Inherited Spinal Stenosis
Congenital spinal stenosis is a condition that is present at birth and which may be immediately apparent in severe cases or remain asymptomatic until well into a person’s twenties, thirties, or even later. When someone is born with a small spinal canal or with small foramina they are more likely to develop symptoms of spinal stenosis earlier as the nerves and spinal cord will come under pressure from lesser formation of bone spurs or less severe disc bulging or other spine changes.
Back Trauma and Stenosis
Acute spinal trauma can also be the cause of spinal stenosis, including falls, whiplash, blunt force trauma, and other mishaps or injuries. Where acute back trauma does occur it may be more likely that a patient requires immediate surgical intervention to prevent nerve damage or spinal cord injury, or to reduce the likelihood of such conditions progressing.
Categorizing Spinal Stenosis
Acquired spinal stenosis through degeneration is more likely to cause intermittent symptoms at first before leading to chronic back pain, radiculopathy, and/or mobility problems. Patients are often able to slow down the degeneration of the spine by making changes to posture, nutrition, and lifestyle habits such as smoking, as well as by engaging in physical therapy and other conservative or alternative treatments for spinal stenosis.
Spinal Narrowing in Bone Disorders
Where arthritis or osteoporosis are the underlying causes of spinal stenosis patients will usually be given medications to reduce inflammation, maintain or improve bone density, and suppress the immune system (depending on the type of arthritis or bone condition). Disorders affecting the bones, including Paget’s disease, may result in bone spur formation (osteophytes) which can then reduce space in the spinal canal or foramen through which nerves pass. Foraminotomy or other spinal stenosis surgery may be necessary in such cases as the cause of the symptoms is structural rather than inflammatory.
Bone Spurs and Trapped Nerves
Osteophytes also form when the stability of the spine has been compromised, such as when ligaments have been damaged, muscles have become weak, discs degenerated, or following trauma or previous back surgery where muscles and ligaments were cut. The body tries to create a wider contact area between vertebrae to add stability to the spine but in the process can trap nerves or compress the spinal cord.
Disc Herniation and Pinched Nerves
Disc herniation or bulging is one of the most common causes of spinal stenosis and occurs when discs become damaged through dehydration, poor nourishment, or simply through repeated shocks due to an active lifestyle. A variety of spine conditions, such as scoliosis, arthritis, ankylosing spondylitis, and other disorders can cause discs to degenerate faster than usual and the unique nature of the intervertebral discs means that they repair themselves poorly, if at all. Newer treatments for disc degeneration involve the injection of stem cells into damaged discs to restore their height and health naturally whereas traditional treatment would involve removal of the disc and possible replacement with an artificial disc. The removal of a disc can affect the stability of the spine as well as mobility and may precipitate further degeneration of nearby levels of the spinal column.
Disc Rupture and Spinal Stenosis
In some cases the disc may have ruptured and leaked its inner material into the space through which spinal nerves pass. This can cause irritation and inflammation of the nerves and resulting pain and radiculopathy. Removing the disc fragments through a minimally invasive spine procedure can help whilst keeping risks low.
Ligament Damage and Spinal Stenosis
Another potential reason behind how you got spinal stenosis is through thickened ligaments in the spine. This may be due to age-related wear and tear or could be a sign of a connective tissue disorder where it occurs in younger patients. Calcification of the ligaments may also occur if other spinal structures are in poor health and the ligaments are trying to maintain spinal stability. Identifying the underlying cause of the hardened and thickened ligaments could then help resolve back pain and other spinal stenosis symptoms.
Spinal tumors are sometimes the reason for spinal stenosis symptoms and where these grow inside the spinal cord itself they require removal by a qualified neurosurgeon rather than orthopaedic surgeon. Bone tumors may also occur in the spine and patients may require spinal fusion or a procedure such as percutaneous vertebroplasty if having spinal bone tumors removed.
Explaining Spinal Stenosis
Some people are predisposed to developing spinal stenosis whereas others can lead similar lifestyles in many ways and remain asymptomatic simply through genetics or good fortune. Systemic inflammatory conditions are likely to worsen symptoms of spinal stenosis, as is engagement in some high impact sports or activity which places lots of pressure on the spine. Chronic poor posture can also lead to spinal stenosis, as can smoking, problems with skeletal health due to inadequate nutrition, and even repeated dehydration that affects the intervertebral discs. If your diagnosis has left you wondering how you got spinal stenosis then you’re not alone as sometimes the multifactorial nature of the condition confounds explanation and simply needs treating as well as possible.