spinal stenosis

see also:

• neurology
• neurosurgery
• oncology
• acute spinal cord compression
• cauda equina syndrome (CES)
• spinal cord syndromes and lesions
• sensory & motor testing including dermatomes, myotomes, reflexes, coordination & balance

• spinal stenosis is narrowing of the spinal canal or neural foraminae resulting in pressure on the spinal cord or nerve roots
• lumbar stenosis is most common followed by cervical stenosis
• 1st described by Antoine Portal in 1803

• usually degenerative as a result of arthritis of the facet joints and thus occurs mainly in those over 50yrs age and females are at higher risk
  • as the disks dry out with age and lose height, more weight is taken on by the facet joints leading to arthritic changes and the neural foraminae become smaller
  • affects some 8% of the elderly population
• congenital forms may present between ages 30 and 50 yrs
• other causes include rheumatoid arthritis, ankylosing spondylitis (AS), spinal tumours, trauma, Paget's disease, scoliosis, spondylolisthesis, achondroplasia

• pain on standing
• neurogenic intermittent claudication may occur on prolonged standing, walking or extension of the lumbar spine
• sciatica may occur and may be bilateral
• severe cases may cause cauda equina syndrome (CES)

• can be more dangerous than lumbar stenosis as it may cause acute spinal cord compression and resulting myelopathy