What is Spinal Stenosis?
Spinal stenosis is a condition in which the space within the spinal canal narrows, placing pressure on the spinal cord and/or nearby nerves.
It most commonly occurs as part of the degenerative (aging) process and is frequently seen in the lumbar (lower back) and cervical (neck) spine.
What Causes Spinal Stenosis?
Spinal stenosis typically develops gradually over time due to a combination of factors, including:
- Disc degeneration and bulging
- Facet joint arthritis
- Thickening of ligaments (such as ligamentum flavum hypertrophy)
- Bony overgrowth (osteophytes)
These changes can collectively narrow the space available for nerves.
Symptoms of Spinal Stenosis
Symptoms depend on the location and severity of the narrowing.
A hallmark symptom—especially in lumbar stenosis—is neurogenic claudication, which includes:
- Pain, heaviness, or fatigue in the legs with walking or standing
- Relief with sitting or bending forward (such as leaning on a shopping cart)
Other symptoms may include:
- Back or neck pain
- Numbness or tingling
- Weakness in the arms or legs
- Balance difficulties (especially in cervical stenosis)
How is it Diagnosed?
Diagnosis is based on a combination of clinical symptoms and imaging findings.
Imaging studies may include:
- MRI (most commonly used) to evaluate nerve compression
- CT scan to assess bony anatomy
- X-rays to evaluate alignment and stability
Radiographic findings often show narrowing of the spinal canal or neural foramina, along with degenerative changes in discs, joints, and ligaments.
Treatment Options
Conservative Management
We almost always begin with non-surgical treatment, especially if symptoms are mild to moderate.
This may include:
- Physical therapy
- Activity modification
- Pain management
- Epidural steroid injections
Many patients experience meaningful improvement with these measures.
Surgical Treatment
If symptoms are severe, progressive, or do not respond to conservative care, surgery may be recommended.
The most common surgical approach is:
- Decompression surgery (such as laminectomy), which removes the structures causing pressure on the nerves
In most cases, decompression alone is sufficient.
However, if there is evidence of:
- Spinal instability
- Spondylolisthesis (vertebral slippage)
- Or other structural concerns
Then a fusion procedure may be performed in addition to decompression to stabilize the spine.
Our Approach
We take a stepwise and individualized approach to spinal stenosis.
Our priority is to begin with conservative management whenever appropriate. When surgery is necessary, we focus on:
- Performing targeted decompression to relieve nerve pressure
- Avoiding fusion unless there is clear instability
- Utilizing minimally invasive techniques when possible to reduce recovery time and tissue disruption
Our goal is to effectively relieve symptoms while preserving as much of the spine’s natural structure and function as possible.
View the approach