In order to allow nerves to travel from the spinal cord to all other parts of the body, the spinal canal relies on vertebra comprised of two parts—the vertebral body and the vertebral arch—and an opening known as the foramen.
When a foramen narrows abnormally there isn’t enough room for existing nerves and they get pinched, a condition called foraminal stenosis. The condition can be the result of a bulging or ruptured disc or from arthritis, bone spurs and scar tissue or an enlargement in a spinal joint. Typically, the thickening and narrowing of the foramen happens naturally as we age, but in the case of foraminal stenosis underlying genetic and even conditions present from birth may be contributing causes.
The most common signs that foraminal stenosis exists includes pain moving throughout the body, numbness or burning sensations, worsening pain in the back or neck and an uncomfortable tingling in the extremities. Symptoms may also be experienced in the shoulders and in the lower extremities and the buttocks if a particular foramen in the lumbar reason is failing, and nerve pain can arise when the muscles of the back are restricted or squeezed.
To determine if a patient has foraminal stenosis, the patient’s medical history will be analyzed, followed by a physical exam. During the exam, the doctor will look for movement limitations, pain and loss of reflexes when the patient moves his or her spine. An MRI, CT scan or x-ray may also be needed to confirm the diagnosis.
Treatment of forminal stenosis depends greatly on the severity of the symptoms being experienced, and may be as simple as changing forms of activity, maintaining better posture or attending physical therapy sessions to reduce pain, build strength and increase mobility. And medication and bracing may be utilized if deemed necessary and effective by a physician.
In the worse cases, surgery may be undertaken in an effort to relieve the pressure on nerves. A laminectomy, cervical discectomy with fusion, or a foraminotomy are all options, and each can be accomplished in a way that is minimally invasive.