Spinal Stenosis-
Overview-
Spinal Stenosis is a condition in which there is narrowing of the spinal canal. This is commonly seen in the lumbar and cervical spine. Lumbar spine stenosis is often accompanied by nerve impingement. It includes central as well as lateral recess stenosis. In lateral canal stenosis as there is involvement of the nerve it results in severe radiculopathy, with muscle weakness, pain and immobility. This results from a series of changes in the components of the central and lateral canal such as ligamentum flavum inflammation, bony spurs, epidural fat deposition and facetal hypertrophy.(1) Management of spinal stenosis includes conservative or surgical treatment. Conservative approach comprises of rest, analgesics, anti inflammatory medications, physical exercises, and weight loss. Surgery is done in patients who have severe pain, disability, neuropathy or malignancy.
Etiology-
Spinal stenosis occurring congenitally is due to segmentation failure, achondroplasia or due to incomplete closure of vertebra arch. Developmental anomalies
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This represents that spinal stenosis accounts to be a major health issue in the United States. About 1 in 1000 of the population in the age group older to 65 years suffers from this condition. It is more prevalent in the older age group. Of these, there are about 35% patients who are asymptomatic. Lower lumbar spine is more prone to forminal stenosis as the diameter of the dorsal root ganglion is larger than that of the foramen. Among the Asians, cervical stenosis is more common. This is due to the ossification of the posterior longitudinal ligament. The longitudinal Framingham heart study recorded degenerative slip disc syndrome in about 1% of men and 1.5% female above the age group of 54. Swedish study revealed 5 of 100,000 residents developed spinal stenosis with the canal diameter 11mm or