Spinal Stenosis / Degenerative Spondylolisthesis
Alternative name: Lumbar Spine Stenosis
What is spinal stenosis/degenerative spondylolisthesis?
What are the signs of spinal stenosis/degenerative spondylolisthesis?
What causes spinal stenosis/degenerative spondylolisthesis?
How does my doctor tell if I have spinal stenosis/degenerative spondylolisthesis?
How is spinal stenosis/degenerative spondylolisthesis treated?
Spinal stenosis/degenerative spondylolisthesis are back conditions that are caused by the narrowing of the spinal canal. As people age, these conditions can develop due to the drying out and shrinking of the disc spaces between the bones (80% of the disc is made up of water). You can feel pain anywhere along your back or leg when the nerve is pressed in this way. Spinal stenosis/degenerative spondylolisthesis have been described as similar to lime build-up inside a garden hose; over time, it narrows the hose and the flow of liquid is less strong.
Spinal stenosis/degenerative spondylolisthesis do not necessarily cause symptoms. People can have significant stenosis that they are unaware of until tests are done. It is most common in women over the age of 50—men are less prone to this condition. The following are possible evidence of spinal stenosis:
- Pain or numbness in the back, legs, and/or buttocks
- Cramping in the legs
- Weakness in the legs
- Bowel and/or bladder problems in some cases
- Prolonged standing or walking makes the pain worse
- Symptoms may come and go, and may vary in severity when present
- Bending forward or sitting increases the room in the spinal canal and may reduce the pain or give complete relief from pain
- Aging is the main cause
- Heredity—sometimes the spinal canal is too small from birth, and symptoms may show up in a relatively young person.
- Changes in blood flow to the lumbar spine
Spinal stenosis/degenerative spondylolisthesis can be diagnosed by careful physical examination. However, unusual leg symptoms are often a clue for the clinician indicating the presence of spinal stenosis.
Depending of the severity of the case, doctors will choose the appropriate level of treatment which could vary from medical management to surgical treatments.
- Changes in posture: People with spinal stenosis may find that flexing the spine by leaning forward while walking relieves their symptoms. Lying with the knees drawn up to the chest also can offer some relief. These positions enlarge the space available to the nerves and may make it easier for stenosis sufferers to walk longer distances.
- Medications: Sometimes the pressure on the nerves is caused by inflammatory swelling. Nonsteroidal anti-inflammatory medication such as aspirin or ibuprofen may help relieve symptoms.
- Rest to gradual activity: Resting, followed by gradual resumption of activity, also can help. Aerobic activity such as bicycling is often recommended.
- Losing weight: This can also relieve some of the load on the spine.
When stenosis causes severe nerve root compression, these treatments may not be enough. Back and leg pain may return again and again. Because many stenosis sufferers are unable to walk even short distances, they often confine their activities to the home.
If non-surgical treatment does not relieve the pain, your spine surgeon may recommend surgery to relieve the pressure on affected nerves. In properly selected cases, the results are quite satisfactory, and patients are able to resume a normal lifestyle. Surgery is more likely to help relieve leg pain, rather than back pain, caused by spinal stenosis. In the surgery, whatever is compressing the nerve (for example, a disc fragment or a bone spur) is removed.
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