Spine Disorders
SIGNS AND SYMPTOMS The space within the spinal canal may narrow without producing
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. People with more severe stenosis may have problems with bowel and
bladder function and weakness in the legs. For example, cauda equina syndrome
is a severe, and very rare, form of spinal stenosis. It occurs due to
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. The
symptoms of spinal stenosis typically result in limitation of physical
activity. This contributes to deconditioning with resultant reduced endurance,
flexibility and strength. It can be helpful for the individual with spinal
stenosis to modify their home environment to make the performance of activities
of daily living more efficiently. CAUSES The normal vertebral canal provides adequate room for the spinal
cord and cauda equina. Narrowing of the canal, which occurs in spinal stenosis,
may be inherited or acquired. Some people inherit a small spinal canal 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. Acquired conditions that can cause spinal stenosis are explained in more
detail in the sections that follow. Degenerative Conditions 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). |