Spinal Stenosis

Spinal stenosis can develop anywhere in your spine, but it occurs most commonly in the lower back and neck. Like many back conditions, spinal stenosis can be related to aging — in fact, your risk of developing spinal stenosis increases after age 50. As you age, the tissues that connect your spine and bones can become thicker and calcified, and the discs between vertebrae can break down. Growths, called bone spurs, sometimes extend into the spinal canal. Stenosis develops when these conditions tighten your spinal canal.

Stenosis in the neck area can lead to cervical myelopathy — a degenerative condition that can cause serious neurological disorders.

Prevention

The spine care experts at El Camino Health offer a wide range of treatments for spinal stenosis, but prevention is also a priority. You can help keep your spine in good form by eating nutritional meals and exercising regularly. Daily exercise can help strengthen your back muscles and enhance your endurance.

You can also help keep your spine healthy by losing excess weight — which puts an added burden on your spine — and avoiding smoking, which causes your spine to degenerate faster. El Camino Health offers a variety of classes and programs to help you maintain good health, including smoking cessation programs at our Cardiac & Pulmonary Wellness Center.

Symptoms

Talk to your doctor if you experience any of these symptoms:

• Pain, weakness, numbness, tingling or cramping in your legs, calves or buttocks that gets worse when you walk and improves when you sit, bend forward or lie down.
• Pain, weakness, numbness, tingling or cramping in your shoulders, arms and legs, sometimes accompanied by clumsy hands and problems with walking and balance.
• Pain that moves up or down your leg (sciatica).
• Bladder and bowel problems, loss of feeling and movement in your lower body, or inability to function.

Diagnosis and Treatment

To diagnose spinal stenosis, your doctor will perform a physical exam along with imaging exams such as X-rays, CT or MRI scans, myelograms or bone scans.

At El Camino Health, doctors use the least invasive treatment whenever possible. In many cases, your doctor will recommend conservative measures initially, such as:

• Physical therapy and exercise. Your doctor may recommend you work with a physical therapist to develop a stretching and exercise plan to stabilize your spine, build endurance and increase flexibility.
• Medication. In some cases, pain-relieving or non-steroidal anti-inflammatory drugs can reduce swelling and pain and relieve symptoms.
• Cortisone injections. When swelling and pain are more severe, your doctor may use cortisone injections to provide temporary relief — you can have a maximum of three injections over a six-month period.

Surgical Treatment

In most cases, doctors consider surgery only after nonsurgical therapies are no longer effective. When symptoms are severe and affect your ability to function, your doctor may recommend surgery.

Spine surgeons at El Camino Health have the expertise to perform a variety of techniques to treat spinal stenosis, such as:

• Decompressive laminectomy – Removes the lamina (top) of the vertebrae and bone or soft tissues pinching spinal nerves to make space for nerves.
• Laminotomy – Removes a small part of the lamina to relieve nerve-root pressure.
• Foraminotomy – Removes the foramen, where nerve roots leave the spinal canal.
• Medial facetectomy – Removes part of the facet, a bony structure in the spinal canal.
• Anterior cervical discectomy and fusion – Removes and replaces a disc with a small bone segment that will fuse the neck vertebrae.
• Corpectomy – Removes part of the vertebra and discs, and may include a bone graft or metal plate and screws to stabilize the spine.
• Laminoplasty – Rebuilds parts of the spine to make more room for the spinal canal.
• Spinal fusion – Involves permanently fusing two or more vertebrae together.

In addition to traditional surgery, El Camino Health offers minimally invasive spinal surgery when appropriate to treat cervical or lumbar spinal stenosis. This less invasive alternative approach involves smaller incisions and can offer less pain and a faster recovery.

Your doctor will discuss the risks and benefits of all your treatment options to assure you have the information you need to make an informed decision.