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How is Spinal Stenosis diagnosed? During the physical and neurological examination the doctor will feel your spine and test your reflexes. Further, he will test your balance while watching you walk normally, on tip toes and heels. To determine how much motion you have in your spine, you may be asked to bend forward, backward, and side to side. These and other movement and reflex tests help to rule out loss of extremity reflexes, muscle weakness, and loss of feeling. The extremities are your arms and legs. Can the doctor tell it is Spinal Stenosis just from an examination? X-Ray: An x-ray is the most common test performed and shows the structure of the spinal bones (vertebrae) and can detect bone spurs.
Sample X-Ray detects a spinal fracture. MRI (Magnetic Resonance Imaging): MRI provides a highly detailed, three-dimensional image of the spine. The spinal cord, nerve roots, and spaces are clearly defined.
Sample MRI detects a spinal fracture. CAT Scan (Computerized Axial Tomography): A CAT Scan renders images of bone better than nerves and is often used to show the shape and size of the spinal canal.
Sample CAT Scan detects a spinal fracture. Myelogram: Using x-ray and a special liquid dye that is injected into the patient intravenously, a myelogram helps to define where there is pressure on the spinal cord or nerve roots from a herniated disc, bone spurs, or a tumor (rare). Bone Scan: This safe test uses a radioactive material that is injected into the patient. The material attaches itself to bone and helps to detect fractures, tumors, infections, and osteoarthritis. The doctor usually relies on other tests in conjunction with a bone scan.
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Article written
04/14/2004
Published online 04/21/2004 Last updated 12/28/2007 |
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I had a great pleasure reading Dr. Stewart Eidelson's 5-part article on spinal
stenosis. The information included in this article is accurate and informative.
I would like add a few comments for the benefit of the readers or potential
patients. First, spinal stenosis is indeed most common in the lumbar spine,
followed by the cervical spine. However, occasionally, the thoracic spine is
affected as well. Spinal stenosis in the thoracic spine can present with pain
radiating around the rib (thoracic radiculopathy) or numbness, spasm, and weakness
of the legs (myelopathy). Sometimes, lumbar stenosis and cervical stenosis co-exist,
and the astute doctor will pickup both diagnoses and render appropriate treatment
for both conditions. Also, leg symptoms and walking difficulty may be due to
clogging of the leg vessels (vascular claudication) rather than due to lumbar
spinal stenosis (neurogenic claudication). Sometimes, both vascular and neurogenic
claudication conditions may co-exist. Again, making the correct diagnosis is
important for subsequent treatment. As Dr. Eidelson mentioned, lumbar stenosis is largely due to "wear and tear"
or degenerative changes in the joints and intervertebral discs in the spine
over many years, but some patients are born with smaller spinal canal (congenital
stenosis). Congenital stenosis patients typically show symptoms in their 40s
and 50s rather than in their 60s and beyond. Because of smaller canals at birth,
minor bulging discs and degenerated joints tend to affect the nerves earlier
in life in these patients. Some patients with congenital stenosis may undergo
discectomy alone without decompressive procedures for the narrowed canal, and
surgical outcomes may be compromised. Again, correct and precise diagnosis leads
to correct treatment.
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