There are two major types Spinal stenosis. Congenital or degenerative (acquired). Congenital variety occurs because of abnormal growth of one or various components of the spine which produces canal narrowing. Patients with short stature are prone to develop this kind of stenosis.

Degenerative stenosis is more common than congenital variety and is usually found in older individuals. As the name suggest, age related wear and tear of the spine such as disc degeneration and facet joint arthritis, causes new bone fomation in and around the canal and nerve holes producing canal narrowing and nerve compression. Usually new bone formation occurs in areas of the spine with high mobility so, degenerative stenosis commonly found in the neck and low back, and rarely in the thoracic spine.

As the narrowing of spinal canal occurs over the time (gradual wear and tear change), typically the symptoms are insidious in onset and rarely occur acutely. The patient usually complain that over weeks or months he or she has noticed difficulty in walking. After certain amount of walking, the legs become tired or numb. At times it compels the patient to stop walking and to sit or to stoop forward. Changes in position of the spine can affect symptoms quickly as many patients admit that when they lean on a shopping cart, the tiredness in their legs improves. Forward bending produces widening of the spinal canal and nerve holes which relieves pressure on the nerves and decreases symptoms.

As with other spinal problems, conservative measures like rest, pain medicines and physical therapy are useful to alleviate the symptoms in the early stages. Physical therapy may improve muscle tone and fitness, but ultimately can not reverse the bony narrowing and nerve compression, which is the primary problem. Another conservative option is to inject cortisone-epidural injections. Here, a needle will be placed in the space around the spine at or near the narrowing and cortisone will be injected on the nerves. Because of the anti-inflammatory effect of cortisone, it may reduce nerve swelling. If the nerve swelling decreases, the relative relationship of the nerve diameter to the bony hole becomes favorable, thereby reducing symptoms. Three epidurals can be injected at an interval of 10-15 days.

When the symptoms do not respond to conservative treatments, then surgery is indicated. The surgery known as decompression-“removal of bony narrowing around nerves” is usually required. The operative strategy will depend not only on the location of the spinal narrowing, but the relative stability and condition of the spine as a whole. If the stenosis is associated with instability, then stabilization and fusion may have to be performed with the nerve decompression. Stenosis with curvature of the spine (scoliosis or kyphosis), may also complicate the treatment. In these conditions, the bony narrowing relieved with surgery may recur quickly in a curved spine because of asymmetric collapse on the concavity of the curve. Stabilization and fusion may have to accompany the decompression in these cases for long term, sustained good results after surgery.

The usual decompression procedures are laminectomy and laminotomy. Every patient's surgical treatment should be individualized according to spinal anatomy and clinical presentation.

As age increses, as our hair become white, our spine also degenerates. Many elderly patients suffer from degenerative spine disease where their nerves are compressed certain spinal level becomes unstable. These patients with their instability of spine experience nerve compression and thus disabling back and leg pain, tingling and numbness of both lower limbs, difficulty in walking and standing. These can happen in lower Back and neck also. Our surgeons do operate on this kind of degenerated spine where, they take the pressure off from nerves and also put specialized spinal implants to stabilized and reconstruct the spine.