Spinal Stenosis

Running head: SPINAL STENOSIS

Spinal Stenosis

Natalie D. Badger

Gulf Coast Community College School of Radiography

Abstract

Spinal Stenosis is a term commonly used to describe a narrowing of the spinal canal. This problem is much more common in people over the age of 60. However, it can occur in younger people who have abnormally small spine canals as a type of birth defect. The problem usually causes back pain and leg pain that comes and goes with activities such as walking. The purpose of this information is to help you understand: the anatomy of the spine related to spinal stenosis the signs and symptoms of lumbar spinal stenosis, how the condition is diagnosed, and the treatments available for the condition.

Spinal Stenosis

Spinal Anatomy

The anatomy of the spine has three major regions: the cervical, the thoracic, and the lumbar. Your spine is a long column of bones (aka vertebra) that stretches from the base of your skull to your tailbone. The vertebrae supports and stabilizes your upper back, while at the same time allowing you to move freely. The vertebrae also protects your spinal cord. The spinal cord is a bundle of nerves and nerve cells that extend the length of your spine. The cord housed inside a channel (aka spinal canal) within the vertebra. 31 pairs of nerves branch off from the spinal cord, providing communication between your brain and the rest of your body.

What is Spinal Stenosis

As defined by the Laser Spine Institute, Spinal Stenosis is the narrowing of the spinal canal by a piece of bone or disc material. This can cause weakness in your extremities. This narrowing results in pressure on the spinal cord and/or nerves. Spinal stenosis can occur in a variety of ways in your spine. Most cases of spinal stenosis occurs in the lower back (lumbar spine) and will affect the sciatic nerve. Most often, spinal stenosis results from degenerative changes in the spine caused by aging. Tumor injuries and other diseases can also lead to the narrowing in the spinal canal.

Symptomology

Lumbar spinal stenosis occurs more commonly in males. This may be a combination of congenitally narrow canal linked with occupational risk. Although symptomatic lumbar spinal stenosis is usually a disease of the middle-aged and the elderly, younger patients may also be affected. Typically, the earliest complaint is back pain, which is relatively nonspecific and may result in delayed diagnosis. Spinal stenosis often starts gradually and worsens over time. Signs of spinal stenosis will not likely develop until the narrowed areas compress the spinal cord or the base of the spinal nerves (nerve roots).

When present, symptoms may include pain that radiates into one or both thighs and legs, back and hip pain, pain in the neck and shoulders, loss of balance, and rarely loss of bowel or bladder functions. Symptoms are often worse with prolonged standing or walking. Symptoms may come and go and may vary in severity when present. Bending forward or sitting increases the room in the spinal canal and may lead to reduce pain or complete relief from pain. Pain relievers tend to be ineffective.

Origination

Spinal stenosis the silent epidemic and is apart of the aging process, it is not possible to predict who will be affected. Complex changes of the spine, dehydration, loss of spine mass, bone growth, all may result in compression of the spinal sac and nerve roots. The 2 forms of spinal stenosis are described as follows:

Primary spinal stenosis: relatively uncommon, results from disorders that are present at birth. The condition is diagnosed more easily because patients are younger and usually lack other complicating medical problems such as diabetes or vascular insufficiency. Achondroplasia would be classified as a primary spinal stenosis. This genetic disorder slows the rate at which bone forms during fetal development and in early childhood. As a result, short stature- often no more than four feet tall when fully grown. They also have a small spinal canal, putting pressure on the spinal cord causing severe back and leg pain.

Acquired stenosis: Develops later in life. Complex changes in the vertebral structures and ligaments of the spine contribute to the development of acquired lumbar spinal stenosis. As the body dehydrates with age bones become less dense and the discs of the spine lose mass. The disc compress, causing tilting, slippage and rotation of the vertebral bodies. Usually as a result of degenerative changes in the spine that occur with aging, patients generally become symptomatic at age 50 years or older.

The main cause of spinal degeneration is Osteoarthritis, an acquired arthritic condition that affects the cartilage that cushions the ends of the bones in the joints. Osteoarthritis can also affect the disks in your spine. By the time your 30, you disks may start to show signs of deterioration, losing their water content becoming flatter and more brittle. Another acquired development, the ligaments in your back may undergo degenerative changes, becoming stiff and thick over time. This loss of elasticity may shorten the spine, narrowing the spinal canal and compressing the nerve roots. Other causes of narrowing of the spine include, spinal tumors, MVA, and Pagent's disease of the bone.

Screening and Diagnosis

Spinal stenosis can be difficult to diagnose because its signs and symptoms are often not continuous and because it resembles those of many age-related conditions. To help diagnose spinal stenosis and rule out other disorders, you will be asked your medical history and to perform a physical exam that may include checking your range of motion and leg reflexes. The diagnosis of spinal stenosis depends largely on the clinical history and physical examination. Radiographic confirmation of the diagnosis can be accomplished using various modalities.

You are also likely to have one or more of the following test:

Spinal radiograph: Although the lateral view of the spine is most useful, most likely it wont confirm that you have spinal stenosis, but it may reveal evidence of narrowed discs and/or thickened facet joints.

Magnetic resonance imaging (MRI): This would be the image test of choice for diagnosing spinal stenosis. Instead of x-rays,