Spinal foraminal stenosis refers to a specific type of narrowing in the spinal column. Nerve roots, vertebrae, vertebral discs, ligaments, and the spinal cord all make up the spinal column. On either side of each bony vertebra, small pockets of empty space, called foramina, allow the spinal nerve roots to pass from the spinal cord on their way to the rest of the body. Since the foramina create passageways for the nerves, any obstruction of these passageways can result in nerves being compressed and pinched. Obstructions are most commonly caused by degenerative disc disease, which can lead to conditions such as osteophytes (bone spurs), herniated discs (often referred to as slipped discs), and bulging discs. The enlargement of ligaments that connect the vertebrae together also can be a culprit of spinal foraminal stenosis.
Spinal foraminal stenosis can present itself in several different regions of the spine. The most common type of spinal stenosis is lumbar foraminal stenosis, which originates in the lower back. Foraminal cervical stenosis begins in the upper back and neck region, while thoracic spinal stenosis resides in the middle back.
Each movement that we make is somehow connected to the spine, which is one of the most complicated regions of the body. Because the spine is made up of so many components that must function in unison, an understanding of their functions and relationships to each other is essential to understanding spinal foraminal stenosis. Some components of the spine are as follows:
- Vertebrae are the stacked bones of the spinal column.
- Intervertebral foramina are spaces on each side of the vertebrae that allow for nerve travel.
- Intervertebral discs are pads of gelatinous fluid that act as shock absorbers in between the vertebrae.
- The spinal cord – an essential component of the central nervous system – extends from the base of the brain down to the lower back and is encased by the vertebral column.
- Facet joints connect the back of each vertebra together and support movement in the spinal column.
- Synovium is a fluid-producing membrane that lubricates the facet joints.
- Ligaments are bands of tissue with elasticity that keep vertebrae from slipping out of alignment.
- Lamina is the part of each vertebrae that creates a thin bony “roof” over the spinal canal and spinal cord.
- The vertebral arch is the cylinder of bone that the spinal cord passes through.
- Pedicles are narrow structures that form the walls of the vertebral arch.
- Cauda equina is a bundle of nerve roots originating in the lumbar region; this bundle provides neurological function to the lower body.
Depending on the location of your spinal foraminal stenosis, symptoms may include pain, numbness, weakness, or a “pins-and-needles” feeling. The pain will often be radicular, meaning that it radiates from the site of the condition to other areas of the body, affecting the arms, shoulders, hips, legs, feet, and hands. Cases of severe foraminal stenosis can include symptoms such as loss of balance or loss of reflexes.
If you have bilateral foraminal stenosis, you likely will experience symptoms on both sides of the body because the foramina on either side of the intervertebral discs are affected. More commonly, however, foraminal stenosis generally affects the foramina on one side, and therefore, symptoms occur on one side of the body. When you see your physician for a diagnosis, he or she may recommend moderate, conventional treatment options, such as mild stretching, rest, physical therapy, anti-inflammatory medications, or steroidal injections. Maintaining a healthy weight and engaging in regular physical activity can also help with the treatment and prevention of spinal foraminal stenosis.
Fortunately, there are options available if your spinal foraminal stenosis does not respond to treatment. Laser Spine Institute offers minimally invasive, state-of-the-art endoscopic techniques to reduce pressure on your impinged nerves and help you regain an active life. Contact Laser Spine Institute today to learn more about our procedures, and to receive a complimentary review of your MRI or CT scan.