$Unique_ID{BRK04235} $Pretitle{} $Title{Stenosis, Spinal} $Subject{Stenosis, Spinal Lumbar Spinal Stenosis Degenerative Lumbar Spinal Stenosis Familial Lumbar Stenosis Stenosis of the Lumbar Vertebral Canal Lumbar Canal Stenosis Lumbosacral Spinal Stenosis Thoracic Spinal Canal Stenosis Cervical Spinal Stenosis Tandem Spinal Stenosis Sciatica Paget's Disease Amyotrophic Lateral Sclerosis Cauda Equina Syndrome Herniated Intervertebral Lumbar disk } $Volume{} $Log{} Copyright (C) 1988, 1989 National Organization for Rare Disorders, Inc. 402: Stenosis, Spinal ** IMPORTANT ** It is possible that the main title of the article (Spinal Stenosis) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Lumbar Spinal Stenosis Degenerative Lumbar Spinal Stenosis Familial Lumbar Stenosis Stenosis of the Lumbar Vertebral Canal Lumbar Canal Stenosis Lumbosacral Spinal Stenosis Thoracic Spinal Canal Stenosis Cervical Spinal Stenosis Tandem Spinal Stenosis Information on the following diseases can be found in the Related Disorders section of this report: Sciatica Paget's Disease Amyotrophic Lateral Sclerosis Cauda Equina Syndrome Herniated Intervertebral Lumbar disk General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Spinal Stenosis is characterized by measurable constriction, compression or narrowing of space inside the spinal canal, nerve root canals, or vertebrae which contains nerves and blood vessels. This condition can affect limited areas of the spine. Constriction may or may not continue to progress. In other cases, symptoms may begin as a result of spinal injury or surgery for spinal disk problems. Abnormal bone growth or deterioration can cause narrowing of the spinal canal. Nerve and blood vessel compression, intermittent limping or problems with walking, and/or urinary incontinence can occur. Pain, numbness or burning sensations may occur in the lower back or legs. Temporary paralysis of the legs can also develop. Symptoms Spinal Stenosis is characterized by narrowing of the space occupied by nerves and blood vessels inside the spinal canal or vertebrae. It can be marked by abnormal bone growth or deterioration. Nerve and blood vessel compression can lead to problems with walking, intermittent limping, urinary incontinence, temporary paralysis of the legs, and pain or burning sensations in the lower back and legs. This disorder tends to occur most often among middle aged or elderly persons although it can be present at birth. Causes Spinal Stenosis may be inherited in some cases as an autosomal dominant trait. (Human traits including the classic genetic diseases, are the product of the interaction of two genes for that condition, one received from the father and one from the mother. In dominant disorders, a single copy of the disease gene (received from either the mother or father) will be expressed "dominating" the normal gene and resulting in appearance of the disease. The risk of transmitting the disorder from affected parent to offspring is 50% for each pregnancy regardless of the sex of the resulting child.) Affected Population Spinal Stenosis tends to affect males more often than females, and is usually found among middle aged or elderly persons. Persons engaging in extremely rough contact sports with a high possibility of sustaining back injuries (such as football or hockey) may have more occurrences than that of the general population. Related Disorders Symptoms of the following disorders can be similar to those of Spinal Stenosis. Comparisons may be useful for a differential diagnosis: Sciatica is a sciatic nerve root disease that causes very severe pain. It may occur alone or in combination with other conditions. Sciatica is characterized by pain radiating down one or both buttocks and/or legs in the distribution of the sciatic nerve. Sciatica can be caused by peripheral nerve root compression from spinal disk abnormalities, tumors, or rarely from infection. The nerves may be compressed inside the spinal canal, pelvis or buttocks. Toxic inflammation (usually caused by Diabetes or alcoholism) may also cause this type of nerve pain in rare cases. Paget's Disease is a slowly progressive disease of the skeletal system characterized by abnormally rapid bone breakdown and formation, leading to the development of bones that are dense but fragile. It usually affects middle-aged and elderly people and most frequently occurs in the spine, skull, pelvis, thighs and lower legs. When the spine is affected, symptoms can resemble those of Spinal Stenosis. (For more information on this disorder, choose "Paget" as your search term in the Rare Disease Database). Cauda Equina Syndrome is characterized by dull pain in the lower back (upper sacral) region with loss of sensation in buttocks, genitalia, or thighs. Bowel and bladder function are disturbed. This is caused by compression of the bundle of spinal nerve roots (cauda equina) below the first lumbar vertebra. Surgical decompression can be successful in alleviating symptoms. A Herniated Intervertebral Lumbar ("slipped") Disk refers to an abnormal protrusion into the spinal canal of the fibrous tissue (spinal disk) that acts as a shock absorber between bony vertebrae. The disk does not actually move, but rather swells outward. The protruded disk can compress the space in the spinal canal and cause nerve injury and pain. This condition is very common, and occasionally may require correction by surgery. The following disorder may precede the development of Spinal Stenosis. This can be useful in identifying an underlying cause of some forms of this disorder: Achondroplasia is an inherited skeletal disorder which is one of a group of congenital disorders known as the chondrodystrophies. These diseases are marked by abnormalities in the way cartilage is converted to bone. Skeletal deformities and dwarfism occur as a result of growth abnormalities in the bone and cartilage. In some cases, the bones and cartilage of the spine are affected causing narrowing in the intervertebral canal or Spinal Stenosis. (For more information on this disorder, choose "Achondroplasia" as your search term in the Rare Disease Database). Therapies: Standard Diagnosis of Spinal Stenosis involves the use of imaging procedures such as magnetic resonance imaging (MRI), Computerized Tomography (CT) scan, myelography, and/or intraoperative spinal sonography (IOSS). Surgery to decompress the spinal canal may be helpful. Other treatment is symptomatic and supportive. Therapies: Investigational Internal Spinal Fixation devices are being tested for some cases of Spinal Stenosis. These devices seek to alleviate pressure on nerves or blood vessels in the spinal canal by mechanically changing the position of some of the bony vertebral sections. More research is required to determine complete long-term effectiveness of these devices. This disease entry is based upon medical information available through April 1989. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Spinal Stenosis, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 National Scoliosis Foundation, Inc. 72 Mount Auburn St. Watertown, MA 02172 (617) 926-0397 The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 For genetic information and genetic counseling referrals, please contact: March of Dimes Birth Defects Foundation 1275 Mamaroneck Avenue White Plains, NY 10605 (914) 428-7100 Alliance of Genetic Support Groups 35 Wisconsin Circle, Suite 440 Chevy Chase, MD 20815 (800) 336-GENE (301) 652-5553 References MENDELIAN INHERITANCE IN MAN, 7th ed.: Victor A. McKusick; Johns Hopkins University Press, 1986. P. 465. SURGICAL MANAGEMENT OF LUMBAR SPINAL STENOSIS: R.J. Nasca; Spine (October 1987, issue 12(8)). Pp. 809-816. LUMBAR HERNIATED DISK DISEASE AND CANAL STENOSIS: PROSPECTIVE EVALUATION BY SURFACE COIL MR, CT, AND MYELOGRAPHY: M.T. Modic, et al.; AJR (October 1986, issue 147(4)). Pp. 757-765. TANDEM LUMBAR AND CERVICAL SPINAL STENOSIS. NATURAL HISTORY, PROGNOSTIC INDICES, AND RESULTS AFTER SURGICAL DECOMPRESSION: T.F. Dagi, et al.; J Neurosurg (June 1987, issue 66(6)). Pp. 842-849. CAUDA EQUINA SYNDROME: A COMPLICATION OF LUMBAR DISCECTOMY: A.C. McLaren, et al.; Clin Orthop (March 1986, issue 204). Pp. 143-149. THORACIC SPINAL CANAL STENOSIS: G.H. Barnett, et al.; J Neurosurg (March 1987, issue 66(3)). Pp. 338-344. INTERPEDUNCULAR SEGMENTAL FIXATION: E. Luque; Clin Orthop (February 1986, issue 203). Pp. 54-57.