From the Guidelines
Central canal stenosis is a condition characterized by the narrowing of the spinal canal, which can lead to pressure on the spinal cord or nerve roots, resulting in symptoms such as pain, numbness, and weakness. This condition typically develops due to degenerative changes in the spine, such as disc herniation, bone spurs, thickened ligaments, or arthritic changes 1. The narrowing of the spinal canal can put pressure on the spinal cord or nerve roots, leading to symptoms like pain, numbness, tingling, or weakness that may radiate down the arms or legs depending on the location of the stenosis.
Key Points
- Central canal stenosis most commonly affects the lumbar (lower back) and cervical (neck) regions of the spine.
- Treatment options range from conservative approaches like physical therapy and anti-inflammatory medications, to surgical interventions in severe cases where neurological function is compromised or conservative treatments fail.
- The development of central canal stenosis is often age-related, as the spine undergoes natural wear and tear over time, though factors like genetics, previous spine injuries, or certain medical conditions can accelerate this process. According to a recent study published in the BMJ in 2021 1, lumbar spine decompression for spinal canal stenosis has shown similar effects to non-surgical treatment in terms of pain intensity, physical function, and quality of life. However, surgical intervention may be necessary in severe cases where neurological function is compromised or conservative treatments fail.
From the Research
Definition of Central Canal Stenosis
- Central canal stenosis refers to the narrowing of the central canal in the spine, which can cause symptoms such as pain, numbness, and weakness in the legs 2.
- It is a type of lumbar spinal stenosis, which can be congenital or acquired, and can occur with or without low back pain, with or without spondylolisthesis 3.
Causes and Symptoms
- Central canal stenosis can be caused by various factors, including degenerative changes, trauma, or congenital conditions 3.
- Symptoms of central canal stenosis can include pain, numbness, and weakness in the legs, as well as neurogenic claudication, which is a condition characterized by pain, numbness, or weakness in the legs that occurs when walking or standing 3.
Treatment Options
- Treatment options for central canal stenosis can include non-surgical interventions, such as physical therapy, medication, and lifestyle modifications 3.
- Surgical interventions, such as decompression surgery, may also be considered in some cases 4.
- Epidural steroid injections may also be used to treat central canal stenosis, although the evidence for their effectiveness is limited 5.
Complications
- Complications of central canal stenosis can include persistent hiccups (singultus) after epidural steroid injection, which can be treated with conservative measures and non-pharmacologic methods, or with medication such as baclofen, gabapentin, or chlorpromazine 2.