Central Spinal Stenosis

Another result of progressive degeneration of the spine is central spinal stenosis.  This can occur in the cervical (neck), thoracic (mid back) and/or lumbar (low back) regions.  The term stenosis means narrowing. Stenosis is characterized by narrowing of the central spinal canal that houses the spinal cord and nerve roots.  In the cervical and thoracic region significant spinal stenosis can result in spinal cord compression. The end of the spinal cord generally lies at the level of the first lumbar vertebrae therefore spinal stenosis below this level can not directly compromise the spinal cord. Individuals who have high-grade (severe) lumbar spinal stenosis often experience leg pain, as well as leg weakness.  Individuals with lumbar spinal stenosis also experience a chronic ache or dull pain within the lower back region when walking or standing.  It is not uncommon for an individual with lumbar stenosis to experience numbness or tingling involving the buttock or legs when they walk.  Individuals with lumbar stenosis usually experience some improvement of leg symptoms when bending forward and experience an increase in buttock and leg symptoms when extending backwards.  Symptoms associated with lumbar spinal stenosis tend to occur more commonly in individuals over 50 years of age

Lateral Spinal Stenosis

Bony projections may develop off the vertebral bodies.  These are referred to as bone spurs or osteophytes.  Spurs which project the right or left of the central of the vertebrae can result in narrowing of the openings along the lateral aspect of the spine.  These openings are called the neuroforamen. This is often referred to a lateral stenosis which is a specific type of spinal stenosis.  Lateral stenosis with spinal nerve compromise may lead to pain in an arm or leg depending upon the level of spinal involvement.  Severe nerve compromise can result in a loss of sensation and extremity muscle weakness. The associated extremity pain tends to be radiating. A lateral disc protrusion or herniation can further contribute to lateral canal stenosis rendering the nerve more vulnerable to compromise. Central and lateral stenosis often occur together at the same levels of the spine.

Degenerative Spondylolithesis

Age-related degeneration of the spine can also lead to spondylolithesis which is a condition characterized by excessive movement of one vertebrae relative to another.  The vertebra becomes displaced in relationship to an adjacent vertebra secondary to excessive movement or instability.