Spinal stenosis is a narrowing of the lumbar (back) or cervical (neck) spinal canal, which causes compression of the nerve roots.
Causes
Spinal stenosis mainly affects middle-aged or elderly people. It may be caused by osteoarthritis or Paget’s disease or by an injury that causes pressure on the nerve roots or the spinal cord itself.
Symptoms:
- Back pain that spreads to the legs
- Difficulty or imbalance when walking
- Leg pain
- Neck pain
- Numbness in the buttocks, thighs or calves, that is worse with standing, walking, or exercise
- Pain in the buttocks, thighs, or calves that is worse with walking or exercise
- Weakness of the legs
Exams and Tests
Neurological examination confirms leg weakness and decreased sensation in the legs.
- EMG may show neurological changes.
- Spinal MRI or CT scan shows spinal stenosis.
- Spinal x-ray shows degenerative changes and narrowed spinal canal.
Treatment
Generally, conservative management is encouraged. This involves the use of anti-inflammatory medications, other pain relievers, and possibly steroid injections. If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves.
Surgery is performed on the neck or lower back, depending on the site of the nerve compression.
Outlook (Prognosis)
If the nerve roots can be successfully relieved of pressure, the symptoms will not worsen and may improve.
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Information from the National Institutes of Health, November 2008
