Congenital Spinal Stenosis
Spinal stenosis or acquired spinal stenosis generally occurs as part of the natural aging process. As one ages, bone spurs may develop, discs shift or bulge and ligaments thicken. These physiological changes invade the spinal column space, which narrows the environment previously occupied exclusively by the spinal nerves. The narrowing compresses nerves and surrounding tissues causing pain and other symptoms. Congenital spinal stenosis refers to an inherited form of the condition often present at birth.
The congenital form of the disorder remains rare and not detectable before birth. There is also no known means of prevention. Though more common in individuals of short stature or born with achondroplasia dwarfism, the disorder might occur in either gender regardless of ethnicity. Anyone inheriting the condition may experience symptoms as early as the teen years or not until after reaching their 40s. The condition may develop anywhere along the spine, but commonly occurs in the lumbar or cervical regions.
Spinal Stenosis Symptoms
Whether having acquired or congenital spinal stenosis, the symptoms remain the same. Patients commonly experience:
* Pain in the exact location where the stenosis develops, which includes the neck or lower back.
* Pain that radiates from the point of origin to the shoulders, arms and hands or to the hips, legs and feet
* Arm or leg cramping
* Numbness, tingling, stiffness or loss of flexibility in the extremities
The type of pain also varies and might include:
* Mild cases causing intermittent pain that starts and stops over the course of several days
* As the condition progresses, individuals often experience chronic pain.
* Pain ranging from a dull ache to a sharp, stabbing sensation that radiates outward.
* Pain aggravated by position changes that include bending, twisting the torso, standing from a sitting position, or during a repetitive physical movement
Congenital Spinal Stenosis Treatment
Healthcare providers typically diagnose the condition by obtaining detailed information concerning the symptoms. Physicians generally perform a physical and neurological examination. Practitioners may also require imaging studies. Treatment in mild cases often involves symptomatic relief. If diagnosed with a more severe form of the condition, a physician may recommend corrective surgery.
Initial treatment options include taking OTC or prescription anti-inflammatory medications. Physicians my use epidural steroid injections for inflammation reduction. Alternating hot and cold pack applications improve circulation while reducing swelling and inflammation. Depending on the location and severity of the condition, physicians may restrict certain physical movements or recommend rest. Individuals may require a neck or back brace. Individuals may receive a referral to a physical therapist who may prescribe deep tissue massage or low-impact exercises.
When the condition does not respond to conventional therapy or worsens and interferes with daily activities, patients usually require referral to an osteopathic surgeon for more surgical treatment that eliminates invading tissue. Though traditionally performed using large incisions, modern spinal surgical advancements include minimally invasive, scope-guided procedures. These procedures reduce the risks commonly associated with surgery and decrease recovery time.
Indirect decompression alternatives relieve spinal nerve pressure by separating the vertebra using a variety of implanted devices. Implants may include everything from artificial discs to metallic cages inserted between and attached to the affected upper and lower vertebra. Decompression surgical options include:
* Foraminotomy – The procedure entails enlarging the opening in the affected vertebra, which alleviates the compression problem.
* Laminotomy – The lamina comprises the outer covering of the vertebra. If this area poses a compression problem, the surgeon may reduce pressure by creating an opening in this tissue.
* Laminectomy – When other options do not offer a viable cure, the surgeon may choose to remove a portion or all of the affected lamina.