression.
Spinal fusion has conventionally been done after spinal decompression to fuse the affected vertebrae into one bone. But, given that it permanently limits spinal mobility and doesn’t always alleviate the patient’s back pain, alternative treatment methods have recently been developed.
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The TOPS System is one spinal fusion alternative that creates a controlled range of spinal motion after laminectomy. Designed to be used for lumbar spinal stenosis and spondylolisthesis, this non-fusion implant can resolve pain and neurological symptoms without compromising spinal mobility. Patients also have far fewer restrictions on them during the TOPS recovery process when compared to spinal fusion.
If you’re suffering from symptoms of spinal stenosis, contact a spine specialist in your area to learn about your treatment options.
What Is the Latest Treatment for Spinal Stenosis?
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Conventionally, cases of spinal stenosis that can’t be resolved with non-surgical therapies have been treated with laminectomy and spinal fusion. Laminectomy creates more space in the spinal canal, while spinal fusion stabilizes the spine.
Regrettably, spinal fusion is a major surgery that comes with many significant risks and downsides. Along with a sizable percentage of patients who require reoperation, fusion diminishes patients’ spinal flexibility, which can limit their mobility.
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Considering these risks and drawbacks, many medical professionals have been seeking out fusion alternatives that can effectively treat spinal stenosis patients. Now, we have a greater range of treatment options available, the newest of which allows patients to avoid fusion altogether.
Here, we’ll discuss the latest treatment for spinal stenosis and how it may benefit the spinal stenosis recovery process.
Can Spinal Stenosis Get Better Without Surgery?
First off, let’s consider non-surgical treatment options for spinal stenosis. Many patients with mild to moderate cases of spinal stenosis can improve their symptoms without going under the knife. This claim is supported by recent medical research.
A 2022 paper published in the Journal of the American Medical Association evaluated patients with lumbar spinal stenosis and their condition after three years without operative intervention. About one-third of the patients’ conditions improved, about half of patients experienced no change in their symptoms, and 10% to 20% of patients’ symptoms worsened.
With these results in mind, patients with moderate to severe cases of spinal stenosis often require surgery for lasting symptom improvement.
Spinal Stenosis Severity Gradation and Corresponding Treatment Options for Every Grade
Physicians evaluate the severity of spinal stenosis using a grading system. There are three different grading systems that they may choose between the Lee system, the Schizas system, and the Miskin system.
The Lee and Schizas systems are the most popular spinal stenosis grading systems. The Miskin system was more recently developed but has proven to reduce inconsistencies between neuroradiologists and musculoskeletal radiologists.
Patients diagnosed with mild to moderate spinal stenosis based on one of the systems listed below can consider non-surgical treatment options. However, patients with moderate to severe and extreme stenosis will likely need to consider surgery to attain significant relief.
The Lee Grading System
The Lee grading system is based on the amount of separation of the cauda equina using axial T2-weighted images.
- Grade 0 or No Stenosis: No obliteration of the anterior CSF (cerebrospinal fluid) space
- Grade 1 or Mild Stenosis: Mild obliteration of the anterior CSF space, but the cauda equina are distinctly separated
- Grade 2 or Moderate Stenosis: Moderate obliteration of the anterior CSF space, and some cauda equina can’t be visibly separated
- Grade 3 or Severe Stenosis: Severe obliteration of the anterior CSF space, and no cauda equina can be visibly separated
The Schizas Grading System
The Schizas grading system features seven grades based on the shape, size, and structure of the dural sac, as well as the proportion of rootlets to cerebrospinal fluid. Physicians use axial T2-weighted images to determine a grade using the Schizas system.
- Grade A (No Stenosis or Minor Stenosis): Evident CSF in the dural sac, but the CSF distribution is uneven
- Grade A1: The rootlets are positioned dorsally and take up less than half of the dural sac region.
- Grade A2: The rootlets are positioned dorsally in a horseshoe shape and are touching the dura.
- Grade A3: The rootlets are positioned dorsally and take up over half of the dural sac region.
- Grade A4: The rootlets are positioned in the center of the dural sac region and take up over half of this area.
- Grade B (Moderate Stenosis): The rootlets take up the entire dural sac region but can be differentiated. The sac has a gritty appearance with some CSF.
- Grade C (Severe Stenosis): No rootlets can be identified and no CSF is apparent. The sac has an even, gray appearance with posterior epidural fat.
- Grade D (Extreme Stenosis): No rootlets can be identified and the posterior epidural fat has been destroyed.
The Miskin Grading System
The Miskin grading system is an adapted version of the Schizas grading system. It was altered based on information from radiologists and non-radiologist spinal specialists.
- Normal Spine: The nerve roots are openly spread out, not crowded, and the thecal sac’s anterior margin is flat or convex
- Mild Spinal Stenosis: The nerve roots are mildly crowded and the thecal sac’s anterior margin is flat or a little concave. The nerve roots can be differentiated from the CSF.
- Moderate Spinal Stenosis: The nerve roots are crowded, giving the CSF a grainy appearance. The thecal sac’s anterior margin is concave.
- Severe Spinal Stenosis: The nerve roots can’t be differentiated from the CSF. the thecal sac’s anterior margin is concave or indistinguishable.
What Is the Newest Treatment for Severe Lumbar Spinal Stenosis?
The latest lumbar spinal stenosis treatment has been referred to with many different names, including non-fusion implant and dynamic stabilization system, among others. These names all refer to devices that are used in place of spinal fusion to provide stability and symptom relief. Premia Spine TOPS System is the best one.
Non-fusion implants establish a controlled range of motion in the affected vertebrae. They replace the tissue removed during decompression surgery, ensuring that the spine remains stable after the procedure.
In addition to spinal stenosis, many dynamic stabilization systems can effectively treat spondylolisthesis and degenerative disc disease. But, as the latest treatment option for spinal stenosis, dynamic stabilization systems aren’t yet being used throughout the U.S.
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One example, the TOPS System from Premia Spine, has received the breakthrough designation from the FDA, which allowed the start of an IDE investigation in 330 to 476 patients in the U.S. Patients with single-level spinal stenosis and spondylolisthesis may talk to their doctors about enrolling in this trial if they’re a good candidate for the TOPS System.
Why Consider The Latest Spinal Stenosis Treatment?
Patients suffering from spinal stenosis symptoms have many factors to consider when choosing a treatment route. Although spinal fusion has been used since the early 1900s, it presents many notable downsides. Dynamic stabilization systems have a shorter history, but they were developed with the drawbacks of fusion in mind. Therefore, this route of treatment can help you avoid complications including:
- Adjacent segment disease
- Failed bone fusion (pseudoarthrosis)
- Lost spinal mobility
- Back muscle atrophy
Spinal stenosis patients should speak with an experienced spine specialist to find the right treatment option for their needs.