Spinal Stenosis Flashcards
What Is Spinal Stenosis?
Spinal stenosis is a narrowing of spaces in the spine (backbone) that results in pressure on the spinal cord and/or nerve roots.
What 3 areas does this disorder usually involve?
(1) the canal in the center of the column of bones (vertebral or spinal column) through which the spinal cord and nerve roots run, (2) the canals at the base or roots of nerves branching out from the spinal cord, or (3) the openings between vertebrae (bones of the spine) through which nerves leave the spine and go to other parts of the body.
Who gets Spinal Stenosis?
This disorder is most common in men and women over 50 years of age. However, it may occur in younger people who are born with a narrowing of the spinal canal or who suffer an injury to the spine.
What Structures of the Spine Are Involved?
Intervertebral discs Facet joints Intervertebral foramen Lamina Ligaments Pedicles Spinal cord / nerve roots Synovium Vetebral arch Cauda equina
What Causes Spinal Stenosis?
Narrowing of the canal, which occurs in spinal stenosis, may be inherited or acquired. Some people inherit a small spinal canal (see fig. 5) or have a curvature of the spine (scoliosis) that produces pressure on nerves and soft tissue and compresses or stretches ligaments. In an inherited condition called achondroplasia, defective bone formation results in abnormally short and thickened pedicles that reduce the diameter (distance across) of the spinal canal.
What would Acquired Spinal Stenosis would develop out of?
Degenerative conditions
What does Spinal Stenosis most often result from?
Spinal stenosis most often results from a gradual, degenerative aging process. Either structural changes or inflammation can begin the process. As people age, the ligaments of the spine may thicken and calcify (harden from deposits of calcium salts). Bones and joints may also enlarge: when surfaces of the bone begin to project out from the body, these projections are called osteophytes (bone spurs).
What happens when one part of the spine fails?
When the health of one part of the spine fails, it usually places increased stress on other parts of the spine. For example, a herniated (bulging) disk may place pressure on the spinal cord or nerve root (see fig. 6). When a segment of the spine becomes too mobile, the capsules (enclosing membranes) of the facet joints thicken in an effort to stabilize the segment, and bone spurs may occur. This decreases the space (neural foramen) available for nerve roots leaving the spinal cord.
What are the two form of arthritis that may affect the spine?
Osteoarthritis and Rheumatoid Arthritis
What are some other acquired conditions?
Tumors of the spine
Trauma
Paget’s disease
Ossification of the posterior longitudinal ligament
What is Paget’s disease of bone?
Paget’s disease of bone is a chronic (long-term) disorder that typically results in enlarged and abnormal bones. Excessive bone breakdown and formation cause thick and fragile bone. As a result, bone pain, arthritis, noticeable bone structure changes, and fractures can occur. The disease can affect any bone of the body, but is often found in the spine. The blood supply that feeds healthy nerve tissue may be diverted to the area of involved bone. Also, structural problems of the involved vertebrae can cause narrowing of the spinal canal, producing a variety of neurological symptoms. Other developmental conditions may also result in spinal stenosis.
What is Ossification of the posterior longitudinal ligament?
Ossification of the posterior longitudinal ligament occurs when calcium deposits form on the ligament that runs up and down behind the spine and inside the spinal canal (see fig. 7). These deposits turn the fibrous tissue of the ligament into bone. (Ossification means “forming bone.”) These deposits may press on the nerves in the spinal canal.
What are symptoms of Spinal Stenosis?
The space within the spinal canal may narrow without any symptoms. However, if narrowing places pressure on the spinal cord, cauda equina, or nerve roots, there may be a slow onset and progression of symptoms. The neck or back may or may not hurt. More often, people experience numbness, weakness, cramping, or general pain in the arms or legs. If the narrowed space within the spine is pushing on a nerve root, people may feel pain radiating down the leg (sciatica). Sitting or flexing the lower back should relieve symptoms. (The flexed position “opens up” the spinal column, enlarging the spaces between vertebrae at the back of the spine.) Flexing exercises are often advised, along with stretching and strengthening exercises.
What are some more severe symptoms?
People with more severe stenosis may have problems with bowel and bladder function and foot disorders. For example, cauda equina syndrome is a severe, and very rare, form of spinal stenosis. It occurs because of compression of the cauda equina, and symptoms may include loss of control of the bowel, bladder, or sexual function and/or pain, weakness, or loss of feeling in one or both legs. Cauda equina syndrome is a serious condition requiring urgent medical attention
How is Spinal Stenosis diagnosed?
Medical history Physical exam X ray MRI CAT Myelogram Bone scan