Spinal stenosis is the narrowing of the spinal canal or foramen (spaces within the spine), which compresses the spinal cord and pinches the nerves. Narrowing often happens over time, and the risk of developing this condition can increase with age.
Types of Spinal Stenosis
Spinal stenosis can occur anywhere along the spine, but it most commonly affects the lumbar spine and cervical spine. Lumbar spinal stenosis occurs due to the narrowing of the spinal canal in the lower back. Cervical spinal stenosis occurs due to the narrowing of the spinal canal in the neck.
Although less common, spinal stenosis could develop in other regions of the spine including the thoracic vertebrae (middle section of the spine spanning from the base of the neck to the bottom of the ribcage), the sacrum (base of the lumbar vertebrae), and the coccyx (tailbone).
Symptoms of Spinal Stenosis
Symptoms will depend on the nerve involved in the stenosis; however, please keep in mind that patients may or may not experience symptoms in the location of the stenosis.
The following symptoms could indicate the possibility of spinal stenosis:
- Pain, including discogenic pain, numbness, tingling, and/or weakness
- Lumbar spinal stenosis can cause lower back pain, weakness, tingling, or numbness, with symptoms that radiate down the buttocks, legs, and/or feet (a condition commonly referred to as sciatica)
- Cervical spinal stenosis can cause possible neck pain and symptoms (weakness, tingling, or numbness) that may radiate down the arms, hands, and/or fingers
- Unsteady gait (walking pattern), also known as ataxia
- In severe cases, patient may experience loss of normal bowel or bladder function
- Symptoms may worsen when standing or walking (neurogenic claudication)
- Symptoms may improve when sitting, laying down, or leaning forward
Some patients may not experience symptoms at all. This can lead to a slow, insidious onset. In order to avoid late diagnosis, be aware of subtle motor changes, which could indicate advancing spinal stenosis without traditional symptoms.
Treatment Options for Spinal Stenosis
Treatment recommendations will vary by patient and case but could include the following:
Non-Surgical
- Physical Therapy: Specific exercises may help relieve pressure, reduce pain, improve mobility, and increase flexibility.
- Pain Relief/Anti-inflammatory Medication: Your doctor may recommend or prescribe NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen (Advil or Motrin), naproxen (Aleve) or analgesics such as acetaminophen (Tylenol) for pain control.
- Steroid Injections: Also known as an epidural, an injection of a steroid or corticosteroid such as dexamethasone or prednisone can provide temporary pain relief.
Surgical
- Decompression without Fusion:
- Laminectomy (Lumbar or Cervical): Removes the entire lamina
- Laminotomy (Lumbar or Cervical): Removes part of the lamina
- Laminoplasty (Usually Cervical): Widens the spinal canal
- Foraminotomy (Lumbar or Cervical): Widens the opening of the spinal canal
- Microdiscectomy (Lumbar or Cervical): A minimally invasive procedure to remove all or part of a herniated disc
- Decompression with Fusion:
- Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery (MIS-TLIF): A minimally invasive procedure to remove a degenerated disc and insert a spacer in its place
- Open Transforaminal Lumbar Interbody Fusion (TLIF): Removes a degenerated disc and inserts a spacer, screws, and/or rods in its place as needed
- Extreme Lateral Interbody Fusion (XLIF): A minimally invasive procedure to fuse two levels of the spine from the side of the body
- Anterior Lumbar Interbody Fusion (ALIF): Replaces damaged discs in the lumbar spine with bone grafts
- Anterior Cervical Discectomy and Fusion (ACDF): Replaces damaged discs in the cervical spine with bone grafts
- Posterior Cervical Laminectomy and Fusion: Removes the lamia and fuses damaged vertebrae together
Which Treatment Is Best for Me?
Every case is different, and your treatment plan will depend on a variety of factors. Your type of spinal stenosis, cause, imaging, severity of symptoms, lifestyle, medical history, and preferences will all play a role in determining the treatment plan right for you
In many cases, patients can pursue non-surgical options as a first step. However, if symptoms are severely impacting quality of life and have not responded to non-surgical treatment methods, your doctor may recommend surgery in order to provide the best chance of relief.
At Nkrumah Neurosurgery, Dr. Nkrumah will spend at least an hour listening to your story, learning about your case, and explaining the various treatment options and recommendations. Once you’ve determined a treatment plan, you will have choices every step of the way to ensure maximum comfort on your road to recovery.
Get in touch with our office by calling (631) 525-1420 or send us a message online if you have any questions or to schedule an appointment with our team.
Sources:
https://www.niams.nih.gov/health-topics/spinal-stenosis
https://www.ncbi.nlm.nih.gov/books/NBK441989/
https://www.aans.org/patients/conditions-treatments/lumbar-spinal-stenosis/https://www.aans.org/patients/conditions-treatments/lumbar-spinal-stenosis/

What Causes Spinal Stenosis?
Spinal stenosis is caused by the narrowing of the spinal canal. Many factors can contribute to this narrowing, including:
- Medical Conditions: Arthritis of the spine, disc herniation, facet (joint) overgrowth, spinal tumors, and scoliosis, among others, can all cause narrowing of the spine.
- Paget’s Disease of the Bone: Also known as achondroplasia, this chronic disorder causes abnormal bone growth.
- Degeneration: The narrowing of the spine can be caused by gradual changes (degeneration) to spinal structure over time. Risk of degeneration can increase with age.
- Spinal Injury or Trauma: Fractures and other injuries could result in spine misalignment and/or obstruction of the spinal canal.
- Congenital Stenosis: This condition causes one to be born with a narrow spinal canal. Congenital stenosis can also increase the risk of developing other conditions that affect the spine.