Spinal stenosis is a narrowing of the lumbar (back) or cervical (neck) spinal canal, which causes compression of the nerve roots. This compression in its simplest terms impedes the signals running down to the nerves.

Causes

Spinal stenosis usually becomes symptomatic in patients after middle-aged. it is common in the elderly.

Symptoms

The usual symptoms are pain in the buttocks, thighs or calves that is classically worse with walking or exercise. The pain often is eased if the patient leans forwards. Some patients experience numbness in the buttocks, thighs or calves, which is worse with standing, walking or exercise. Back pain can also be a symptoms, and this usually radiates to the legs. Weakness can occur in some patients.

Investigation

Spinal MRI is the gold standard for investigation and shows narrowing of the spinal canal by a combination of disc, osteophytes, and ligaments.

Treatment

Surgery is usually very effective in stopping progression of the stenosis. In many patients they also achieve relief of their leg symptoms. the operation involves removing bone form the back of the spinal canal to make the nerves more room. 

Complications of Surgery

Complications are rare (1%), but include infection, csf leak, meningitis and nerve damage including the nerves to bladerand bowel. A recurrence of the symptoms is also possible.