What Are The Final Stages of Spinal Stenosis?

Spinal stenosis is a condition that impacts the structures of the spine, often due to age-related spinal degeneration or genetic factors. In either case, with this condition, the patient’s spinal canal narrows, leading to less open space surrounding the spinal cord and nerves. 

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Typically, spinal stenosis progresses at a slow pace if it’s not treated properly. As the condition advances, the open space in the spinal canal continues to decrease. Eventually, spinal stenosis can lead to nerve impingement as the spinal canal presses on nearby nerves. 

Understanding how spinal stenosis progresses and what to expect in the final stages of this condition can be helpful for patients. Continue reading for more information about this prevalent topic. 

What Are the Final Stages of Spinal Stenosis?

In the late stages, spinal stenosis causes:

  • loss of body functions: no bladder or bowel control;
  • saddle region numbness;
  • numbness in feet or legs;
  • leg pain when walking;
  • inability to stand or walk.

The final stages of spinal stenosis may be effectively treated with surgery.

What is Considered Severe Spinal Stenosis?

Spine specialists generally take an MRI scan to determine the severity of a spinal stenosis case. An MRI can give the physician a detailed image of the spinal structures, which makes it possible to view how far the condition has progressed. 

Once the physician has obtained the MRI scan, they may use the following spinal stenosis grading system

  • Stage 0: No lumbar spinal stenosis, no obliteration of the anterior cerebrospinal fluid (CSF) space
  • Stage 1: Mild lumbar stenosis with visible separation of the cauda equina
  • Stage 2: Moderate lumbar stenosis with some aggregation of the cauda equina so that they can’t be visibly separated
  • Stage 3: Severe lumbar stenosis with no separation of the cauda equina

The cauda equina is a clump of spinal nerves and nerve rootlets found at the lower end of the spinal cord. These nerve roots’ function is to supply sensation to the legs, as well as support bladder and bowel function. 

What Happens When You Have Severe Spinal Stenosis?

With severe spinal stenosis, the spinal canal has narrowed to a considerable degree. As a result, patients with the severe form of this condition may experience a significant loss of function, potentially including bladder and/or bowel function.  

Additionally, lumbar spinal stenosis may be considered severe if conservative treatment options have repeatedly failed to improve the patient’s symptoms. 

Cauda Equina Syndrome

Severe spinal stenosis can cause cauda equina syndrome. This syndrome occurs when the cauda equina nerves, which are located at the lower end of the spine, are compressed. 

Cauda equina syndrome can cause permanent nerve damage and disability if it’s not treated immediately. Patients with spinal stenosis who experience symptoms of this syndrome should seek out emergency medical care. 

Symptoms of cauda equina syndrome include: 

  • Loss of bladder or bowel control

A new loss of bladder or bowel control is a key symptom of cauda equina syndrome to be aware of. If you experience this symptom, make sure to contact your doctor immediately. 

  • Saddle anesthesia

Saddle anesthesia affects the saddle region, which includes the buttocks, groin, genitals, and upper inner thighs. With this symptom, patients experience weakness, tingling, and/or numbness in all or part of the saddle area. 

  • Sciatic nerve pain on the right and left sides of the body

Cauda equina syndrome can cause a stabbing, sharp, and/or hot pain that radiates from the bottom of the spine down the backs of the legs. In some patients, this pain may also travel into the calves and feet. 

  • Neurological symptoms in the lower extremities

Patients with cauda equina syndrome may experience weakness, tingling, or numbness in the feet or legs. These sensations may occur on one or both sides of the body and may inhibit the patient’s ability to stand or walk.

Neurological symptoms in the lower extremities are also a symptom of spinal stenosis itself. This can make it difficult to identify this symptom as a sign of cauda equina syndrome. However, if you experience new or worsening neurological symptoms, or if they’re accompanied by other symptoms listed here, contact your doctor immediately. 

Can You Live With Severe Spinal Stenosis?

Unfortunately, spinal stenosis isn’t a curable condition – it can only be corrected with surgery. However, most patients can live normally with the condition if it’s treated in its early stages. 

Once patients have reached the final stages of spinal stenosis, they’re likely to experience a notable degree of disability. This may hold them back from partaking in normal activities. Additionally, patients with severe spinal stenosis are likely to experience back pain and neurological symptoms with day-to-day motions, including standing and walking. 

Surgery for severe spinal stenosis is typically required to restore patients’ quality of life. 

Severe Spinal Stenosis Surgery

Surgery is a spinal stenosis treatment option that specialists may recommend in severe cases. Generally, physicians don’t recommend spinal stenosis surgery unless patients have undergone six to 12 months of non-surgical treatment without symptom improvement. 

As a treatment for severe spinal stenosis, surgery typically involves spinal decompression. While there are multiple methods of surgical spinal decompression, laminectomy is the most common approach for spinal stenosis. 

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Laminectomy and Spinal Fusion

Laminectomy involves surgically removing some or all of the lamina to create more space in the spinal canal. The lamina is a small piece of bone that covers the back of the spinal canal, acting like a roof. By removing a portion of the bone, spinal surgeons can alleviate nerve compression and resolve patients’ symptoms. 

Along with laminectomy, severe spinal stenosis surgery often involves spinal fusion. Fusion is performed to prevent spinal instability by fusing the affected vertebrae into one bone. This is achieved with bone graft material. 

Unfortunately, spinal fusion can greatly limit patients’ mobility. After fusion, you can’t bend, twist, or flex the spine at the fused spinal segment. 

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Now, with motion preservation surgery and non-fusion implants, patients can undergo severe spinal stenosis treatment without the need for fusion. These procedures preserve patients’ mobility while alleviating the symptoms of severe spinal stenosis. 

If severe spinal stenosis is diminishing your quality of life, talk to a spine specialist about the complete range of treatment options available today.