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Types of Spinal Stenosis

      Spinal stenosis can affect any part of the spine, but it is most commonly found in the lower section of the spine (lumbar region) and uppermost section of the spine (cervical region). The major types of spinal stenosis include:

      Foraminal stenosis. As a nerve root leaves the canal through a side hole called the lateral foramen, a disc herniation, bone spur, cartilage fragment, scar tissue or any other unnatural growth or obstruction can press on the nerve root. This type of stenosis may is called lateral spinal stenosis. This is by far the most common form of spinal stenosis. Over 72% of cases of foraminal stenosis occur at the lowest lumbar level, usually trapping the emerging nerve root of the sciatic nerve. Neural foraminal narrowing is a common result of disc degeneration. The process of disc degeneration or bulging can cause the foraminal canal to narrow. Once the foraminal opening reaches a point of compressing the nerves inside the spinal column, pain, numbness, tingling, and muscle weakness often occur. Other possible causes of neural foraminal narrowing include rheumatoid arthritis, osteoarthritis, chronic meningitis, tumors, and neurofibromas.
 

      Lumbar spinal stenosis is a narrowing of the spinal canal which compresses the nerves traveling through the lower back into the legs. While it may affect younger patients due to developmental causes, it is more often a degenerative condition that affects adults. Lumbar spinal stenosis is a result of the degeneration of the facet joints and the intervertebral discs in the spine. The discs may become less spongy with age, resulting in reduced disc height and bulging of the hardened disc into the spinal canal. At the same time, bones spurs, which are called osteophytes, may develop to help reduce the stress on the weakened disc. These bone spurs usually grow into the spinbal canal. The facet joints also enlarge as they become arthritic, which contributes to a decrease in the space allowed for the nerve roots. Currently, it is estimated that about 400,000 Americans may be suffering from the symptoms of lumbar spinal stenosis.
 

    When present, symptoms may include:
 

            Pain, weakness, or numbness in the legs, calves, or buttocks
 

            Pain radiating into one or both thighs and legs, similar to sciatica
 

            In rare cases, loss of motor functioning of the legs
 

            In rare cases, loss of normal bowel or bladder function


      Degenerative spondylolisthesis is a condition associated with lumbar spinal stenosis. Degenerative spondylolisthesis (slippage of one vertebra over another) is caused by osteoarthritis of the facet joints. Most commonly, it involves the L4 slipping over the L5 vertebra. It is usually treated with the same conservative and surgical methods as lumbar spinal stenosis.
 

      Degenerative scoliosis (curvature of the spine) occurs most frequently in the lower back and more commonly affects older people. Back pain associated with degenerative scoliosis usually begins gradually, and is linked with activity. The curvature of the spine in this form of scoliosis is often relatively minor, so surgery is required when conservative methods fail to alleviate pain associated with the condition.
 

      Cervical stenosis. Cervical stenosis occurs when the spinal canal narrows and compresses the spinal cord and is most frequently caused by aging. The discs in the spine that separate and cushion vertebrae may dry out. As a result, the space between the vertebrae shrinks, and the discs lose their ability to act as shock absorbers. At the same time, the bones and ligaments that make up the spine become less pliable and thicken. These changes result in a narrowing of the spinal canal. In addition, the degenerative changes associated with cervical stenosis can affect the vertebrae by contributing to the growth of bone spurs that compress the nerve roots. The main causes of cervical spinal stenosis include cervical spondylosis, diffuse idiopathic skeletal hyperostosis (DISH), or calcification of the posterior longitudinal ligament. Cervical spinal stenosis is more common in males than females, and is mainly found in the 40-60 year age group. Signs of cervical spinal stenosis include spastic gait; upper extremity numbness; upper extremity, lower extremity weakness or both; radicular pain in the upper limb; sphincter disturbances; muscle wasting; sensory deficits; and reflex abnormalities in reflexes.
 

      In cervical spinal stenosis, the spinal canal becomes increasingly narrow, putting pressure on the bundle of nerves that runs through it. This narrowing can result from a variety of factors, including general aging and wear-and-tear, ruptured discs, slipped vertebrae (spondylolisthesis), enlarged joints, and bone spurs. Cervical spinal stenosis can also be a congenital condition.
 

      For more information: www.spinaldisorders.com