Pediatric Orthopedic Surgeons treating Spinal Dislocation

SPINAL STENOSIS

Spinal stenosis can lead to a slow but steady loss of strength in the legs. The severe pain caused by this condition can be quite disabling, even if you have no muscle weakness since it greatly affects your ability to work and enjoy life. The natural course of the disease is one of slow progression over time.

At Medical City Children’s Orthopedics and Spine Specialists, our expert Spinal Stenosis Doctors are dedicated to diagnosing and treating spinal problems in children and ensuring comprehensive care tailored to each patient’s needs. With advanced techniques and a compassionate approach, our team is here to diagnose, treat and care for children suffering from Spinal Stenosis.

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Spinal Stenosis

Spinal StenosisSpinal stenosis narrows the spinal canal. This puts pressure on the spinal cord. Nerves passing through also feel pressure. This causes pain, numbness, or tingling. Weakness and walking difficulty also result. Many causes and types exist. Doctors treat it with surgery or other methods.

Spinal stenosis is rare in children. Adults get it more from aging. Children rarely develop this condition. It links to birth defects when it appears. Skeletal disorders like achondroplasia cause it. Trauma is another cause. Pediatric spinal stenosis needs special care. Early diagnosis helps manage symptoms. It prevents long-term problems.

Congenital vs. Acquired Spinal Stenosis in Children

Congenital stenosis means a child is born with it. The spinal canal is smaller. This difference exists from birth. It increases future complication risk. Degenerative stenosis affects adults more. Arthritis or disc issues cause it. Genetic factors affect spine development in congenital cases. Children show symptoms earlier. This happens especially with skeletal conditions.

Acquired stenosis results from other factors. Trauma, tumors, or disorders cause it. Early evaluation is necessary. Treatment prevents long-term mobility issues. It also improves life quality.

How Rare Is Congenital Cervical Spinal Stenosis?

Congenital cervical stenosis is very rare in children. Adult degenerative forms are common. Only a small fraction of cases are congenital. Many children get diagnosed later. Symptoms become significant then. This often happens in adolescence or adulthood. Cervical canal narrowing can exist silently. It goes unnoticed for years. Injury or neurological changes reveal it. Early identification minimizes complications. It ensures the best outcomes.

QUESTIONS AND ANSWERS.

What is spinal stenosis, and how does it affect my child?

Spinal stenosis is a condition where the spaces within the spine narrow, putting pressure on the spinal cord and nerves. In children, it can be congenital (present at birth) or acquired. The healthcare provider can explain the specific type and severity of spinal stenosis your child has and how it may impact their daily life.

What are the treatment options available for children with spinal stenosis?

Treatment options can vary depending on the severity of spinal stenosis. They may include physical therapy, medication, and in some cases, surgery. The healthcare provider can discuss the potential benefits and risks of each option and help determine the most appropriate course of action for your child.

What lifestyle modifications or precautions should we take to support our child with spinal stenosis?

Understanding how to manage daily activities, exercise, and any necessary lifestyle modifications is crucial. The healthcare provider can provide guidance on activities that may help strengthen your child’s back, as well as any restrictions or precautions they should follow to prevent further complications.

Remember, these questions are general in nature, and it’s essential to consult with a healthcare professional who can provide personalized advice based on your child’s specific condition and medical history.

Schedule an appointment and see a pediatric orthopedist quickly for spine problems at Medical City Children’s Orthopedics and Spine Specialists.

Causes

Spinal stenosis can be caused by several factors, including degenerative changes in the spine, trauma, tumors, infections, and congenital abnormalities. Presently, the most common cause of this condition is age-related degeneration of the spine, which results in the thickening of ligaments and the formation of bone spurs. Furthermore, other causes may include Juvenile Scoliosis, herniated discs, spinal tumors, and spinal injuries.

Types of Spinal Stenosis:

Lumbar Stenosis

Lumbar stenosis is the most common type of spinal stenosis, and it occurs in the lower back. Significantly, it can be caused by several factors, including degenerative changes, herniated discs, and bone spurs. In addition, symptoms of lumbar stenosis can include back pain or numbness in the lower back, buttocks, legs, or feet. Unfortunately, the pain may be worse when standing or walking and may improve when sitting or leaning forward. In severe cases, lumbar stenosis can cause weakness or loss of sensation in the legs or feet.

In some cases, lumbar stenosis can be congenital, meaning the spinal canal is naturally narrower from birth. Congenital lumbar spinal stenosis tends to present symptoms earlier in adulthood, often between the ages of 30 and 50, and is more common in men. People with this condition may experience lower back pain, sciatica, or leg weakness, even in the absence of significant degenerative changes.

Cervical Stenosis

Cervical stenosis is less common than lumbar stenosis, and it occurs in the neck. In this case, it is caused by several factors, including degenerative changes, herniated discs, and bone spurs.

Similar to the lumbar region, congenital narrowing can also occur in the cervical spine. Congenital cervical stenosis leads to a tighter spinal canal in the neck area from birth. Symptoms may include neck pain, weakness or numbness in the arms, and difficulties with coordination, especially when the spinal cord is affected.

What is platelet-rich plasma (PRP) therapy, and how can it help with congenital spinal stenosis?

Platelet-rich plasma (PRP) therapy is a minimally invasive procedure in which a sample of your child’s blood is processed to concentrate the platelets—cells known for their role in healing. This concentrated platelet solution is then carefully injected into the affected area of the spine. The goal is to promote tissue repair, decrease inflammation, and relieve pain by harnessing the body’s natural healing processes.

While PRP therapy has shown promise for various orthopedic conditions, its use in children with congenital spinal stenosis is still being explored. If your child’s provider recommends PRP, they will discuss the potential benefits, the evidence behind this approach, and whether it could play a role in your child’s overall treatment plan.

Congenital Canal Stenosis

Congenital canal stenosis refers to a narrowing of the spinal canal that is present from birth. Unlike conditions that develop later in life due to aging, injury, or degenerative changes, congenital canal stenosis occurs when a child is born with a spinal canal that is smaller than average. This narrowing can affect any region of the spine and may lead to symptoms if the space becomes too tight for the spinal cord and nerves.

Children with congenital canal stenosis might experience signs such as back pain, leg weakness, difficulty walking, or other neurological issues, even at a young age. Early identification is especially important so that the right medical support and personalized care plan can be put in place to protect spinal health and overall well-being.

Symptoms of Spinal Stenosis

To begin with, symptoms of cervical stenosis can include pain or numbness in the neck, shoulders, arms, or hands. To explain, the pain may be worse when moving the neck and may improve when resting. In severe cases, cervical stenosis can cause weakness or loss of sensation in the arms or hands. The symptoms of spinal stenosis can vary depending on the location and severity of the condition. To summarize, common symptoms of this condition include:

  • Pain in the neck or lower back
  • Numbness or tingling in the arms, hands, legs, or feet
  • Weakness in the arms or legs
  • Difficulty walking or standing for extended periods
  • Loss of bladder or bowel control (in severe cases)

The way these symptoms appear often depends on how much the spinal canal has narrowed and where the narrowing occurs. For instance, some people may experience localized back pain in the affected region of the spine, while others notice radiating pain down the legs, commonly known as sciatica, due to nerve compression. Numbness and tingling can also show up in the arms or legs, reflecting nerve involvement.

Additionally, muscle weakness might lead to difficulty with walking or performing everyday activities. In cases where cervical stenosis is present, problems with coordination and balance may occur, sometimes even impacting fine motor skills.

If you notice any combination of these symptoms, especially if they worsen over time or interfere with your daily life, it’s important to seek medical evaluation. Early diagnosis can help guide effective treatment and prevent complications.

Diagnosis

Diagnosing spinal stenosis in children and adolescents involves a combination of medical history review, physical examination, and imaging studies. As the condition is rare in children, it is often linked to congenital or developmental issues. Here’s a concise overview of the process:

Medical History Review

Doctors ask about symptoms such as back pain, leg pain, numbness, tingling, or weakness, which may worsen with activity or certain positions.

  • They inquire about family history, congenital conditions (e.g., achondroplasia), or trauma that could contribute to spinal narrowing.
  • Questions focus on symptom onset, duration, and impact on daily activities like walking or sports.

Physical Examination:

  • Neurologic assessment checks for reflexes, muscle strength, sensation, and coordination to identify nerve compression signs.
  • Doctors evaluate posture, gait, and spinal alignment for abnormalities like scoliosis or kyphosis.
  • Tests like the straight leg raise may be used to assess nerve irritation.

Imaging Studies:

  • X-rays: Initial imaging to assess spinal alignment, bone structure, and signs of congenital anomalies or degenerative changes.
  • MRI: Preferred for detailed views of soft tissues, including spinal cord, nerves, and discs, to confirm stenosis and rule out other conditions like tumors or herniated discs.
  • CT Scan: Used if MRI is unavailable or contraindicated, often with myelography to visualize spinal canal narrowing.

Additional Tests (if needed):

  • Electromyography (EMG) or nerve conduction studies may assess nerve function if symptoms suggest nerve damage.
  • Rarely, genetic testing or bone density scans used if underlying conditions like achondroplasia or osteopetrosis are suspected.

Differential Diagnosis:

Doctors differentiate spinal stenosis from other causes of pain or neurologic symptoms, such as disc herniation, tethered cord syndrome, or juvenile arthritis.

Spinal stenosis in children is often congenital (a narrow spinal canal at birth) or caused by conditions like achondroplasia. The diagnostic process emphasizes identifying underlying causes. In congenital spinal stenosis, a child is born with a smaller-than-normal spinal canal due to genetic factors or developmental differences. Unlike degenerative stenosis, which develops over time from wear-and-tear or conditions like arthritis, congenital stenosis is present from birth and may predispose children to symptoms as they grow.
Recognizing whether stenosis is congenital, developmental, or acquired is critical for guiding both diagnosis and management. This approach helps distinguish pediatric spinal stenosis from other spinal or neurologic conditions, ensuring that children receive appropriate, targeted care.

Treatment of Spinal Stenosis

Spinal stenosis involves a narrowed spinal canal, causing pain or numbness. Doctors tailor treatment to symptom severity and patient needs.

Non-Surgical Treatments

Mild cases respond well to non-surgical options. These include:

  • Physical Therapy: Exercises strengthen spine-supporting muscles. Stretches improve flexibility. Therapists create tailored programs focusing on posture, stability, and mobility.
  • Medications: Pain relievers reduce discomfort. NSAIDs manage inflammation, swelling.
  • Epidural Steroid Injections: Injections deliver anti-inflammatory drugs near the spinal cord. They provide temporary symptom relief.
Other non-surgical treatments address individual needs:
  • Chiropractic Care: Manual adjustments realign the spine, easing nerve pressure. Discuss with doctors for children’s safety.
  • Decompression Therapy: Gentle stretching widens the vertebral space. It reduces nerve pressure, improves circulation, and eases pain.
  • Shockwave Therapy: Sound waves stimulate healing. Therapy reduces inflammation, promotes tissue repair.
  • Massage Therapy: Massage reduces muscle tension. It promotes relaxation, improves blood flow, and eases pain.
  • PRP Therapy: PRP injections encourage tissue healing. They reduce pain but remain rare in children.

Doctors choose treatments based on symptoms, age, and health. They prioritize the least invasive options. Persistent symptoms may require further intervention.

Massage Therapy for Congenital Spinal Stenosis

Massage therapy can be a valuable addition to a treatment plan for children with congenital spinal stenosis. Through gentle, targeted techniques, massage helps relax tight muscles, ease discomfort, and enhance overall circulation. By improving blood flow, it may help reduce inflammation around the spine and ease tension in supporting muscles, which can sometimes alleviate pain.

Additionally, massage can promote a sense of relaxation and well-being, helping children better cope with the persistent discomfort often associated with spinal stenosis. While not a cure, it is a supportive therapy that may complement other medical treatments and improve your child’s quality of life.

Always consult with a pediatric orthopedist or licensed massage therapist familiar with congenital conditions to ensure massage therapy is safe and tailored to your child’s needs.

Decompression Therapy

Decompression therapy manages symptoms non-surgically. Specialized devices stretch the spine, reduce spinal cord, nerve pressure. It widens the vertebral space, improves circulation, and eases discomfort. Doctors combine it with physical therapy for better results. They assess suitability for each patient.

Shockwave Therapy

Shockwave therapy supports congenital spinal stenosis. Focused sound waves boost blood flow, aid healing in affected areas. It reduces inflammation, eases pain, and improves mobility. Doctors recommend it alongside physical therapy, medication for better relief. Pediatric orthopedists supervise to ensure safety, assess benefits.

Surgery

Severe cases may need surgery. Options include:

  • Laminectomy: Surgeons remove vertebral bone to widen the spinal canal. It relieves spinal cord, nerve pressure, improving symptoms.
  • Spinal Fusion: Surgeons fuse vertebrae to stabilize the spine. It maintains alignment, prevents worsening symptoms.
  • Foraminotomy: Surgeons remove bone or tissue compressing nerve roots. It reduces pain, improves mobility.

Specialists like orthopedic surgeons plan procedures. Doctors discuss options based on condition, health, and daily life.

Post-Surgery Rehabilitation

Rehabilitation aids recovery after surgery. Physical therapy restores strength, flexibility, and confidence. Therapists design personalized plans for age, health, and needs.

  • Initial rehab includes gentle stretching, range-of-motion exercises.
  • Strength training follows gradually.
  • Therapists monitor progress, ensure safety.
  • Guidance covers posture, body mechanics, and safe activity levels.

Care teams communicate with families to address concerns. Consistent rehab helps children return to school, sports, and play.

Prevention

Preventing spinal stenosis may not always be possible, especially in cases where it is caused by congenital factors or natural degeneration with aging. However, there are several steps you can take to reduce the risk of your child developing this condition or slow down its progression:

  • Exercise regularly: Exercise is one of the most effective ways to keep your child’s spine healthy and prevent spinal stenosis. Strengthening the muscles around the spine, especially the core muscles, can help to support the spine and reduce pressure on the nerves.
  • Maintain good posture: Poor posture can put unnecessary stress on the spine and increase the risk of spinal stenosis. Maintaining good posture, especially when sitting or standing for long periods, can help prevent this condition.
  • Avoid repetitive motions: Repetitive motions, such as those performed in certain sports or work activities, can cause wear and tear on the spine and increase the risk of spinal stenosis. Be sure to take breaks and stretch regularly if you engage in repetitive motions.
  • Manage weight: Being overweight can put additional stress on the spine and increase the risk of spinal stenosis. Maintaining a healthy weight through a balanced diet and regular exercise can help prevent this condition.
  • Seek treatment for spine injuries: Injuries to the spine, such as herniated discs or fractures, can increase the risk of spinal stenosis. Seeking prompt treatment for spine injuries can help prevent this condition.

In summary, maintaining good spinal health through exercise, posture, and weight management can help prevent spinal stenosis. Avoiding repetitive motions, quitting smoking, and seeking prompt treatment for spine injuries can also reduce the risk of developing spinal stenosis.

Conclusion

Finally, spinal stenosis is a common condition that can cause pain, weakness, or numbness in the legs, arms, or other parts of the body. The causes of spinal stenosis can vary, and the type of stenosis can also differ depending on the location within the spine. Lumbar stenosis is the most common type of spinal stenosis and occurs.

How your child will heal from a spinal stenosis procedure to fix the problem depends on how severe the spinal stenosis is. As a parent, you can help your child get the best result by not missing any of the follow-up doctor visits, giving proper meds as directed, and following the doctor’s instructions regarding activities.  Finally, our doctors at Medical City Children’s Orthopedics and Spine Specialists, with offices in Dallas, ArlingtonFlower Mound, Frisco, and McKinney, TX, understand the importance of maintaining your child’s health. In addition, our experts and specialists have the training, knowledge, and experience required to stop the pain from Spinal Stenosis in a child. If your child needs the best spine doctors in Texas, please call our office at 214-556-0590 to schedule an appointment at one of our five locations.

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Footnote:

National Institute of Health: Spinal Stenosis

 

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