Neuroforaminal Stenosis Defined

What is Neuroforaminal Stenosis?

Depiction of a spine with spondylosis and facet joint hypertrophy
Facet joint hypertrophy may cause radiculopathy symptoms. Medical Art Inc./E+/Getty Images

Neuroforaminal Narrowing

Spinal stenosis is a term that refers to a narrowing of one or more spaces in the spinal column. Generally speaking, it is related to arthritis, which means the narrowing is most often caused by the degenerative changes in the spinal bones. Spinal stenosis can occur anywhere along the length of the spine; however, it tends to up in the lumbar and cervical areas the most.

Spinal stenosis can be of 2 types: Central canal stenosis or neuroforaminal stenosis.

The term “central canal stenosis” implies a narrowing of the spinal canal, which is a hollow space in the center of the spinal column The spinal cord is located inside the spinal canal.

Central canal stenosis may affect any area of the body served by the affected level of the spinal cord - or lower.

Related:  What is the Spinal Canal?

Symptoms of lumbar central canal stenosis often include neurogenic claudication and the risk for a fall.

Cervical spine central canal stenosis may lead to an impairment in your manual dexterity, which could affect the things you do with your hands like holding bags or other items, getting dressed and writing.  Other symptoms include an overall change in sensory perceptions, a feeling that you're weaker than you were before, changes in your gait, bowel and/or bladder dysfunction, and more.

Related: Neurogenic Claudication

Neuroforaminal stenosis is a narrowing that occurs in the foramina.

Foramina are holes located on the sides of the spinal column, but they are smaller than the spinal canal.  Spinal nerves exit the foramina once they've branched off from the spinal cord. These nerves then traverse out to all areas of the body; spinal nerves are responsible for relaying your sensations and movement impulses to and from the brain and cord.

Dr. Robert Bray, neurosurgeon at the DISC Sports and Spine Center in Marina del Rey, California says that in contrast to central canal stenosis, neuroforaminal stenosis disrupts the existing nerve only at the specific level at which stenosis is located.

In other words, in neuroforaminal spinal stenosis, if a particular vertebral level or levels (levels are called segments) do not have bony changes that result in a narrowing of the foramina, then symptoms related to that level will not be present. This does not preclude you from having symptoms at all, though. If other segments of your spine are narrowed, you may well experience related pain and other symptoms as a result.

What Causes Spinal Stenosis?

Passageways in the spine can be narrowed by a number of factors, says Dr. Allen Wilkins of Manhattan Physical Medicine and Rehabilitation. Among the most common are disc herniations, arthritis of the neighboring facet joints, disc bulges, and synovial cysts.

Dr. Ali Bydon, Associate Professor of Neurosurgery, Director of Spinal Column Biomechanics and Surgical Outcomes Laboratory at Johns Hopkins Medical School, and Clinical Director of Spine Surgery at Johns Hopkins Bayview Medical Center agrees, adding that disc space collapse, facet hypertrophy (which is similar to Dr. Wilkins assessment of facet arthritis above) and spondylolisthesis are others potential causes.

“Every one of these conditions become more common as people age, but may also be the result of traumatic injury," Bydon adds.

Simply the passage of time – combined with the effect of life's responsibilities has on your spine - may lie at the root of your neuroforaminal stenosis. “Neuroforaminal stenosis is caused by normal wear and tear, by aging of the joint or when a joint has been injured and does not hold up over time, among other reasons, Dr. Bray concludes.

Related:  Neuralforaminal Stenosis Treatment


Email Interview. Bray,, Robert S. Jr., MD. DISC Sports & Spine Center. Marina del Rey, CA. December 2013.

Email Interview. Bydon, A., MD. Associate Professor of Neurosurgery, co-Director of Neurosurgery Medical Student Education, Director of Neurosurgery Undergraduate Student Education, Director of Spinal Column Biomechanics and Surgical Outcomes Laboratory at Johns Hopkins University, Clinical Director of Spine Surgery at Johns Hopkins Bayview Medical Center. December 2013.

Email Interview. Wilkins, A., MD. Manhattan Physical Medicine and Rehabilitation. New York. December 2013.

Freedman, B., Hoffler, C., Cameron, B., Rhee, J., Bawa, M., malone, D. Bent, M. Yoon, T. A Comparison of Computed Tomography Measures for Diagnosing Cervical Spinal Stenosis Associated with Myelopathy: A Case-Control Study Asian Spine J. Feb 2015. Accessed: March 2016.

Lee, S., Kim, T., Oh, J., Lee, S., Soo, M. Lumbar Stenosis: A Recent Update by Review of Literature. Asian Spine J. Oct. 2015 Oct. Accessed: March 2016.

Continue Reading