Spinal Stenosis Health Article

Treatment

Mild cases of spinal stenosis may be treated with rest, nonsteroidal anti-inflammatory drugs (such as aspirin), and muscle relaxants. Spinal stenosis can be a progressive disease, however, and the source of pressure may have to be surgically removed (surgical decompression if the patient is losing control over bladder and bowel functions. The surgical procedure removes bone and other tissues that have entered the spinal canal or put pressure on the spinal cord. Two vertebrae may be fused, to eliminate improper alignment, such as that caused by spondylolisthesis. For surgery, patients lie on their sides or in a modified kneeling position. This position reduces bleeding and places the spine in proper alignment. Alignment is especially important if vertebrae are to be fused. Surgical decompression can eliminate leg pain and restore control of the legs, bladder, and bowels, but usually does not eliminate lower back pain. Physical therapy and massage can help reduce the symptoms of spinal stenosis. An exercise program should be developed to increase flexibility and mobility. A brace or corset may be worn to improve posture. Activities that place stress on the lower back muscles should be avoided.

Prognosis

Surgical decompression does not stop the degenerative processes that cause spinal stenosis, and the condition can develop again. Nevertheless, most patients achieve good results with surgical decompression. The patient will probably continue to have lower back pain after the surgical procedure.

BOOKS

Berkow, Robert, ed. Merck Manual of Medical Information. White-house Station, NJ: Merck Research Laboratories, 1997.

Dee, Roger, et al. Principles of Orthopaedic Practice. New York: McGraw-Hill Health Professional Books, 1997.

Larsen, D. E., ed. Mayo Clinic Family Health Book: New York. William Morrow and Co., Inc., 1996.

John T. Lohr, PhD

KEY TERMS

Computed tomography (CT) scans—An imaging technique in which cross-sectional x rays of the body are compiled to create a three-dimensional image of the body's internal structures.

Congenital—Present before birth. The term is used to describe disorders that developed in the fetal stage.

Doppler scanning—A procedure in which ultra-sound images are used to watch a moving structure such as the flow of blood or the beating of the heart.

Electromyography—A test that uses electrodes to record the electrical activity of muscle. The information gathered is used to find disorders of the nerves that serve the muscles.

Evoked potential—A test of nerve response that uses electrodes placed on the scalp to measure brain reaction to a stimulus such as a touch.

Magnetic resonance imaging (MRI)—An imaging technique that uses a large circular magnet and radio waves to generate signals from atoms in the body. These signals are used to construct images of internal structures.

Nerve conduction velocity test—A test that measures the time it takes a nerve impulse to travel a specific distance over the nerve after electronic stimulation.

Stenosis—The narrowing or constriction of a channel or opening.