Spinal stenosis

Acquired spinal stenosis is usually a result of degenerative changes in your spine that develop as you age. This includes the following conditions:

• Thickened ligaments: Over time, arthritis can thicken the ligaments that hold your spine together, and make them bulge into your spinal canal. 
• Bulging discs: With time, the round vertebral discs that act as shock absorbers can dry out, flatten and leak, placing pressure on the nerves in your spinal canal.
• Spinal fractures and injuries: Injuries to your vertebrae or discs can narrow the space in your spinal canal.
• Spinal cysts or tumours: Growths within your spinal canal, or between your spinal canal and vertebrae, can reduce space in your spinal canal.

Spinal stenosis can occur in any section of your spine, but it's most common in your lower back (lumbar region), less common in your neck (cervical region) and least common in your mid back (thoracic region).

1. Lumbar spinal stenosis puts pressure on the nerves that connect the end of your spinal cord to your lower limbs and pelvic organs, including your bladder, rectum and internal genital organs. 

Lumbar stenosis can also lead to cauda equina syndrome, a severe condition that can cause permanent damage. 

Fast treatment is essential, so it's important you seek help if you experience any of the following:

• Loss of bowel control
• Severe numbness between your legs, inner thighs and back of your legs
• Numbness or tingling around your genital region and anus
• Severe pain and weakness that spreads into one or both legs, making it difficult to walk, stand or get up out of chairs

2. Cervical spinal stenosis directly affects your spinal cord (myelopathy) and can affect any part of your body below the compression point. It can not only affect your neck and arms but also your legs, leading to leg weakness, gait abnormalities and loss of balance. 

Myelopathy is a potentially serious condition, so it's vital you speak to a specialist if you experience any symptoms.

• Thoracic spinal stenosis is less common but can lead to a loss of motion and difficulty rotating your torso, because your thoracic vertebrae are attached to your 

Most people who have spinal stenosis don't need surgery. If non-surgical treatments don’t relieve or improve your symptoms, then surgery could be the most effective treatment.

Spinal stenosis is a complex condition, and your spinal cord and nerves are extremely delicate. 

This complexity requires very specific treatment, which is why a number of different surgical techniques have been developed, including some minimally invasive techniques.  Your consultant will recommend the procedure that’s right for your specific condition, which might include one of the following:

• Laminectomy: Also known as decompression surgery, this procedure involves removing a portion of your vertebra to make more room for your spinal cord and nerve roots. This operation is most commonly used to treat your lumbar spine.
• Laminotomy: Surgery to remove a partial area of your lamina that’s causing the most pressure on your spinal cord and nerves. 
• Laminoplasty: The lamina in your cervical spine can be moved into a more open position and fixed in place with a small metal plate and screws. This allows for greater strength and stability in your spine. 
• Foraminotomy: This surgery involves removing bone or tissue around your foramen, which is the area in your vertebrae where the nerve roots exit your spinal canal and connect with other parts of your body. 
• Interspinous process spacer placement: One  of the latest treatments for spinal stenosis, this involves the insertion of small ‘spacer’ devices between the spinous processes in each of your vertebra. Those spacers widen the spinal canal in your lumbar region.
• Spinal fusion: This is a last option. Spinal fusion permanently joins together two of your vertebrae so that they heal as a single bone. The surgeon places bone or a bonelike material in the space between your two vertebrae, before inserting metal plates, screws or rods to hold them together. 

Your consultant will suggest the treatment they think will be the most effective, depending on the specifics of your condition. They'll explain what the procedure involves in detail and talk through any risks before you decide to go ahead.

Almost everyone develops some degree of osteoarthritis in their spine by the age of 50 or so, and there isn't anything you can do to completely prevent spinal stenosis. However, there are things you can do to lower your risk of developing spinal stenosis, including:

Eating healthy foods: Nutrition plays an important role in keeping your bones strong, so getting enough calcium and vitamin D from your diet is vital.

Getting regular exercise: Strong, flexible back and core muscles are important for keeping your spine healthy. Resistance exercises can help you strengthen these muscles, along with aerobic exercises like walking and cycling.

Practising good posture: You should sleep on a firm mattress and sit in ergonomic chairs that support the natural curves of your back. Learning how to safely lift heavy objects can help avoid putting unnecessary stress on your spine.

Maintaining a healthy weight: Being overweight puts excess stress on your back and contributes to you developing spinal stenosis.

The likely course of your spinal stenosis depends on the location and severity of your condition, as well as your overall health. It's positive in most cases. Many people with spinal stenosis benefit from non-surgical treatments, which help them live well-rounded lifestyles. Yet it's important to bear in mind that spinal stenosis affects each person differently, so the results of a given treatment will vary on a case-by-case basis.

In severe cases, spinal stenosis can lead to significant complications. Cervical spinal stenosis can lead to myelopathy or severe compression of the spinal cord. This can lead to irreversible damage and permanently impair your ability to control essential body movements and functions. It gets worse over time if left untreated.

Lumbar spinal stenosis can lead to cauda equina syndrome, which can cause irreversible damage to the nerves of the cauda equina. This can affect your bowel and bladder control and sexual function and even lead to paralysis of the legs. 

It's vital you see a spinal specialist if you're experiencing symptoms of spinal stenosis, as early treatment of spinal stenosis could help prevent more significant complications from developing.

Recent advances in spinal stenosis treatments offer more minimally invasive approaches, meaning smaller incision sites and faster recovery times. At HCA UK, we offer a range of advanced surgical treatment options, including the insertion of interspinous spacers to widen your spinal canal.

Some of the worst symptoms of spinal stenosis include severe nerve damage which, if left untreated, can cause permanent paralysis or disability. Other symptoms include loss of balance, numbness and loss of control of your bladder and bowel. If you experience any of these, or find that your symptoms have increased in intensity, you should seek urgent medical attention.

If you have a family history of the condition, you’re at greater risk, but you won’t necessarily go on to develop spinal stenosis. 

While many people only develop symptoms later in life, it’s also possible for children to develop the condition early and suffer from bone growth disorders as a result. Your consultant will ask you about your family history in your initial assessment.

If you have a family history of the condition, you’re at greater risk, but you won’t necessarily go on to develop spinal stenosis. 

While many people only develop symptoms later in life, it’s also possible for children to develop the condition early and suffer from bone growth disorders as a result. Your consultant will ask you about your family history in your initial assessment.

Surgical treatments for spinal stenosis generally have a good rate of success. It’s important to speak to your consultant about the different treatment pathways to ensure you’re receiving the treatment plan that gives you the best outcomes.

The cost of your treatment will depend on the package of care your consultant recommends. For your peace of mind, we offer transparent pricing and will outline exactly what’s included in your treatment package and the overall amount you can expect to pay. It’s important to be aware that the final cost of your treatment will depend on the specific diagnostic and treatment plan that your consultant agrees is right for you.