Spinal Stenosis

The spine is a complex structure of our body that is part of the axial skeleton that makes up the central part of our body. The spine is composed of 33 small units called vertebrae, 7 cervical, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal. The vertebrae have a canal in their posterior part in which the nervous system passes through, innervating various structures to allow perception of sensation and movement. Spinal canal stenosis is a condition that occurs when the spinal cord (the neural system that passes through the spinal canal), is compressed due to narrowing of the spinal spaces. This narrowing can be congenital or occur over time. Gradual narrowing can be caused by several factors, such as a reported injury to the spine, bony conditions that lead to excessive bone growth (for example: osteoarthritis), disc disease (protrusions and hernias), and other medical conditions (for example: cysts). Depending on the specifics of the condition, patients with this condition may report significantly different symptoms, from being completely asymptomatic, to presenting with twinges in the lower back and neural symptoms (for example: tingling, burning, weakness, etc.). In addition to collecting data regarding the mechanism of injury and performing a physical assessment of the patient, an instrumental examination (e.g., X-ray, computed tomography, MRI, etc.) is necessary to optimally visualize the specifics of the injury. It is important to emphasize that the presence of anatomical abnormalities of the spine detected by instrumental examination do not necessarily correlate with the symptoms reported by the patient, and false positives are common. For this reason, a holistic approach is critical in the diagnosis and treatment of patients with back disorders.