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Spinal stenosis is a narrowing of the spinal canal - the space where the spinal cord and nerves travel from the neck to the lower back.
The spinal cord or spinal nerve is compressed, and pain and weakness often result. Spinal stenosis results from the accumulation of spurs of bone and enlargement of the supporting ligaments of the spine as the spine degenerates with time (a part of the normal aging process). Some patients may also be born with a small spinal canal, resulting in congenital spinal stenosis.
If spinal stenosis occurs in the neck symptoms can include weakness of the arms or legs, difficulty walking, balance issues and pain in the neck or arms.
In the lower back the symptoms are usually leg pain with walking and weakness of the legs. Back pain may or may not be present.
An MRI scan will confirm the diagnosis in the cervical and lumbar spine. The severity of stenosis may affect the treatment suggested.
If the symptoms of stenosis are mild and not interfering with the patient's quality of life, medical treatment may not be needed. Sometimes epidural steroids may be of value.
Surgery in the cervical spine may be needed to relieve the pressure on the spinal cord or spinal nerves. This can be done in several different ways depending on the location of the compression and the severity. In some cases, the surgery is performed from the back of the spine - this involves a laminectomy with removal of the bone, which may be combined with a fusion. Alternatively, the surgery may be done from the front of the spine. This consists of removal of the spurs and ligament causing the compression as well as a fusion with a titanium plate.
In the lumbar spine, the surgery consists of relieving the pressure on the spinal nerves and can now be done by minimally invasive techniques. The X lift procedure increases the space for the nerves through a minimally invasive surgery performed from the side of the spine. In other situations, a laminectomy with removal of bone and ligament to make room may be a better choice. The removal of the compression results in relief of the symptoms.