Spinal stenosis

Definition

Degenerative disease prevalent in those in their 50s or older

Spinal stenosis is due to the compression of the spinal nerve by the spinal canal or the intervertebral foramens narrowed by aging, degeneration, or external stimulation. Usually it starts in the 40s and progresses into the 50s and 60s. Common places are between 3-4 and 4-5 lumbar (back) vertebrae, and 5th lumbar and the first sacral vertebrae. It is slightly more common in females and commonly accompanied with spondylolisthesis.

Symptoms

Difficulty in extended walking due to pain, which gets relieved when the back is bent. “hunchbacked granny”

  • 1.In many cases, the pain starts from the buttocks rather than back
  • 2.Numbness of the thigh extending to the sole
  • 3.As the disease worsens, the walkable distance gets shorter, up to less than 10 minutes in severe cases.
  • 4.Squatting causes temporary widening of the spinal canal and relieves the pain
  • 5.Paralysis or urinary disability may happen in severe cases.

Cause

Acquired

  • Degenerative hypertrophic ligament flavium and facet
  • Complication of spondylolysis, degenerative spine disease, disc herniation

Congenital

Congenitally narrow spinal canal may cause extended stenosis when the degeneration of bones and ligaments starts after their 30s.

Treatment

Diagnosis : X-ray, CT, MRI

Non-surgical treatment

  • Rest
  • Physiotherapy
  • Exercise therapy
  • Medication
  • Injection
  • Neuroplasty
  • Balloon expansion

Surgical treatment

  • Endoscopic laser decompression