6 Tests Used to Diagnose Spinal Stenosis

Spinal stenosis is a common condition that can cause symptoms of both back and leg pain.  The most common problems associated with spinal stenosis occur when the nerves that go down the legs are compressed in the spinal canal.  This can lead to pain, numbness, and weakness in the legs. 

There are several causes of spinal stenosis, but all are associated with loss of space available for the spinal nerves.  Therefore, when making the diagnosis of spinal stenosis, your doctor will be looking for signs of compression in and around the spinal canal.  Below are some of the test commonly used to help make the diagnosis of spinal stenosis.

Medical History and Examination

Henglein and Steets / Getty Images

The medical history is the most important tool to diagnosis stenosis as it will tell your doctor about your symptoms, possible causes for your spinal stenosis, and other possible causes of back pain.

The physical examination in a patient with spinal stenosis will give your doctor information about exactly where the nerve compression likely exists. Some important factors that should be investigated are any areas of sensory abnormalities or numbness, the nature of your reflexes, and any muscular weakness.

X-Ray

Nancy Ross / Getty Images

An x-ray is a simple, easy to perform procedure, and the risks of x-rays are minimal. The x-ray will show your doctor the bones of your spine. The x-ray is helpful is looking for causes of spinal stenosis including tumors, traumatic injury, spinal arthritis or inherited abnormalities.

MRI Test

Fuse / Getty Images

An MRI has become the most frequently used study to diagnose spinal stenosis. The MRI uses magnetic signals (instead of x-rays) to produce images of the spine. MRIs are helpful because they show more structures, including nerves, muscles, and ligaments, than seen on x-rays or CT scans. MRIs are helpful at showing exactly what is causing pressure on the nerves of the spine, and the precise location of the problem

Myelogram

Ed Reschke / Getty Images.

The myelogram is an x-ray, with an added twist. Dye is injected into the spinal fluid around the spinal cord and nerves. The dye shows up on x-rays around these nerves unless there is no space surrounding the nerves. Because of increasing use of MRIs, myelograms are much less commonly performed these days. However, they can be very useful in some situations where patients may be unable to have an MRI, for example in patients with cardiac pacemakers.

CT Scan

mri ct scan test
Geri Lavrov / Getty Images

A CT scan is also similar to an x-ray, but provides a better degree of differentiation of tissues in your body; in other words, you can see more, because more structures show up on a CT scan. CT scans, often called 'CAT' scans, provide your doctor with a good view of areas of compression within the spinal canal.

Bone Scan

bone scan
Hero Images / Getty Images.

A bone scan is not a test that will detect spinal stenosis, but it can be helpful to look for problems that may be related to spinal stenosis. A bone scan is performed by injecting radioactive material into a vein, this material is attracted to areas of high bone activity. A bone scan may be used if there is concern for fractures, tumors, infections, and other potential causes of spinal stenosis.

Treatment of Spinal Stenosis

woman with back pain
BSIP/UIG/Universal Images Group/Getty Images

Treatment of spinal stenosis can often be accomplished with simple, non-invasive treatments.  It is often the case that allowing inflammation to subside, improving spinal posture, and relieving stress on the back can alleviate symptoms sufficiently.

However, there are some situations where people have persistent symptoms despite non-surgical treatments.  In these situations, a surgical procedure to create more room for the spinal nerves may be considered.

Sources:

Issack PS, et al. "Degenerative Lumbar Spinal Stenosis: Evaluation and Management" J Am Acad Orthop Surg August 2012 vol. 20 no. 8 527-535.

More »

Continue Reading