Spinal Stenosis

Spinal Stenosis Specialist
Spinal stenosis is a common condition that usually affects people over 50. It is caused by gradual degeneration in the spine — you may notice yourself looking more stooped forward in photos — and leads to a consequent decrease in physical activity. At the Pacific Heights Spine Center in San Francisco, Dr. Ray Oshtory helps you manage this condition from its earliest stages, minimizing the impact it has on your life. He recommends an ongoing treatment plan combining different therapies to reduce pain and increase function. Schedule an appointment by phone or request one online to discuss your individual needs with him today.

Spinal Stenosis Q & A

What is spinal stenosis?

The word stenosis means “narrowing.” Spinal stenosis occurs when the canal containing the spinal cord and nerve roots narrows, usually as part of the aging process, gradually putting pressure on the spinal cord or surrounding nerves and causing radiating pain, weakness, or numbness.

This narrowing can be caused by arthritis when bone spurs grow into the spinal canal. It can also happen as the result of thickened spinal ligaments, a common consequence of aging, or an abnormal growth, like a tumor. Additionally, fractures or herniated discs can impinge into the spinal canal putting pressure on the nerves or spinal cord.

Two areas of the spine are particularly prone to degenerative stenosis, the lower back (lumbar stenosis) and the neck (cervical stenosis). The mid-back (thoracic) is more prone to infection and metastatic tumors that can impinge on the spinal cord in that region.

What are the symptoms of spinal stenosis?

Symptoms can be very subtle at first and tend to develop slowly as we get older. Symptoms vary depending on where the stenosis is located in your spine and which nerves are affected.

Lumbar stenosis causes pain and cramping in the legs or weakness when walking. Cervical stenosis is more serious, as, in addition to pain and weakness, it can also lead to balance, bowel and bladder problems, even paralysis if left untreated.

What are the nonsurgical options for treatment of spinal stenosis?

Dr. Oshtory uses diagnostic tests like X-rays, MRI scans, and CT myelograms to examine your spine. He often begins treatment with physical therapies that control the symptoms and increase function, sometimes in combination with epidural injections to reduce inflammation and allow you to stretch and move more freely.  

Exercise is very important for stenosis patients, so Dr. Oshtory devises an individual activity program to build up your strength. He may also recommend pain management and anti-inflammatory medication, often in conjunction with a non-surgical pain specialist.

What does surgical intervention for spinal stenosis involve?

Dr. Oshtory performs minimally invasive decompressive surgery using a microscope to remove thin pieces of bone and ligament to relieve pressure on the spinal cord or the surrounding nerves. This operation is sometimes performed along with spinal fusion — a bone graft that helps maintain normal spacing between parts of the spine.

While these surgeries often require a general anesthetic, recovery time is rapid. You may notice immediate pain relief and be walking around the day of surgery. Most patients go home the same day or next day after these types of surgeries.

 

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