3 key points on canal stenosis

Canal stenosis is a very common disease after the age of 60. Osteoarthritis and wear and tear of the spine cause a decrease in the caliber of the spinal canal. It should be remembered that the spinal cord passes through this canal at the level of the neck and thorax, while in the lumbar region this narrowing compresses the nerve roots (cauda equina).

It is a disease that progresses over time, but not in a linear fashion, i.e. for many years it may be stable and in a few months become very symptomatic. The presence of pain or functional impotence should be a reason to consult a specialist.

Types of canal stenosis

Canal stenosis can be classified according to its location:

  • Cervical (at the neck level)
  • Dorsal (at the level of the thorax)
  • Lumbar (the most frequent)

In addition, these stenoses can be central (midline), lateral recess stenosis (most lateral portion of the canal) and/or foraminal (at the level of the nerve exit). Finally, stenosis can be classified as mild, moderate or severe, depending on the caliber of the spinal canal that is affected.

Symptoms of canal stenosis

Symptoms depend on its location:

  • Cervical: produces spinal cord compression, this is a very serious disease, affecting the functions of mobility and sensitivity of the hands and feet. The patient may or may not present pain. The most frequent cause is a herniated disc.
  • Dorsal: the most rare, the symptoms are similar to cervical stenosis, but affect only the legs.
  • Lumbar: the most frequent symptom is pain when walking that forces the patient to stop and sit down to rest, known as gait claudication. It is produced by many causes, such as disc herniation, disc protrusions, spondyloarthrosis, enpondylolisthesis, among others.
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Operation for canal stenosis

Surgery for canal stenosis is the definitive treatment for moderate and severe stenosis, since rehabilitation only temporarily improves symptoms in mild forms. There are currently many techniques available to enlarge the size of the canal, these are classified as follows:

  • Decompressive without fusion (no screws required).
  • Decompressive with fusion (requiring the placement of screws/rods)
  • Indirect decompression (interspinous devices, X-LIF, etc).

The neurosurgeon will choose the best technique according to age and degree/location of canal stenosis.