Spinal Stenosis / Foraminal Stenosis / Central Canal Stenosis

What is Stenosis?
Spinal Stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and/or exiting nerve roots. Stenosis is from the Greek word meaning “a narrowing”. Central canal stenosis is a narrowing of the channel in the center of each vertebra through which passes the spinal cord on its way down the spine. Foraminal stenosis is a narrowing of the channel on either side of the vertebra where the spinal nerve roots exit on their way to various parts of the body such as down the arms or legs. The vertebral foramen is a small opening or hole for the exiting spinal nerve root that is formed where the downward notch in the bone of a vertebra meets the upward notch of the vertebra below it. Spinal stenosis may affect the cervical, thoracic or lumbar spine. Lumbar spinal stenosis results in low back pain and can radiate down the nerves into the buttocks, hips, thighs, legs, or feet. Cervical spinal stenosis results in neck pain and can radiate down the nerves into the shoulders, arms, wrists, and hands.

What Causes it?
Although it is true that some individuals congenitally have larger or smaller canals than do others, the cause of the narrowing is usually a combination of 3 different degenerative factors present in varying degrees in different patients. First, when a disc herniates the bulge takes up space narrowing the nerve channel. Second, as the involved disc dries out and loses height (a process known as desiccation) it causes the vertebra to become closer together further narrowing the nerve channel. Third, as the stress on the joint compounds and osteoarthritis begins to result, bone spurs (osteophytes) form and ligaments thicken (hypertrophy) gradually narrowing the channel even further. These 3 factors in various combinations and degrees of severity compromise the space in the channel and conspire to compress (pinch) the spinal cord or nerve root. These 3 factors may also be referred to as Degenerative Disc Disease, the most common cause of spinal stenosis.

Spondylolisthesis and scar tissue formation as a result of prior surgical fusion are other factors that can contribute to spinal stenosis. Spondylolisthesis describes the anterior displacement of a vertebra or the vertebral column in relation to the vertebra below. Also, rarely, various bone diseases such as Paget’s Disease or tumors in the spine are responsible for the narrowing. An MRI can rule in or rule out a wide range of possibilities rare though they may be.

A Non-surgical Solution
Spinal Decompression Therapy, first approved by the FDA in 2001, has since evolved into a cost-effective treatment for herniated and degenerative spinal discs, and the resultant spinal stenosis; one of the major causes of back pain and neck pain. It works on the affected spinal segment by significantly reducing intradiscal pressures. The vacuum thus created retracts the extruded disc material allowing more room for the pinched nerve, and will many times additionally increase the spacing between the vertebra as the involved discs are rehydrated, allowing even more room for the nerve. Furthermore, as the disc rehydrates its shock absorbing capabilities are restored reducing mechanical stress on the related structures (facet joints and supporting ligamentous tissues) slowing or halting the osteoarthritc damage. This is a non-surgical conservative procedure for patients suffering with bulging or herniated discs, degenerative disc disease, posterior facet syndrome, sciatica, failed back surgery syndrome, and non-specified mechanical low back or neck pain resulting in spinal stenosis.