Jason H. Thompson, MD

Stenosis? Arthritis? What is the difference?

 

One of my patients asked me about the difference between Spinal stenosis and Arthritis.
Spinal stenosis is a narrowing of spaces in the spine (backbone) that results in pressure on the spinal cord and/or nerve roots (National Institute of Arthritis and Musculoskeletal and Skin Diseases). Spinal arthritis is the breakdown of the cartilage between the joints in the spine that quite often leads to pain. The joints become inflamed and increased joint degeneration creates more pain. Back motion and flexibility decrease in proportion to the progression of back pain felt while standing, sitting and even walking. 

In Spinal stenosis, bone spurs (small irregular growths on the bone) typically form on the joints and around the spinal vertebrae. These bone spurs are a response to joint instability and are nature’s attempt to help return stability to the joint. The enlargement of the normal bony structure indicates degeneration of the spine. Bone spurs are a normal part of aging and do not directly cause pain, but may become large enough to cause irritation or trap the nerves passing through the spinal structures, and they may result in less room for the nerves to pass (spinal stenosis).

Spinal stenosis can occur as a result of the effects of arthritis, aging, inherited conditions, tumors, injuries, Paget’s disease ( a disease that affects the bones), too much fluoride in the body calcium deposits on the ligaments that run along the spine . (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

When Should Surgery Be Considered and What Is Involved?
In many cases, the conditions causing spinal stenosis cannot be permanently resolved by nonsurgical treatment, even though these measures may relieve pain for a period of time. A doctor may recommend such treatment first, but surgery might be considered immediately if a patient has symptoms including numbness or weakness that interferes with walking or impaired bowel or bladder function. The effectiveness of nonsurgical treatments, the extent of the patient’s pain and the patient’s preferences may all factor into whether or not a physician recommends surgery.

The purpose of surgery is to relieve pressure on the spinal cord or nerves and to restore and maintain the spine’s alignment and strength. This can be done by removing, trimming, or adjusting diseased parts that are causing the pressure or loss of alignment. The most common surgery is called decompressive laminectomy: removal of the lamina (roof) of one or more vertebrae to create more space for the nerves. A surgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disk. Various devices may be used to enhance fusion and strengthen unstable segments of the spine following decompression surgery. (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

www.niams.nih.gov/Health_Info/Spinal_Stenosis/#spine_e

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