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Spinal stenosis is caused by the narrowing of spinal space, leading to pressure on the spinal cord and nerve roots. The narrowing can affect the following three regions: the center of the canal, the base, or the opening between the vertebrae. When pressure is exerted on the lower portion of the spinal canal, symptoms such as pain and numbness in the legs are experienced. Pressure on the upper region of the spinal canal leads to pain in the shoulder and sometimes the legs.
Spinal stenosis tends to be more common in people above 50 years. Spinal stenosis can be inherited or acquired. For example, individuals with a small spinal canal, or abnormal spinal curvature (scoliosis), or the inherited bone disease—achondroplasia—may get spinal stenosis. On the other hand, instances of acquired spinal stenosis can occur from degenerative processes (e.g. osteoarthritis, rheumatoid arthritis), spinal tumors, spinal trauma, Paget’s disease, etc.
Typical symptoms include pain, numbness, cramping of the legs or arms, and sometimes radiating pain down the legs. Severe cases of spinal stenosis are associated with bowel and bladder function disorders.
Spinal stenosis can be diagnosed with a physical examination, and imaging tests (e.g. X-ray, Magnetic resonance imaging, Computerized tomography, bone scan) to detect structural abnormalities. A myelogram can help identify nerve compression areas.
Conservative measures for treating spinal stenosis include the use of nonsteroidal anti–inflammatory drugs (e.g. aspirin, naproxen, ibuprofen), analgesics (e.g. acetaminophen), physical therapy, restriction of activity and lumbar braces.
People, who do not respond to conservative treatment, may benefit from surgical interventions. The aim of surgery is to remove degenerated tissue (e.g. decompressive laminectomy), or realign the spinal canal. However, surgery is associated with risks, such as anesthesia complications, infection, blood clots, tear in protective spinal membrane, and a prolonged recovery time.
People, who are suffering from persistent spinal stenosis, may benefit from stem cell therapy. Stem cells are primitive cells that can undergo differentiation to form different types of cells in the body, such as bone, blood, cartilage, tendon, ligaments, etc. These cells are responsible for healing tissue damages by generating new healthy cells. However, with age, the body loses its ability to attract enough stem cells to the site of injury. In this regard, stem cell therapy delivers a high concentration of stem cells to the affected area to promote natural healing.
Unlike steroid injections, stem cell therapy does not present side effects, and is generally well-tolerated in patients. Moreover, because these cells are derived from the patient, there are no chances of immune rejection. Other types of stem cells used in practices include amniotic derived stem cells and umbilical cord blood cells, both of which are not recognized by the patient’s immune system, and therefore very safe to administer.
As mentioned earlier, spinal stenosis can result from degenerative processes affecting the spine. Although most chronic cases end up with surgery, stem cell therapy has shown some promising results in improving spinal degenerative problems in animal models as well as human subjects.
A recent pilot study evaluated the safety and effectiveness of mesenchymal stem cells (MSC) in 10 patients with chronic back pain. All subjects presented lumbar disc degeneration with intact annulus fibrosus. They were treated with MSC injection into the nucleus pulposus area. Subsequent, 12-month follow-up revealed significant improvement in pain and disability. In addition, there was a significant increase in disc water content, as visualized through magnetic resonance imaging. Therefore, stem cells offer a simple yet effective treatment option for repairing degenerative conditions.
Amniotic and Umbilical Cord Stem Cell Treatments
The most revolutionary regenerative medicine treatments now being offered include amniotic and umbilical stem cell treatments. These are FDA regulated and contain growth factors, hyaluronic acid, cytokines and stem cells.