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Spinal stenosis

Screening and diagnosis

Spinal stenosis can be difficult to diagnose because its signs and symptoms are often intermittent and because they resemble those of many age-related conditions. To help diagnose spinal stenosis and rule out other disorders, your doctor will ask about your medical history and perform a physical exam that may include checking your range of motion and leg reflexes.

You are also likely to have one or more of the following tests:

• Spinal X-ray. Although an X-ray isn't likely to confirm that you have spinal stenosis, it can help rule out problems that cause similar symptoms, including a fracture, bone tumor or inherited defect.

• Magnetic resonance imaging (MRI). In many cases, this is the imaging test of choice for diagnosing spinal stenosis. Instead of X-rays, an MRI uses a powerful magnet and radio waves to produce cross-sectional images of your back. The test can detect damage to your disks and ligaments as well as the presence of tumors.

• Computerized tomography (CT) scan. This test uses a narrow beam of radiation to produce detailed, cross-sectional images of your body, including the shape and size of your spinal canal. Because this test exposes you to more radiation than does a regular X-ray, it's not recommended if you're pregnant.

• CT myelogram. This may be the most sensitive test for detecting spinal stenosis, but because it poses more risks than MRI or CT, it may not be your doctor's first choice. If you're contemplating surgery, however, your doctor may recommend a CT myelogram to assess the severity of the stenosis. In a myelogram, a contrast dye is injected into your spinal column. The dye then circulates around your spinal cord and spinal nerves, which appear white on the X-ray. A myelogram can show herniated disks, bone spurs and tumors.

• Bone scan. In this test, a small amount of a radioactive material that attaches to bone is injected into a vein in your arm. The material emits waves of radiation that are detected by a gamma camera. The camera then produces images of your bones. In a sense, a bone scan is the opposite of a standard X-ray, in which radiation passes through your body to create an image on film. A bone scan can detect a number of bone disorders, but often can't distinguish among them. For that reason, it's usually performed with other tests.

• Other diagnostic procedures. Sometimes your doctor may inject you with a spinal nerve block or epidural steroids. If your symptoms improve after the injection — you can walk without pain, say — spinal stenosis is likely the cause of your discomfort. The problem with this approach is that a negative finding doesn't mean you don't have spinal stenosis.

Complications

Nerve compression sometimes causes a loss of feeling in your feet or legs. As a result, cuts or wounds may become seriously infected because you're not aware of them. In addition, spinal stenosis sometimes interferes with bowel or bladder function — a problem that can affect your quality of life. And although treatment can relieve symptoms of spinal stenosis, it doesn't stop degenerative changes. Some of these changes, such as muscle atrophy, may be permanent, even after the pressure is relieved.

Spinal stenosis > 1 > 2 > 3 > 4

Related Site:

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• Spinal stenosis

Treatments

 

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