Bilateral foraminal stenosis is a medical condition that can be broken down to determine its meaning. Bilateral means that it involves two identical sides. Foramen is a natural opening. Stenosis is a narrowing or constriction of a passage or duct. Putting them all together, bilateral foraminal stenosis is the narrowing of the disk space along both sides of the spinal cord.
The spine is comprised of 33 vertebrae. Each vertebra has two foramina, one located on each side, right and left. These foramina, or openings, are where the nerves run through the body. As the foramina become constricted or blocked, the nerves become compressed, thereby causing back pain.
The foramina can be narrow due to congenital defects, meaning it is present at birth. However, usually the condition is a result of the degenerative process. This means that the condition develops over time, at a slow rate. It can be due a repetitive activity, either a physical activity like a leisure sport, or even a repetitive motion in the workplace. This degenerative process can lead to spinal arthritis, or the presence of osteophytes which are bone spurs that can protrude into the foramen space. Herniated discs can also cause bilateral foraminal stenosis. Between each vertebra is an intervertebral disc made of cartilage. This disc acts as a shock absorber and allows for movement in the back. The disc can bulge into the foramen space, thereby compressing nerves. The cervical vertebrae have projections on the sides called uncinate process. This part of the vertebra can become enlarged and protrude into the foramen.
The spine is divided into five regions; the cervical is the first 7 vertebrae located in the neck, the thoracic are the next 12 vertebrae, the lumbar region consists of the next 5 vertebrae and are larger as they support much of the body’s weight, the sacrum is the 4 or 5 vertebrae that are fused into the triangular bone and the very bottom of the spine is known as the coccyx or tailbone. Foraminal stenosis is most common in the cervical, or neck, region. However, it can also occur in the lower lumbar region as well. Most times the patient experiences pain on either the right or left side of the body, but when both sides are affected it results in bilateral foraminal stenosis.
There are really no direct signs and symptoms of bilateral foraminal stenosis. The symptoms occur when the narrowing of the foramen affects the nerves. When a nerve is compressed, the patient can suffer from pain, tingling, numbness or weakness.
Diagnosis and Treatment
The diagnosis of bilateral foraminal stenosis begins with a discussion of medical history and symptoms with a doctor. The doctor may then suggest either an x-ray or MRI (magnetic resonance imaging) to try to capture an image of the narrowing. There are treatment options, which try to treat the symptoms, and cure options that try to correct the cause of the problem. Treatment options include medications, chiropractic, acupuncture, massage therapy, electrotherapy and more. Cure options include spinal decompression or surgery, known as foraminotomy. A foraminotomy is surgery that strives to widen the foramen space where the nerves run.