Neural Foraminal Stenosis – What is it?

neural foraminal stenosisSpinal stenosis comes in many forms, causing a variety of symptoms and with a range of causes. Neural foraminal stenosis is a specific type of spinal stenosis that involves the narrowing of the spaces through which nerve roots exit the spinal column. A reduction in this space does not necessarily cause symptoms but, where nerve compression does occur, pain, weakness, numbness and paralysis can all result from severe neural foraminal stenosis.

Symptoms of Neural Foraminal Stenosis

Radicular pain is a particular feature of neural foraminal stenosis and sciatica is probably the best known sign of this kind of spinal narrowing (as a result of lumbar foraminal stenosis). Such pain is referred along the length of a nerve and can result in symptoms far from the point of nerve compression, such as in the feet or hands.

Radicular pain from neural foraminal stenosis tends to be deep-seated, consistent and able to be triggered upon certain movements or positions such as standing or walking. Nerve compression in the spine can also cause widespread numbness across the whole area fed by that nerve, leading to muscle wasting where the pinched nerve continues to be compressed and there is severe foraminal stenosis. Bilateral stenosis (narrowing on both sides of the spine) can cause symptoms of radicular pain on both sides of the body, while unilateral foraminal stenosis can lead to symptoms in just one side of the body, such as sciatica in one leg only.

Treating Neural Foraminal Stenosis

Conservative therapies are the usual strategy for treating mild to moderate neural foraminal stenosis and early signs of nerve compression. However, where pain relief is not forthcoming and/or the nerve compression is worsening back surgery for foraminal stenosis is often recommended. A foraminotomy can be performed to remove osteophytes that have caused foraminal stenosis, or a discectomy or partial discectomy may be appropriate if herniated disc material is the cause of the narrowing in the spine. Surgeons may use both open back surgery techniques and minimally invasive back surgery to remove the problematic bone, soft tissue and disc fragments blocking the neural foramina and causing symptoms of spinal stenosis.

Diagnosing and Treating Neural Foraminal Stenosis

Anyone suspecting that they have neural foraminal stenosis should seek medical attention in order to stop permanent nerve damage from occurring. This may involve use of a back brace, physical therapy, epidural steroid injections and other anti-inflammatory drugs or surgery to remove the cause of the narrowing in the neural foramen. The need for surgery may be prevented through prompt action to realign and strengthen the spine and reduce the causes of neural foraminal stenosis and nerve pain.

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