Understanding spinal foraminal stenosis

Spinal foraminal stenosis is a particular type of narrowing of the passageways in the spinal column. The spinal column is made up of many intricate parts, including nerve roots, vertebrae, vertebral discs, ligaments and the spinal cord. On either side of each bony vertebra, small pockets of empty space called foramina (or singular, foramen) allow the spinal nerve roots to pass from the spinal cord to the rest of the body. Since the foramina establish passageways for the nerves, any obstruction of these passageways can result in nerves being compressed and pinched. Obstructions are frequently caused by normal, age-related degeneration, 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 cause spinal foraminal stenosis.

Where in the spine does spinal foraminal stenosis occur?

Spinal foraminal stenosis can present itself in more than one region of the spine. The most common type of spinal stenosis is lumbar foraminal stenosis, which begins in the lower back. Foraminal cervical stenosis occurs in the neck and upper back region, while thoracic spinal stenosis resides in the middle back.

Each movement that our bodies make is somehow connected to the spine, and the spine is one of the most complicated regions of the body. The spine is made up of many components that must function in unison, and 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 — the stacked bones of the spinal column
  • Spinal foramina — the spaces on each side of the vertebrae that allow for nerves to pass through
  • Spinal discs — pads of gelatinous fluid that act as shock absorbers in between the vertebrae
  • Spinal cord — extends from the base of the brain down to the lower back and is encased by the vertebral column
  • Facet joints — connect vertebrae together and support movement in the spinal column
  • Synovium — a fluid-producing membrane that lubricates the facet joints
  • Ligaments — flexible bands of tissue that keep vertebrae from slipping out of alignment
  • Lamina — the part of each vertebra that creates a thin, bony “roof” over the spinal canal and spinal cord
  • Vertebral arch — the cylinder of bone that the spinal cord passes through
  • Pedicles — narrow structures that form the walls of the vertebral arch
  • Cauda equina — a bundle of nerve roots extending from the bottom of the spinal cord that provides neurological function to the lower body

Symptoms of spinal foraminal stenosis

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.

With bilateral foraminal stenosis, symptoms are experienced on both sides of the body because the foramina on either side of a vertebra are affected. More commonly, however, foraminal stenosis generally affects a foramen on just one side and, therefore, only causes symptoms on one side of the body.

Treatment options for spinal foraminal stenosis

More often than not, a physician will first recommend conservative treatment, 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.

However, there are options available if your spinal foraminal stenosis does not respond to moderate treatment methods. Laser Spine Institute offers minimally invasive spine surgery to address many spine conditions, including spinal foraminal stenosis. Our procedures are a safer and effective alternative to traditional open back procedures,^ and we help thousands of patients find relief from chronic neck and back pain each year. For more information, please contact us today. We can provide a free MRI review* to determine whether you may be a candidate for our procedures.