Can Severe Canal Stenosis And Bilateral Forminal Narrowing At L4-l5 Cause Paralysis Or Bladder/bowel

Question

Asked by Concerned wife

Can Severe Canal Stenosis And Bilateral Forminal Narrowing At L4-l5 Cause Paralysis Or Bladder/bowel

issues? Physical therapy has been recommended, a course of physical therapy was already completed. I'm concerned about Cauda Equina Syndrome. By the way, the condition has been present for over a year with different forms of therapy tried to no effect, and there is numbness of the foot and leg as well as pain.

Answer

Severe central canal stenosis can lead to cauda equina syndrome (which is a severe irritation of the "horse tail" bundle of nerve roots attached to the end of the spinal cord). Bladder "issues" are actually more common then people realize. Bladder incontinence or retention can both occur when the sacral nerve roots are being irritated. This condition is called a neurogenic bladder and upwards of 60% of people with stenosis will have some symptoms of a neurogenic bladder. Bowel incontinence is less common and hence considered more serious. (Constipation is so common that it may or may not be attributed to a spine problem)

Complete paralysis is rare, even with severe stenosis. Partial paralysis or weakness can be present and/or progressive with stenosis. The nervous system should be examined regularly to watch for changes and progressive nerve damage. Progressive nerve damage is usually an indicator for surgery.

Surgery for stenosis is not always done depending on the individual situation. Anyone with signs of nerve damage from a spinal condition should see a spine specialist sooner rather than later.

Dr. Christina Lasich, MD

Answered by Christina Lasich, MD