Neurology Now:
doi: 10.1097/01.NNN.0000324756.88933.48
DEPARTMENTS: ASK THE EXPERTS: Your Questions Answered

SPINAL STENOSIS

Wang, Michael Y M.D

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Michael Y Wang, M.D., is associate professor of neurological surgery at the University of Miami Miller School of Medicine.

Q What causes spinal stenosis, and what treatments are available for it?

DR. MICHAEL Y. WANG RESPONDS:

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A Spinal stenosis is primarily caused by arthritis, which in turn is caused by age. As people get older, the bones in their spine thicken and enlarge. These changes narrow the lumbar spinal canal, putting pressure on the nerves and spinal cord and in many cases, causing pain.

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CURRENT TREATMENTS INCLUDE:

* Physical therapy

* Steroid injections

* Pain medications

* Spacers: A surgeon places a spacing device between the spinal column, which opens up the spine and relieves some of the pressure on the nerves.

* Laminectomy: A surgeon will remove the bone, cartilage, or ligament that is pressing on the spinal nerves.

* Spinal fusion: If there is painful movement between two vertebrae in the spine, a surgeon will try to close the gap by growing the bones together. This can be done with real or fake bone.

Researchers are currently looking at using physical therapy to relieve neural compression around the spine and its ligaments. Other promising approaches include new injectables that are more effective at reducing inflammation with fewer side effects, and minimally invasive laminectomy and fusion procedures that cause less pain and shorter hospital stays.

Spinal stenosis can develop from bulging discs (left) and from thickening bone (right). Central stenosis (top, left and right) is due to pressure on the central spinal canal, and lateral stenosis (bottom, left and right) is due to pressure where the nerve root exits the central canal.

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©2008 American Academy of Neurology

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