The spine is one of the most important organs of the body supporting the body’s weight, giving the body a straight posture and allows for movement and flexibility and in the same time protecting the spinal cord and nerves inside it. Hence any injury to the spine may limit the body’s movement.
“Spinal canal stenosis is the abnormal narrowing of the spinal canal – it may occur at any part of the canal. The most common types of spinal stenosis are lumbar (lower back) stenosis and cervical (near the throat) stenosis,” said Dr. Sebouh Kassis, Specialist Neurosurgery at Burjeel Hospital for Advanced Surgery, Dubai. “Lumbar stenosis affects a person’s ability to walk whereas cervical stenosis is the more dangerous of the two as it results in the compression of the spinal cord which may lead to complete paralysis from neck down if left untreated.”
The most common symptoms of cervical stenosis are neck pain, numbness or ‘pin and needles’ feeling in the hands and arm pain.
“Due to the fact that stenosis is a progressive condition over time the symptoms worsen and a patient may experience weakness in their hands and they will have trouble doing simple tasks such as buttoning their shirts,” said Dr. Kassis. “They will also have balance problems. It is usually at this stage that patients consult a Doctor.”
In patients suffering from lumbar stenosis, the typical symptoms are lower back pain, leg pain, heaviness in legs and difficulty walking for long periods of time.
“As with cervical stenosis, the symptoms of lumbar stenosis are also progressive. The patient will first have trouble walking a distance of 1 kilometre, over time this will lessen to 500 metres and so forth. They feel obliged to sit,” said Dr. Kassis. “When a patient consults a Doctor with these symptoms, the first step in diagnosis is taking a patient’s medical history – establishing the possibility of stenosis or alternative reasons for back and leg pains. Afterwards a Doctor will perform a physical examination on the patient to determine any irregular reflexes, sensory abnormalities and weakness in the muscle. A MRI is then used to determine the exact extent of the spinal narrowing and nerve compression.”
Treatment options vary depending on the extent of the narrowing and whether the stenosis is cervical or lumbar.
“In the case of lumbar stenosis, treatment may be conservative. Doctors will first advise exercises coupled with injections to limit the effect of the symptoms and to limit the progression of the stenosis,” the Doctor said. “In instances where these treatments are not effective, surgery is performed to widen the spinal canal. To treat cervical stenosis, surgery is needed to decompress the spinal cord and stabilize the spine if needed to avoid the progression to paralysis. There have been technological advancements changing the way surgeries are performed. The decompression and even the stabilization of the spine can now be performed using minimally invasive key hole surgery.”
“There is no one cause of stenosis and the condition is mainly seen in the elderly – the compression is rarely known to begin before the age of 45 and gets progressively more common after the age of 60,” said Dr. Kassis. “If patients experience neck pain, back pain or leg pain that lasts more than 3 weeks or has weakness in his or her muscles he should immediately consult a Doctor to mitigate the effects of the disease.”