The spine is an important structure that surrounds and protects the spinal cord. The spinal cord works to send nerve signals back and forth between the brain and nerves in the body. Sometimes injuries to the spine can cause problems with the spinal cord, which can lead to problems developing with the nerves coming out of the spinal cord.
Foramen is an anatomical term to describe a hole or passage in the body. It most commonly is used to describe holes in bones that allow for the passage of one or more nerves. The spine is made up of many bones called vertebrae. Each vertebrae has two foramen through which the spinal nerves pass.
Bilateral Foraminal Stenosis
Foraminal stenosis is a condition in which the vertebral foramen become narrowed. This typically happens only with the foramen on one side of the vertebrae (unilateral foraminal stenosis). However, in some cases, both foramen are narrowed, causing bilateral foraminal stenosis.
Bilateral foraminal stenosis can cause pinching of the spinal nerves that pass through the foramen. Pinched spinal nerves can cause pain, tingling, numbness or weakness in parts of the body.
The parts of the body affected are those that are innervated by the nerve. Generally speaking, spinal nerves at the top of the spine innervate the upper parts of the body (such as the head or upper torso), whereas those at the bottom of the spine innervate the legs and feet. Severe bilateral foraminal stenosis can impair balance and walking as well as cause patients to have diminished control over their bladders and bowel movements.
One cause of bilateral foraminal stenosis is a slipped disc, which can cause vertebrae to fall out of position, blocking the foramen. Discs also can collapse, which may shift vertebrae out of alignment. Another potential cause is arthritis in the spine, which can lead to small bony growths (called osteophytes) to form in the foramen, causing them to narrow. The risk of foraminal stenosis increases with age.
Most cases of bilateral foraminal stenosis initially are treated with a combination of medications, physical therapy and rest. Rest gives your body (particularly your nerves) time to heal, which keeps you from aggravating your injury. Medications are prescribed to help relieve any pain that the pinched spinal nerves are causing as well as to reduce inflammation that can exacerbate the symptoms. Physical therapy strengthens the muscles in the back, which helps provide support and stability for the vertebrae.