What is Foraminal Stenosis?
The foramen has the important job of being the doorway for the spinal nerves to exit the spinal canal and branch out to the lower body. It is a small hole in the bony vertebral structure. When the foramen becomes narrowed and the nerve becomes pinched the condition is called foraminal stenosis. The development of bone spurs and disc degeneration are often the triggers of foraminal stenosis. In vertebral sections where the vertebra create a more exaggerated tilt the foramen narrowing can be more severe than other areas of the spinal structure leading to foramen collapse. As a spine surgeon, Dr. Ernest Braxton specializes in the surgical and non-surgical treatment of foraminal stenosis.
What Causes Foraminal Stenosis?
Foraminal stenosis is most commonly caused by degenerative spinal conditions. Conditions such as spinal arthritis, bone spurs, degenerative disc disease or a herniated disc lead to foraminal stenosis. As the foramen space is reduced the exiting nerves have less space to easily maintain position; once the narrowing becomes great enough the nerves begin to compress and create pain signals. The increase in compression can also result in a pinched nerve.
How Do I Know I Have Foraminal Stenosis?
The symptoms of foraminal stenosis may not develop in the narrowing stage of the condition. As the nerve becomes trapped or pinched symptoms usually impact one side of the body and can include:
Both the left and right side can be impacted with foraminal stenosis. This occurs when the nerve root becomes pinched or compressed on both sides of the vertebra.
How to Diagnose Foraminal Stenosis?
Dr. Braxton will diagnose foraminal stenosis by completing a comprehensive patient medical history in addition to a physical exam to identify the areas of pain, abnormality, degeneration and tenderness. He will also test for limitations in range of motion, loss of reflexes, abnormal sensation and spinal movement. Diagnostic imaging including include X-ray, MRI, CT scan, EMG and possibly a myelogram scan or bone scan will help facilitate Dr. Braxton’s diagnosis.
How to Treat Foraminal Stenosis?
The first course of treatment for foraminal stenosis is typically non-surgical. Non-surgical treatments for foraminal stenosis include:
- Pain management
- Steroid injections
- Activity limitation and rest
- Physical therapy
- Targeted exercise
- Support brace
When non-surgical treatment options do not help improve symptoms surgical treatment options may be required to alleviate pain.
Does Foraminal Stenosis Require Surgery?
Dr. Braxton works closely with patients to determine if surgery is the correct treatment for foraminal stenosis. In most cases surgery is not considered until non-surgical treatment options have failed. Once the exact cause of the patient’s pain is identified Dr. Braxton can make his recommendation for the correct surgical or non-surgical procedure. The goal of surgery is to return the patient to their preferred activities and lifestyle as quickly as possible.