The spinal canal is a long cylindrical space starting from the base of the skull all the way down to the tail bone. The walls of this cylindrical space are the dices and vertebral body from the front side and other portions of the vertebrae on the sides and the back. The bony borders protect the content of the spinal canal which are the Spinal cord and the nerve roots.
Within the spinal canal space is of a premium. Spinal cord and segmental nerve roots need to travel and then exit out of the spinal canal without crowding. The condition in which there is less space available for the spinal cord or nerves to pass through is called spinal stenosis (the word stenosis means narrowing in Latin). A number of conditions may leads to development of spinal stenosis. This includes herniation of the discs, arthritis of the adjacent joints called “facets,” thickening of internal spinal ligaments, fracture of the vertebrae, developments of a cyst (synovial cyst) and in rare cases tumors. Generally it is "arthritis" that is a major contributor to the development of stenosis in the neck or low back. Symptoms often develops over a long period of time.
Spinal stenosis may affect travelling spinal cord or the nerve root at the most narrowed segment. This can lead to slowly developing symptoms of back /neck pain, leg or arm pain, numbness, tingling and weakness, difficulty with balance, poor dexterity and in rare cases incontinence. The most common symptom in lumbar stenosis is back and leg pain with standing or walking. Associated symptoms includes numbness, tingling, and in advanced cases weakness and bladder and bowel changes. Sitting down or leaning forward on a chair or shopping cart often alleviates the symptoms.
Activity modification and pacing is recommended in patients with spinal stenosis. Other treatment options available for spinal stenosis at Tufts MC in Boston include:
- Aback brace offered for comfort.
- Pain relief can be achieved by means of over-the-counter and prescribed pain medications.
- Physical therapy exercises can improve function and in many cases reduce pain. Minimally invasive spinal procedures can be safe and effective method of controlling pain. This includes Epidural steroid injections and for a subset of patients minimally invasive percutaneu decompression procedures.
- For patients whom fail to improve with conservative care or if they develop progressive neurologic deficits, Surgical options including Laminectomy with or without instrumentation/Laminoplasty should be considered.
Programs + Services
The Tufts MC Pain Management Center in downtown Boston specializes in eliminating or reducing chronic pain (particularly in the back and neck) and cancer pain.
The Tufts MC Spine Surgery Program in Boston provides a range of diagnostic and therapeutic services for spinal disorders, such as herniated discs and spinal tumors.
The Orthopaedic Spine Program at Tufts Medical Center in Boston provides orthopedic spinal care for adults suffering from trauma, disease and deformity.
The Spine Clinic at Tufts Medical Center in Boston provides alternatives to back surgery, such as bracing, exercise, physical therapy, medication and precisely guided injection therapy.