About Foraminal Stenosis
The spinal “foramina” are the holes through which nerves exit your spinal canal. The word “stenosis” simply means narrowing. Foraminal stenosis is the narrowing of the spinal foramina, which could be caused by arthritis or degenerative disc disease. Foraminal stenosis can occur in any section of the spine but is most common in the neck and lower back. Depending on the location of the condition, symptoms will vary. Some symptoms include pain, numbness, or tingling down your leg or arm. There could also be a weakness often exacerbated by standing or walking and with certain movements.
Common Symptoms of Foraminal Stenosis
Typically symptoms are produced in one extremity from the compression of an isolated nerve root. Based on the nerve root involved, the patient will typically experience pain or sensory changes in the area supplied by the nerve. If severe, weakness may develop in the specific muscles supplied by the nerve.
Diagnosis of Foraminal Stenosis
The diagnosis is established through a careful history and physical exam and confirmed imaging. The test of choice is an MRI that clearly defines the compression of the nerve; however, a CT scan with or without myelography may also be considered.
Treatment of Foraminal Stenosis
Nonsurgical treatments for foraminal stenosis may be considered. This typically involves activity modification, use of pain medication, physical therapy, and possible injections. Activity modification is a good option for those okay with cutting some of their strenuous activity out of their daily routine and who are not in a great deal of pain. It is not unreasonable to live with foraminal stenosis, and surgery should be reserved for unresponsive symptoms or if neurological deficits develop.
Those patients electing surgery require a procedure that will widen the foramina. The type of procedure is based on the location of the stenosis, cervical or lumbar, and the degree of compression. If excessive removal of surrounding bone and ligament is required to decompress the nerve, a fusion is usually included to maintain and restore spinal stability.