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What is Spinal Stenosis?
Spinal stenosis occurs when the spinal cord becomes painfully compressed by the narrowing of the spinal canal.
Your spinal cord is a delicate bundle of nerves that functions to coordinate voluntary movements, balance, and sensation between your brain—the site of intention and awareness—and your extremities. Because your spinal cord fulfills a vital messaging function, it is housed protectively within your spinal canal—a series of hollow openings that run successively through each vertebra of your spine.
When the bony anatomy that protects your spinal cord becomes injured or damaged, a degenerative cascade of events may be set into motion. For example: Ligaments that reinforce the spine may thicken; osteoarthritis may cause bony protrusions—known as bone spurs—to develop on the vertebrae or facet joints of the spine; and, intervertebral discs may lose their shape and balloon outward, herniating (or rupturing) as the mounting internal pressure becomes too intense.
As bones grow, ligaments thicken, and intervertebral discs swell, your spinal cord loses its natural real estate and may become painfully crushed or pinched—by the very anatomy that serves to protect it!
Additional causes of spinal stenosis may include:
- Spondylolisthesis (Slipped Vertebra): When a vertebra slides forward out of alignment—whether from arthritic changes in the spine or sudden injury—the dislocated vertebral body can cause spinal stenosis by applying undue pressure to the spinal cord.
- Spinal Tumors: Spinal tumors create obstructions in the spinal canal. As abnormal cells multiply, the spinal cord may suffer compression, amplifying pain signals that shoot into the arms and legs.
- Paget’s Disease: Paget’s disease results from an imbalance in bone remodeling, in which the rate of bone breakdown—a natural, ongoing process—overtakes the rate of bone reconstruction. To compensate for this increased bone loss, the body produces enlarged bones that are substandard in quality. These enlarged bones reduce the space that is typically reserved for the spinal cord, resulting in a narrowing of the spinal canal.
- Spinal Trauma: Vehicular or motorcycle accidents; high-impact sports; or sudden, severe falls can dislodge spinal vertebrae or produce shards of bone that penetrate into the spinal column.
Do your symptoms of nerve pain—the tingling, numbness, and loss of balance or motor skills—sound like spinal stenosis? Our Harvard-trained and internationally recognized surgeon, Dr. Frazier, has devoted his life to identifying minimally invasive surgical solutions that are effective for restoring spine health!
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What are the Symptoms of Spinal Stenosis?
Because your spinal cord is responsible for regulating movement, balance, and sensation, spinal stenosis often renders walking painful or impossible, disrupts balance, and results in tingling or loss of sensation in the extremities. Although the severity of spinal stenosis may vary from a mild annoyance to an incapacitating burden, common symptoms may include:
- Pinched Nerve Pain: Searing pain that discharges from the region of spinal nerve compression and builds in intensity as it travels down through the limbs
- Sciatica: White-hot, electric, or stabbing pain that emanates from the sciatic nerve in the lower back and spreads downward through the hips, buttocks, legs, or feet; occurs commonly with lumbar (i.e. lower back) spinal stenosis
- Cervical Radiculopathy: Throbbing or scorching pain that stems from the site of spinal stenosis in the cervical spine (i.e. the neck) and migrates downward through the shoulders, arms, hands, and fingertips
- Pain while Walking: Also known as claudication, spinal stenosis can cause severe pain that interferes with walking; claudication is often only alleviated by sitting or bending forward at the waist to relieve nerve compression
- Paresthesia: Numbness, tingling, or pins-and-needles sensations that assail the extremities
- Global Balance Disturbances: Loss of balance or weakening of gross motor skills that coordinate walking or moving the arms and legs
- Deterioration of Fine Motor Skills: Worsening of fine motor skills that enable deft movements of the fingers, hands, wrists, feet, or toes; for example: cervical radiculopathy may be accompanied by a loss of hand-eye coordination, such as difficulty using kitchen utensils or buttoning your shirt
- Muscular Pain: Muscular cramps, progressive weakness, or stiffness in the bodily regions that are innervated by the inflamed spinal nerves
- Emergency Symptoms: Seek urgent medical intervention if you develop incontinence (or loss of bowel and bladder control); paralysis of the arms or legs; or absence of feeling in the buttocks, hips, or groin (also termed saddle anesthesia).
Researching effective treatments to eliminate spinal stenosis? Dr. Frazier—orthopedic surgeon, accomplished researcher, and Harvard alumnus—has nearly 20 years of experience in delivering sophisticated non-operative and surgical solutions to spinal stenosis!
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What are the Treatments for Spinal Stenosis?
The preferred course of treatment for spinal stenosis often begins with exploring the full range of non-surgical healing options. In mild to moderate cases of spinal stenosis, more conservative techniques have demonstrated a high rate of effectiveness for eliminating neck or back pain. Recommended nonoperative interventions may involve pain management techniques (including over-the-counter, anti-inflammatory, or prescription strength pain relievers); epidural or steroidal injections; physical therapy; or alternative treatments (such as acupuncture, yoga, or massage therapy).
Despite these interventions, however, a small proportion of patients will witness a gradual worsening of their symptoms. For individuals who suffer from the debilitating or unremitting pain of spinal stenosis, Dr. Frazier—hailed by New York Times Magazine as a “Super Doctor”—may recommend one of the following noninvasive, outpatient procedures:
- Minimally Invasive Laminectomy: This technique involves pressure-relieving removal of the lamina (or backside of a vertebra) to broaden the spinal canal and reverse spinal stenosis. This effective outpatient procedure is often regarded as the benchmark against which all other lumbar decompression surgeries are compared.
- Artificial Disc Replacement: This minimally invasive surgical procedure corrects spinal stenosis by extracting and replacing a damaged intervertebral disc with a more durable, artificial model. This same-day procedure boasts faster recovery times and less postoperative pain than “traditional” methods.
- Foraminotomy: A foraminotomy is a minimally invasive surgical solution to eliminate foraminal stenosis—a subtype of spinal stenosis in which spinal nerve compression occurs at the foramina. Foramina are hollow corridors in the vertebrae through which spinal nerves exit from the spinal cord to innervate the body. During a foraminotomy, your surgeon excises overgrown bone or inflamed tissues that occlude the foramina and impinge upon spinal nerves.
Although these techniques represent three of the most popular surgical interventions to correct spinal stenosis, Dr. Frazier evaluates the needs of each of his patients on an individual basis. Dedicated to providing the highest quality of patient-centered care, Dr. Frazier tailors each of his procedures to optimize a patient’s recovery time and to minimize post-operative pain.
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Dr. Frazier is a Harvard-trained, board-certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment and continues to consult for several international spine companies.
After completing undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.
Education & Training
MD / Cum Laude
Harvard Medical School
Mass. General Hospital
Spinal Deformity Fellowship
Doctor’s Hospital (Miami, FL)