Spinal Stenosis Treatment In San Antonio

What Is Spinal Stenosis?

The word "stenosis" simply means abnormal narrowing of an opening or passageway. In someone with heart disease, there is often stenosis of one or more of the blood vessels of the heart, and this is called coronary stenosis.

In the spine, the term stenosis can actually refer to more than one passageway and to more than one thing causing the narrowing.

First, there are two types of spinal passageways in which narrowing, or stenosis, can occur. One opening is the "central canal", which is the main passageway for the spinal cord that runs through the center of the spine (the spinal cord is represented in the picture above by the yellow structure running from top to bottom inside the spinal column). Narrowing of this passageway may be called spinal stenosis or central stenosis.

The second type of passageway that can be narrowed is what is called an intervertebral foramen, which is a fancy term for one of the openings where the nerves branching off from the spinal cord exit the spine (in the picture above, the spinal nerves are the yellow structures running sideways out from the center of the spine at a slightly downward angle). Although it is more technically correct to call narrowing of these openings foraminal stenosis, lateral stenosis, or neural stenosis (these terms are used interchangeably), it is often called spinal stenosis, even though this term is supposed to be reserved for narrowing of the central canal around the spinal cord as described above.

This brings us to the issue of what is causing the narrowing. In most cases, stenosis of either central canal around the spinal cord, or the openings for the spinal nerves is caused by excess bone growth, a bulging spinal disc, or both. In rare instances, a tumor or some other unusual pathology can also cause stenosis, but bone growth and/or disc bulging are by far the most common causes.

Excess bone growth occurs in many cases of degenerative arthritis and disc degeneration in which the body tries to reinforce areas of excessive mechanical stress with additional bone. Typically, this extra bone will deposit in either "spurs", which ar long-thin projections, or "bars" or "ridges", which are more broad-based. In either case, you may see the term "osteophytes" on a doctor's report, and this is the "official" term for this type of degenerative bone growth. Over time, the bone growth can cause significant narrowing of either the central spinal canal, or the openings for the nerves. The picture below gives a simplified representation of "bony" or "osteophytic" stenosis":

The image to the left above represents a normal passageway through the bone (represented in the off-white color). The image on the right shows the opening being taken over by abnormal bone growth.

The other common cause of both spinal (central) and neural (also called lateral or foraminal) stenosis is a bulging or protruding disc. The picture below gives a simplified representation of this type of stenosis:

In the picture above, the image to the left shows the normal orientation of the disc (shown in red at the top of the picture) to the opening, and the figure to the right shows what happens when a disc bulges or protrudes into it.

Of course, there are also situations that get the "double whammy", and get narrowing from both abnormal bone growth and disc protrusion at the same time.

Remember, in a real spine, the openings shown in the images above are not empty - they are filled with sensitive neurological structures (the spinal cord in the case of spinal or central stenosis, or a spinal nerve in the case of neural, foraminal, or lateral stenosis).

When the openings get sufficiently narrowed, the neurological structures become compressed and symptoms begin to develop. In the case of spinal stenosis, in which the spinal cord (which in the lower spine becomes a group of individual nerves rather than a single cord) becomes compressed, the symptoms tend to be things like numbness and weakness in the legs and feet, that often gets worse over time.

In the case of stenosis that compresses the spinal nerves, the symptoms will often start out as pain, tingling, burning, and other sensations but may shift more towards numbness and weakness over time if the problem is not adequately treated.

How Can Stenosis Be Treated?

The treatment for spinal stenosis is dependent on the type and severity of the stenosis.

When it comes to bony stenosis, there is no non-surgical way to remove the excess bone; however, even bony stenosis can usually be effectively treated without having to resort to surgery. In many cases, a patient's symptoms are actually caused by a combination of the narrowing caused by the extra bone along with pressure caused by inflammatory swelling. This is why treatments like anti-inflammatory medications and cortisone injections (which are simply a way to deliver a potent anti-inflammatory right at the source of trouble) often provide temporary relief for people with bony stenosis. But there is another way to provide more long-term relief for people with bony stenosis that can stop the progression of the problem and prevent the need for surgery in most situations.

Spinal decompression promotes improved hydration to the discs, which can gradually improve the thickness of the discs and this in turn decreases the mechanical stress on the bone surfaces. The immediate effect of this reduced mechanical stress is often a dramatic decrease in inflammation - and since it is helping the CAUSE of the inflammation, rather than artificially suppressing it, the anti-inflammatory effect from decompression can be long-lasting.

Perhaps more importantly, the reduced mechanical stress on the bones that results from enhanced disc hydration will often translate to a slowing or stopping of the progression of the abnormal bone formation. In other words, by helping the discs, the abnormal bone growth may often be kept from getting worse, and ultimately may help prevent the need for invasive treatment (surgery) down the road.

When it comes to disc-related stenosis, spinal decompression can be even more effective, since it is usually possible to produce retraction of the bulging disc material and gradual healing and stabilization to prevent the disc from bulging back into the spinal canals.

The bottom line is, spinal decompression is often a very effective treatment for both disc and bone-related stenosis and can provide an excellent alternative to surgical treatment in many cases.

If you would like to find out what South Texas Non-Surgical Spinal Center can do to help you with your spinal stenosis, please contact us for a FREE consultation and evaluation.

Call us today at (210) 408-7888!

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