Spinal Stenosis is a condition that causes the spinal canal to become narrow, resulting in increased pressure on the nerves and, in some cases, the spinal cord itself. The disease is typically divided into two types: lumbar spinal stenosis (LSS) and cervical spinal stenosis (CSS). Lumbar spinal stenosis is much more common, affecting between eight percent and 11 percent of the population in the U.S. [1] Cervical spinal stenosis is estimated to occur in about five percent of Americans. [2]

Although it’s less common, cervical spinal stenosis is potentially more serious because it can cause the spinal cord to become squeezed, resulting in paralysis. The spinal cord does not travel through the lumbar spine, and lumbar spinal stenosis, while painful and debilitating on its own, is not associated with cord damage. [3]

A few people may be born with an exceptionally narrow spinal canal which leads to stenosis, but in most cases, the condition develops with degenerative changes associated with aging. Degenerative changes like osteoarthritis and rheumatoid arthritis are the most common causes of spinal stenosis, but other possible causes include: [4]

  • osteoarthritis
  • rheumatoid arthritis
  • bone spurs
  • herniated or compressed discs
  • thickened ligaments
  • tumors
  • trauma

WHAT ARE THE SYMPTOMS?

In some people, spinal stenosis causes no symptoms, even though the condition may show up on x-ray. When the disease does cause symptoms, they usually begin gradually and become worse over time. Some of the most common symptoms of spinal stenosis include: [5]

  • aching or pain in the neck or lower back
  • weakness, tingling or numbness in the leg, foot, arm or hand
  • leg cramps that may be relieved when leaning forward

In severe cases and especially when the spinal cord is involved, symptoms can also include:

  • loss of bladder or bowel function
  • sexual dysfunction
  • significant pain, weakness or loss of feeling in one or both legs

TRADITIONAL MANAGEMENT

Treatment for spinal stenosis begins with conservative approaches, including the use of pain and anti-inflammatory medications and modification of activity to relieve stress and help open the spinal space.

Epidural injections of cortisone can also help, especially when oral pain medications do not provide adequate relief. Injections provide satisfactory levels of relief in about half of all patients.

Exercise is also important for maintaining strength and mobility, but it is not intended to relieve symptoms of spinal stenosis. When pain limits movement, working with a physical therapist to learn special techniques to reduce pain may be helpful.

When conservative approaches do not provide relief and symptoms begin to take a toll on everyday activities and quality of life, surgery may be considered to widen the spinal canal. The procedure most often used is called laminectomy. In this procedure, a portion of the affected vertebra is removed to provide additional room and eliminate pressure on the nerves. Laminectomy for decompression of the nerve is effective in about eight out of 10 patients, but results tend to deteriorate over time as the spine continues to experience additional age-related changes.

Laminectomy is often followed by spinal fusion surgery with or without bone grafting to help stabilize the spine in the area of the laminectomy. Surgery does carry specific risks, including nerve deterioration, rupture of the spinal membrane and blood clots. [6]

Want to find out more?

Your Name (required)

Your Email (required)

Phone Number (required)

Your Message

Please leave this field empty.

STEM CELL THERAPY FOR SPINAL STENOSIS

Stem cell therapy offers multiple advantages for the management of diseases and medical conditions like spinal stenosis. First, adult stem cells have virtually the same differentiation capability as embryonic stem cells. That means they can be used to replenish or replace cells lost or damaged by diseases like osteoarthritis and rheumatoid arthritis that can contribute to spinal stenosis. Anti-inflammatory and angiogenic (promoting growth of new blood vessels) properties also support healing of damaged tissues. These unique characteristics have made stem cells an especially attractive research target for a wide range of musculoskeletal issues, including stenosis in the neck and lower back.

Several processes contribute to the degeneration that causes spinal stenosis. Three of the primary degenerative changes leading to stenosis include deterioration of the discs that separate the vertebrae; degradation of the surfaces of the spinal joints (facet joints); and bone spurs, small projections of bone that form along the edges of vertebrae in response to arthritic damage.

Several studies have explored the use of stem cells in managing deteriorating discs that have lost volume due to age and disease. While many studies promote injection of stem cells near the affected discs, newer techniques inject stem cell concentrates directly into affected discs to facilitate the formation of the extracellular matrix that is a prime component of healthy spinal discs. [7,8]

It has been proposed that stem cells can also be used to promote healing of cartilaginous damage on the facet joint surfaces. [9] Studies have shown injecting mesenchymal stem cells into or near arthritic joints can promote healing of damaged cartilage and form new cartilage cells to replace those that have been worn away by age-related changes.

Finally, studies have shown stem cells can mitigate the inflammation-mediated effects of arthritis, one of the primary causes of bone spurs. [10] When spurs grow along the vertebrae, they can begin to invade the spinal canal resulting in stenosis. By using stem cell therapy to help control or prevent inflammation in the early stages of arthritis, bone spur formation may be avoided.

For patients for whom laminectomy is necessary, injections of stem cells can help support grafts by promoting the growth of new blood vessels and increasing the viability of graft material. Research has also shown that in some patients, concentrated stem cells are a potential substitute for both autologous and allogenic bone grafts. [11]

Suggested Reading:

  1. Shamie, N. Lumbar spinal stenosis: The growing epidemic. AAOS.
  2. Lee, MJ, Cassinelli, EH, Riew, KD. Prevalence of Cervical Spine Stenosis. Anatomic Study in Cadavers. The Journal of Bone and Joint Surgery. 2007;89(2):376–380. doi:10.2106/JBJS.F.00437.
  3. Spinal stenosis. Mayo Clinic.
  4. Questions and Answers About Spinal Stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
  5. Fast Facts Spinal Stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
  6. Treatments and Drugs Spinal stenosis. Mayo Clinic.
  • Sobajima, S, Vadala, G, Shimer, A, Kim, JS, Gilbertson, LG, Kang, JD. Feasibility of a stem cell therapy for intervertebral disc degeneration. The Spine Journal. 2008;8(6):888–896. doi:10.1016/j.spinee.2007.09.011.
  1. Acosta, FL, Lotz, J, Ames, CP. The potential role of mesenchymal stem cell therapy for intervertebral disc degeneration: a critical overview. Neurosurgical FOCUS. 2005;19(3):1–6. doi:10.3171/foc.2005.19.3.5.
  2. Nöth, U, Steinert, AF, Tuan, RS. Technology Insight: adult mesenchymal stem cells for osteoarthritis therapy. Nature Clinical Practice Rheumatology. 2008;19(3):1–6. doi:10.1038/ncprheum0816.
  3. Bouffi, C, Bony, C, Courties, G, Jorgensen, C, Noël, D. IL-6-Dependent PGE2 Secretion by Mesenchymal Stem Cells Inhibits Local Inflammation in Experimental Arthritis. Agarwal S, ed., eds. PLoS ONE. 2010;5(12):e14247–6. doi:10.1371/journal.pone.0014247.
  4. [Clinical study of lumbar fusion by hybrid construct of stem cells technique and biodegradable material]. Zhang P, Gan YK, Tang J, Hao YQ, Wang Y, Sun YH, Zhu ZA, Dai KR. Zhonghua Wai Ke Za Zhi. 2008 Apr 1;46(7):493-6. Chinese. PMID: 18785556

 

Percutaneous injection of autologous bone marrow concentrate cells significantly reduces lumbar discogenic pain through 12 months.

Pettine KA, Murphy MB, Suzuki RK, Sand TT.

Stem Cells. 2015 Jan;33(1):146-56. doi: 10.1002/stem.1845.

Intervertebral disc repair by autologous mesenchymal bone marrow cells: a pilot study.

Orozco L, Soler R, Morera C, Alberca M, Sánchez A, García-Sancho J.

Transplantation. 2011 Oct 15;92(7):822-8. doi: 10.1097/TP.0b013e3182298a15.

Mesenchymal stem cells in regenerative medicine: Focus on articular cartilage and intervertebral disc regeneration.

Richardson SM, Kalamegam G, Pushparaj PN, Matta C, Memic A, Khademhosseini A, Mobasheri R, Poletti FL, Hoyland JA, Mobasheri A.

Methods. 2016 Apr 15;99:69-80. doi: 10.1016/j.ymeth.2015.09.015. Review.

The Inflammatory Milieu of the Degenerate Disc: Is Mesenchymal Stem Cell-based Therapy for Intervertebral Disc Repair a Feasible Approach?

Krock E, Rosenzweig DH, Haglund L.

Curr Stem Cell Res Ther. 2015;10(4):317-28. Review.

Harnessing the Potential of Mesenchymal Stem Cells for IVD Regeneration.

Clarke LE, Richardson SM, Hoyland JA.

Curr Stem Cell Res Ther. 2015;10(4):296-306. Review.

A systematic review of the safety and efficacy of mesenchymal stem cells for disc degeneration: insights and future directions for regenerative therapeutics.

Yim RL, Lee JT, Bow CH, Meij B, Leung V, Cheung KM, Vavken P, Samartzis D.

Stem Cells Dev. 2014 Nov 1;23(21):2553-67. doi: 10.1089/scd.2014.0203. Review.

Stem cell regeneration of degenerated intervertebral discs: current status (update).

Gilbert HT, Hoyland JA, Richardson SM.

Curr Pain Headache Rep. 2013 Dec;17(12):377. doi: 10.1007/s11916-013-0377-0. Review.

Disclaimer:
Actual results may vary. The statements are not intended to imply that the results would be the same or similar for each patient. Each patient is unique and no particular result or outcome can be predicted or guaranteed. The statements in this website have not been evaluated by the Food and Drug Administration. Some of these procedures may be considered experimental. These procedures are not intended to diagnose, treat, cure or prevent any disease. The use of stem cells is not approved by the Food and Drug Administration to combat aging or to prevent, treat, cure or mitigate any disease or medical condition mentioned, cited or described in this website. The science of treatment with stem cells is in its early stages and stem cell treatments are not considered to be the standard of care for any medical condition, ailment, illness or disease. There could be significant and unknown risks associated with stem cell treatments, as long-term studies have not been performed.