Spinal Stenosis

Simply defined, it is any narrowing of some or all of the spinal column, through which the spinal cord and nerves pass. This narrowing is called "stenosis" and can exert a tightening constriction and pressure upon the structures that occupy the spinal canal, namely nerves. It can be found at virtually any and every level of the spinal column, but is seen more commonly in the lumbar (low back) and cervical (neck) regions.

This condition occurs when there are abnormalities of the bony and soft tissue structures of the spinal column formed during embryonic development. This could manifest itself by the presence of excess bone causing a "tight" spinal canal. Other manifestations could include abnormal number of spinal segments and/or overgrowth of supportive bone elements in the spinal column. It is often diagnosed in adolescent years when there is a difficulty and pain with performing athletic or sporting activity.

This type is typically caused by overall deterioration and degeneration of the various structures that make up the spinal column, such as bones and inter-vertebral discs.

With the aging process comes the degeneration of the disc material which causes narrowing of bony spaces throughout the spinal column, but the lumbar and cervical areas in particular. With this narrowing comes bone spur formation which compounds the resulting pressure on the spinal nerves. Bone spurs press, discs bulge and, voila; a plugged canal.

This pathologic variation is typically caused by encroachment of the spinal nerves by some sort of "space-occupying" abnormality such as a tumor. These tumors do not have to be malignant to be problematic. Even benign, non-cancerous tumors and cysts can cause abnormal and dangerous pressure on the spinal nerves as they grow and enlarge.

Because spinal canal obstruction can occur in different forms of severity, treatment varies, and is relative to this severity. The more pressure that is applied to spinal nerves, the more severe the potential problems can be come, such as permanent nerve injury, and even loss of bodily functions (i.e. bowel/bladder function).

Cauda Equina Syndrome refers to the name given to the area of the spinal cord where the cord itself ends and the nerves continue down the canal; hence cauda equina ('horse's tail")

This most severe and threatening form occurs when there is massive obstruction of the lumbar spinal canal, frequently the result of a large ruptured inter-vertebral disc, or subluxation (partial dislocation) of a spinal vertebral segment, which compresses the spinal nerves to the point that they can no longer function and can affect bodily functions. The bodily functions typically involved in this scenario are loss of bowel and bladder function.

This is a true emergency, for if the pressure on these nerves is not relieved expeditiously, the loss of these bodily functions can become permanent.

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