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Spinal Stenosis

Spinal stenosis is the narrowing of nerve passages in the spine. It occurs when the bones, ligaments or discs of the spine squash the nerves of the spine (usually the sciatic nerve) causing pain, usually in the lower back and legs. It usually affects people in late middle age and older.

Causes of spinal stenosis

  • Age-related changes in the spine
  • Changes in the ligaments of the spine
  • Diseases of the bone, such as Paget’s disease

Less commonly, sciatica may be caused by:

  • Infection
  • Injury
  • A growth within the spine, such as a tumour

Symptoms of spinal stenosis

The space within the spinal canal may narrow without producing any symptoms. However, if narrowing places pressure on the spinal cord, cauda equina, or nerve roots, there may be a slow onset and progression of symptoms. The neck or back may or may not hurt. More often, people experience numbness, weakness, cramping, or general pain in the arms or legs. If the narrowed space within the spine is pushing on a nerve root, people may feel pain radiating down the leg (sciatica). Sitting or flexing the lower back should relieve symptoms. (The flexed position “opens up” the spinal column, enlarging the spaces between vertebrae at the back of the spine.) Flexing exercises are often advised, along with stretching and strengthening exercises.

People with more severe stenosis may have problems with bowel and bladder function and foot disorders. For example, cauda equina syndrome is a severe, and very rare, form of spinal stenosis. It occurs because of compression of the cauda equina, and symptoms may include loss of control of the bowel, bladder, or sexual function and/or pain, weakness, or loss of feeling in one or both legs. Cauda equina syndrome is a serious condition requiring urgent medical attention.

Spinal stenosis surgery

In many cases, the conditions causing spinal stenosis cannot be permanently altered by nonsurgical treatment, even though these measures may relieve pain for a period of time. To determine how much nonsurgical treatment will help, a doctor may recommend such treatment first. However, surgery might be considered immediately if a patient has numbness or weakness that interferes with walking, impaired bowel or bladder function, or other neurological involvement. The effectiveness of nonsurgical treatments, the extent of the patient’s pain, and the patient’s preferences may all factor into whether or not to have surgery.

The purpose of surgery is to relieve pressure on the spinal cord or nerves and restore and maintain alignment and strength of the spine. 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.

Patients with spinal stenosis caused by spinal trauma or achondroplasia may need surgery at a young age. When surgery is required in patients with achondroplasia, laminectomy (removal of the roof) without fusion is usually sufficient.

Contact us

For further questions relating to Spinal Stenosis or to book an appointment, call us on 020 3370 1030 or email spinespecialists@hje.org.uk

Spine Clinic

The Spine Clinic at St John & St Elizabeth Hospital is a centre for excellence in the diagnosis, intervention and aftercare of all spinal conditions.

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Patient information

Our Hospital is renowned for providing exemplary levels of care across more than 90 services. From orthopaedics, to urology, our private GP practice and Urgent Care Clinic, our services are led by some of London’s leading Consultants. For more information, and to find a service suitable for your care, find out more about the services that we offer.

Make an enquiry

If you have any questions relating to treatment options or pricing information, get in touch with us by filling out one of our contact boxes or giving us a call on 020 3370 1030.

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you are self-paying you don’t need a referral from your GP for a consultation. You can simply refer yourself* and book an appointment.

If you have health insurance (e.g. Bupa, Axa Health, Aviva), you will need to contact your insurer to get authorisation before any treatment, and in most cases you will also require a referral letter from your GP.

If you are not registered with a GP, we have an in-house private GP practice you can use. Alternatively, we can suggest the most appropriate course of action for you to take, given your location and individual circumstances.

*Please note – for investigations such as X-rays and MRIs, a referral will be required. However, we may be able to arrange this for you through our on-site private GP.

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