Introduction
Spinal stenosis is a usually painful consequence of underlying (“degenerative”) changes in the spine. All people suffer from degenerative changes in various structures of the body in the course of their lives. This results in bony attachments (osteophytic attachments), arthrosis-like changes in the intervertebral joints and degenerative changes in the intervertebral discs.
These processes can now lead to a narrowing of the spinal canal, i.e. the canal within the vertebral bodies in which the spinal cord runs, and the intervertebral holes (Foramina intervertebralia). The so-called spinal nerves, the extensions of the spinal cord, emerge from these holes and can thus be compressed. The lumbar spine is mainly affected, since it is subject to a great deal of force and must bear the most weight.
Spinal canal stenosis manifests itself here in particular through load-dependent lower back pain that radiates into the legs. Those affected can only walk pain-free for a certain distance (claudication spinalis). However, spinal canal stenosis of the cervical spine is also possible.
Typical are complaints in the shoulder and neck region. Movement restrictions and sensory disorders of the arms, but also of the legs, are possible. The diagnosis is made using imaging techniques. Priority is given to the MRI, on which the narrowing of the spinal canal can be clearly seen. Therapeutically, both conservative and surgical procedures are used.
Causes
Spinal canal stenosis is primarily the product of years of degenerative processes and changes in the spine. Such degenerative changes occur in every person in the course of his/her life. However, not everyone suffers from spinal canal stenosis.
Whether or not such processes cause discomfort depends on the extent of the changes as well as the strain on the spinal column. Degenerative processes lead to a kind of wear or decay of tissue, so that functional limitations may occur. Various changes in the spinal column can lead to spinal stenosis.
Bony attachments, also known as spondylophytes, form as a result of wear and tear. These are bone tissue that is virtually deposited at various points on the vertebral bodies or the bony forest branches of the vertebrae. These attachments can constrict the spinal canal or compress nerve roots at their exit points in the intervertebral holes (Foramina intervertebralia).
In addition, wear and tear of the intervertebral discs causes a loss of height and they become narrower. The wear and tear of the intervertebral discs leads to increased stress on the individual vertebral bodies. A further consequence of the loss of height is a loss of elasticity of the ligamentous apparatus of the spine, which is less taut.
This can cause the vertebral bodies to slide against each other (spondylolisthesis). Finally, arthrosis-like changes in the intervertebral joints must also be mentioned. These joints connect the vertebrae with each other and are also called facet joints.
All these processes gradually lead to constrictions (stenoses) at various points of the spinal canal or intervertebral holes, which are generally referred to as spinal canal stenosis. Strong back muscles can help to stabilize the spine. People who do not have strong back muscles due to lack of exercise or for other reasons, therefore, develop such complaints more quickly.
Spinal canal stenoses rarely occur in the context of other primary diseases. Another rare cause of spinal canal stenosis is spinal surgery. Excessive scar tissue after the operation can lead to spinal canal stenosis of the cervical spine. Injuries to the spinal column or herniated discs of the cervical spine can also lead to spinal canal stenosis of the cervical spine.
