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Spinal Stenosis

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What Is Spinal Stenosis?

Spinal stenosis is a condition where the spinal canal, the bone around the spinal cord, narrows, putting pressure on the spinal cord and nerves and causing back pain. In most cases, the condition affects the lower back or neck. Some symptoms associated with spinal stenosis include:
  • Numbness in the extremities
  • Issues with coordination of the limbs
  • Weakness of the limbs
  • Difficulty with bowel or bladder control
  • Pain in the neck and shoulders or in the low back and glutes

HOW DOES SPINAL STENOSIS HAPPEN?

Spinal stenosis is attributed to a variety of causes. While it most often occurs in people over the age of 50 as an age-related condition, younger populations suffering from spinal degeneration, spinal injuries, disc bulges, disc herniation or synovial cysts may also experience spinal stenosis. Osteoarthritis and rheumatoid arthritis are also common causes of spinal stenosis, as both conditions result in the inflammation of the joints in the spine. Some cases are also the result of heredity, as some individuals are born with narrowing spinal canals and structural malformations.

WHAT ARE THE SYMPTOMS OF SPINAL STENOSIS?

Spinal stenosis can present with many different symptoms. The symptoms are mainly determined by severity and location in the spine. Here are the most common symptoms:
  • Sciatica – Pain that shoots down one or both legs that may start as an ache in the lower back or buttocks
  • Foot Drop – A term that refers to a weakening of the muscles that allow for flexing of the ankle and toes. The result of foot drop may cause a person to “drag” their foot on the ground.
  • Trouble With Standing Or Walking – Spinal stenosis can compress the spinal nerves and cause pain while you stand for long periods of time.
  • Tingling Sensation – Spinal stenosis can compress the spinal nerves in the back and neck causing tingling symptoms in the legs or arms and hands.

HOW IS SPINAL STENOSIS DIAGNOSED?

Spinal stenosis diagnosis requires a complete review of a patient’s medical history and a physical examination, during which time the specialist will review the patient’s symptoms to determine if and where the spinal cord is compressed. Following the initial diagnosis, they may order imaging tests to confirm, including X-Ray, MRI, CT or Myelogram imaging tests. Once the location and cause of the compression are identified, the specialist can then move on to spinal stenosis treatment.

WHAT ARE THE TREATMENT OPTIONS FOR SPINAL STENOSIS?

Spinal stenosis treatment in NJ often starts with nonoperative pain management, such as anti-inflammatory medications, physical therapy, weight reduction or epidural injections. If these treatment options prove unsuccessful, the specialist may then consider spinal stenosis surgery. In our NJ office, several surgical options are available to help make more room for the spine by removing bone or ligaments.

NON-OPERATIVE TREATMENT

Least Invasive Procedures

If pain persists after conservative treatment and interventional spine injections, and there is evidence by CT Scan, MRI or X-ray or neurological deficit, then surgical intervention is usually recommended. The following least invasive procedures treat spinal stenosis with a high success rate through the removal of compressed tissue:

ENDOSCOPIC LAMINOTOMY

After making a 1-2 centimeter incision, our doctor can observe and open the small area of the lamina above and below the spinal disc using an HD camera/scope. The specialist can then also remove any thickened ligaments to relieve painful nerve compression and remove any herniated disc or bone spur causing additional pain. Patients are free to leave the clinic on the same day as the procedure, and most return to work within three months.

VERTIFLEX

Vertiflex’s Superion is another least invasive alternative that requires no bone work or tissue removal. As an indirect decompression device, the Superion implant is planted between the vertebrae and holds them open to relieve pressure. Our specialist inserts the device through a small tube the size of a dime, which reduces blood loss and damage to the surrounding tissue and allows for fast recovery. This solution is ideal for patients who have undergone six months of non-operative treatments without relief or for those who find traditional spinal surgery options too demanding.

MINIMALLY INVASIVE LUMBAR DECOMPRESSION

Minimally invasive lumbar decompression or MILD® is a least-invasive procedure which can help spinal stenosis patients stand up longer and walk further distances with reduced pain. As opposed to traditional open surgery, MILD® spine surgery utilizes a very small incision, allowing for a faster recovery and quick pain relief. During the procedure, your doctor will remove overgrown ligament and bone located at the lower part of your spine. After a short recovery, many patients quickly return to their normal, everyday activities. These technique prevents the spinal instability associated with open surgery and avoids the invasive fusion surgical approach.

MINIMALLY INVASIVE SPINE SURGERY

In some cases, spinal stenosis may be so severe that it may not be able to be treated with our least invasive techniques, and therefore we use some of the minimally invasive techniques widely used by spine surgeons across the world.
  • MIS Lumbar Discectomy/Laminectomy – The goal of the minimally invasive technique is to decompress the bony lamina and facets that are pressing on the spinal nerves.
  • MIS Transforaminal Lumbar Interbody Fusion (TLIF) – This minimally invasive spine fusion provides stability for the spine and complete decompression of spinal stenosis and any pressure on the nerves at this level.
  • Anterior Cervical Discectomy and Fusion (ACDF) – The goal of an ACDF surgery is to remove pressure on the spinal cord and spinal nerves while stabilizing the affected spinal disc. The ACDF procedure has a 90% success rate.