Spinal Stenosis

By | March 31, 2015

We have used this illustration before to illustrate the boney overgrowth resulting from facet joint arthritis.  In this blog we are interested in the effect of this overgrowth on constricting the spinal canal both centrally and laterally.

We have used this illustration before to illustrate the boney overgrowth resulting from facet joint arthritis. In this blog we are interested in the effect of this overgrowth on constricting the spinal canal both centrally and laterally.

As we said in an earlier blog spinal stenosis is a condition where there is narrowing of the spinal canal. As was the case with foraminal stenosis obstruction of an otherwise patent canal by a herniated lumbar disc does not qualify as stenosis because the epidemiology and treatment of disc disease is different from true spinal stenosis. At Schlesinger Pain Centers the vast majority of the patients with true stenosis are elderly, usually significantly older than the patients with lumbar disc disease or foraminal stenosis and the narrowing is primarily the result of boney overgrowth primarily from arthritic facet joints.   The symptoms of spinal stenosis are also different and not classically radicular because the concentric narrowing of the canal compresses all of the roots equally. Patients with spinal stenosis are also more likely to present with symptoms of incontinence than other patients. The treatment of pure spinal stenosis is usually a posterior decompression via lumbar laminectomy. The real problem we experience here at Schlesinger Pain Centers is that most of these patients have multilevel stenosis and are too old and infirm to tolerate the extensive surgical procedures that would be necessary to fully treat them. I speak to friends at medical meetings from time to time and these patients are among the most vexing we treat, not just in Burbank, but around the country.


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