Congenital Spinal Stenosis: Symptoms, Diagnosis, Treatment and Complications

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Congenital spinal stenosis is a condition of the spinal cord that is present at birth, characterized by a narrowed spinal canal. While this condition is present at birth, it is not hereditary. This condition is present at birth, but most patients are not aware they have it until they are into adulthood. This condition is rare and it cannot be prevented or detected prior to birth.

Signs and Symptoms

If this condition is affecting the neck, patients may experience shoulder or neck pain, numbness or weakness or loss of bladder or bowel control. If this condition is affecting the lower back, patients may experience cramping or pain in the legs with walking or prolonged standing. Balance problems are also possible.

Testing and Diagnosis

This condition can be hard to diagnose which is why it often goes undiagnosed until adulthood. Spinal X-rays are often performed. These are usually done to rule out other conditions that could be causing similar symptoms, such as a bone tumor, fracture or inherited defect.

A CT myelogram may be performed to get cross-sectional, detailed images of the patient’s body, including the size and shape of his or her spinal canal. With this test, a contrast dye will be injected into the patient’s spinal column to outline the nerves and spinal cord. This will be able to reveal bone spurs, tumors and herniated discs.

Magnetic resonance imaging is the diagnostic test of choice for this condition and it provides cross-sectional images of the patient’s spine. This test is able to detect ligament and spinal disc damage as well as tumors. Most importantly, an MRI can reveal pressure on spinal nerves or on the spinal cord.

Treatments and Drugs

There are a variety of treatments for congenital spinal stenosis. Medications are commonly used. Taking tricyclic antidepressants at night are beneficial in helping some patients ease their pain. Commonly prescribed tricyclic antidepressants include nortriptyline and amitriptyline. Certain anti-seizure drugs may be effective in reducing nerve damage-related pain, such as pregabalin and gabapentin. Opioids may be prescribed in cases of moderate to severe pain, such as oxycodone and hydrocodone.

Physical therapy may help patients. A physical therapist can help patients maintain spinal stability and flexibility, control pain, build endurance and strength, and improve balance.

Steroid injections may be beneficial in alleviating pain. This condition can cause pinched nerves which can cause irritation, swelling and pain. Injecting these steroids can reduce some of the pressure and inflammation.

In some cases, surgery is necessary. Patients who are disabled by their symptoms and those who experience no relief from conservative treatments may be surgical candidates. Surgery can help to take pressure off of the nerves and spinal canal and create space. Surgery, in most cases, will greatly reduce the symptoms a patient experiences.

Complications

This condition may cause complications. If nerves in the cervical spine are compressed, patients are at risk for incontinence and weakness or paralysis. If nerves in the lumbar spine are compressed, patients are at risk for cauda equina syndrome, a medical emergency that can cause paralysis and numbness that may require surgery.

Resources

Laser Spine Institute. (2011). Congenital Spinal Stenosis. Retrieved on March 22, 2011 from the Laser Spine Institute: https://www.laserspineinstitute.com/back_problems/spinal_stenosis/congenital

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2011). Spinal Stenosis. Retrieved on March 22, 2011 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases: https://www.niams.nih.gov/Health_Info/Spinal_Stenosis/