Spinal stenosis is a narrowing of the spinal canal that occurs most often in the low back (lumbar) region of the spine. The spinal canal is the small space that holds the nerve roots and spinal cord. When that space becomes narrower, it can squeeze the nerves and the spinal cord, causing pain and other symptoms.
Some people are born with a narrow spinal canal, but most often spinal stenosis is a result of aging. Some medical conditions can cause spinal stenosis, including osteoarthritis, rheumatoid arthritis, spinal tumors, trauma, Paget’s disease of the bone, and having a previous spinal surgery.
At UPMC, we begin with conservative treatments such as medications and physical therapy to alleviate pain and increase mobility. Many patients experience relief from pain within a month or two with conservative treatment. When these treatments fail to provide relief, our neurosurgical team may recommend surgery such as decompression laminectomy or spinal fusion.
To diagnose spinal stenosis, the doctor will perform a physical exam and medical history. The doctor will try to locate the origin of the pain and test how it affects the patient’s strength, movement, reflexes and loss of feeling.
Symptoms may include:
A neurological exam may be performed to confirm leg weakness and decreased feeling in the legs. The doctor may also order an EMG, MRI, and CT scan. An x-ray may be done to check for abnormalities in the vertebrae, such as osteoarthritis, bone spurs, and narrowing of the spinal canal.
At UPMC, we typically treat spinal stenosis with a combination of pain medication and physical therapy. Drug therapy may include nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, antidepressants, anti-seizure drugs, opioids, or cortisone injections.
Physical therapy may also be prescribed to build strength and endurance, maintain flexibility in the spine, improve balance, and control pain. Other treatments may include wearing a lumbar brace to help stabilize the spine and alleviate pain.
For patients whose symptoms are not improved by conservative therapy, your surgeon may recommend surgery. Surgical treatments are aimed at relieving pressure on the spinal cord and nerve roots.
A decompression laminectomy removes bony spurs or increased bone mass in the spinal canal, freeing up space for the nerves and spinal cord. Spinal fusion is a technique in which two vertebrae (back bones) are fused together. This provides stronger support for the spine, and is almost always done after decompression laminectomy.
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