Spinal Stenosis

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Dr Kau Chung Yuan (许医生)


MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)


What is Spinal Stenosis?

Spinal stenosis is a condition characterised by the narrowing of spaces within the spine, which can exert pressure on the nerves travelling through the spinal column. This condition predominantly occurs in the lower back and the neck. The narrowing can occur in different parts of the spine and affects the gap in the bones of the spine through which nerves pass.

Types of Spinal Stenosis

Spinal stenosis can be categorised into two main types, depending on the region of the spine affected:

Cervical Stenosis

This type occurs in the neck area (cervical spine). It involves the narrowing of the spinal canal in the cervical region, which can compress the spinal cord and nerve roots.

Lumbar Stenosis

The more common form, lumbar stenosis, occurs in the lower back (lumbar spine). This condition is characterised by the narrowing of the spinal canal in the lumbar region, potentially compressing the nerve roots.


The development of spinal stenosis is often attributed to changes in the spine that occur as a natural part of ageing. However, several factors can contribute to or accelerate the narrowing of the spinal canal:

  • Degenerative Changes
    Age-related wear and tear is the most common cause of spinal stenosis. Degenerative processes like ligament thickening, disc herniation, and bone spur formation can narrow the spinal canal, encroaching on its space.
  • Osteoarthritis
    This condition, often associated with ageing, can lead to the development of bone spurs that can narrow the space within the spine.
  • Herniated Discs
    The soft cushions (discs) between the vertebrae can sometimes bulge out or rupture, encroaching upon the spinal canal.
  • Ligament Thickening
    Over time, the spinal ligaments can thicken and stiffen, protruding into the spinal canal.
  • Spinal Injuries
    Trauma to the spine, such as from accidents or falls, can cause dislocations or fractures that may damage the spinal canal.
  • Spinal Tumours
    Abnormal growths can form inside the spinal cord, within the membranes covering the spinal cord, or in the space between the spinal cord and vertebrae, leading to a narrowing of the canal.
  • Certain Conditions
    Diseases like Paget’s disease of bone, achondroplasia, and scoliosis can also contribute to spinal stenosis.


The symptoms of spinal stenosis vary depending on the location and severity of the nerve compression. Common symptoms include:

  • Pain
    One of the most frequent symptoms, it can occur in the area of the spine where the stenosis is located. In lumbar stenosis, this often includes lower back pain, while cervical stenosis may cause neck pain.
  • Numbness or Tingling
    A reduction in space within the spinal canal can lead to compression of nerve roots, resulting in numbness, tingling, or a sensation of “pins and needles” in the extremities.
  • Muscle Weakness
    Compression of nerves may lead to weakness in the muscles that the nerves supply. This might manifest as difficulty in grasping objects, problems with walking, or a general sense of weakness in the arms or legs.
  • Problems with Walking or Balance
    In severe cases, especially in cervical stenosis, individuals may experience issues with coordination and balance, leading to difficulty in walking.
  • Loss of Bowel or Bladder Control
    In rare cases, severe spinal stenosis can lead to issues with bowel or bladder control, a condition known as cauda equina syndrome, which requires immediate medical attention.


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Diagnosing spinal stenosis involves a comprehensive evaluation that includes a medical history review, physical examination, and imaging studies. The process typically includes:

Medical History

A thorough review of symptoms, including their onset, duration, and factors that improve or worsen them. The orthopaedic surgeon may also ask about previous spine problems or surgeries.

Physical Examination

The orthopaedic surgeon assesses the spine’s range of motion, muscle strength, and nerve function. This may include tests for sensation, reflexes, and walking ability.

Imaging Tests
  • X-rays: While X-rays cannot show soft tissues like discs and nerves, they can reveal changes in bone structure, such as bone spurs, that could indicate spinal stenosis.
  • Magnetic Resonance Imaging (MRI): An MRI can provide detailed images of soft tissues, including discs, nerves, and ligaments. It is particularly useful in identifying damaged discs and assessing the severity of canal narrowing.
  • Computed Tomography (CT) Scan: In cases where MRI is not possible, a CT scan can provide detailed images of bone structures. A CT myelogram, where a contrast dye is injected, can also provide clear pictures of the spinal cord and nerves.
Other Tests

In some cases, the doctor may recommend nerve tests such as electromyography (EMG) to assess nerve function and determine if symptoms are caused by nerve compression.

Non-Surgical Treatment Options

For many individuals with spinal stenosis, non-surgical treatments can effectively manage symptoms. These options include:


    • Pain Relievers: Over-the-counter pain medications, such as ibuprofen or acetaminophen, can help ease mild to moderate pain.
    • Antidepressants: Certain antidepressants may be prescribed to help alleviate chronic pain.
    • Anti-seizure Drugs: These medications might be used to reduce pain caused by damaged nerves.

Physical Therapy: A tailored physical therapy program can help improve strength, flexibility, and balance, potentially reducing the symptoms of spinal stenosis.

Steroid Injections: Corticosteroid injections can reduce inflammation and relieve pain temporarily. However, their effectiveness diminishes with frequent use, and they can have side effects.

Activity Modification: Learning how to modify activities and adopting ergonomic practices can help manage symptoms and prevent the worsening of the condition.

Assistive Devices: For some patients, using devices like braces, corsets, or walking aids can provide additional support and reduce pain.

Surgical Treatment Options

Surgery may be considered for spinal stenosis patients when non-surgical treatments have not provided adequate relief, or if there is severe impairment of function or quality of life. Surgical options include:

  • Laminectomy
    Laminectomy is the most common surgery for lumbar spinal stenosis. Often referred to as decompression surgery, this procedure involves removing the back part of the affected vertebra (lamina) to create more space within the spinal canal and relieve pressure on the nerves.
  • Laminotomy
    Similar to laminectomy, but involves removing only a portion of the lamina, targeting the specific areas that are causing nerve compression.
  • Laminoplasty
    Performed only on the cervical spine, this procedure involves creating more space for the spinal cord and nerves by reshaping the vertebrae.
  • Foraminotomy
    This surgery enlarges the openings where nerve roots exit the spinal canal, easing pressure on nerves.
  • Spinal Fusion
    In some cases, particularly where spinal stenosis is associated with spinal instability, orthopaedic surgeons may perform spinal fusion. This procedure involves joining two or more vertebrae together to provide stability to the spine.

Dr. Kau Chung Yuan

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

  • Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
  • Master of Medicine (Orthopaedics), Singapore (MMed) 2013
  • Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
  • Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

Prevention Strategies

While it may not be possible to prevent spinal stenosis, especially due to its association with age-related degeneration, there are strategies to reduce risk and slow its progression:

  • Regular Exercise: Engaging in activities that strengthen the back and abdominal muscles can help support the spine. Low-impact exercises such as walking, swimming, or cycling are beneficial.
  • Maintain a Healthy Weight: Excess body weight can put additional stress on the back, contributing to spinal problems. Managing weight through diet and exercise can alleviate this stress.
  • Good Posture: Practising good posture can reduce the pressure on the spine and the likelihood of developing stenosis symptoms.
  • Ergonomic Workspace: Setting up a workstation to promote good posture can help minimise stress on the spine, especially for individuals who sit for long periods.
  • Avoid Smoking: Smoking can accelerate the degeneration of spinal tissues and should be avoided.
  • Regular Check-ups: Regular medical check-ups can help detect spinal issues early and allow for timely intervention.

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Patient Feedback

Ethan Chan
Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.
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I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.

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    Frequently Asked Questions (FAQs)

    Can Spinal Stenosis Be Cured?

    Spinal stenosis is a chronic condition that cannot be cured, but its symptoms can often be effectively managed with treatment. The management approach depends on the severity and type of symptoms.

    How Common Is Spinal Stenosis?

    Spinal stenosis is more common in individuals over the age of 50 and is often a result of the natural ageing process of the spine. However, it can also occur in younger people due to congenital conditions or spinal injuries.

    Is Exercise Safe for People with Spinal Stenosis?

    Yes, certain exercises are safe and recommended for people with spinal stenosis. Activities that strengthen the back and abdominal muscles and improve flexibility can be beneficial. It is advisable to consult with an orthopaedic surgeon to tailor an exercise program.

    Can Spinal Stenosis Lead to Paralysis?

    While rare, severe cases of untreated spinal stenosis, especially in the cervical region, can potentially lead to significant nerve damage and paralysis. Prompt and appropriate treatment is crucial to prevent severe complications.

    What Is the Recovery Time After Surgery for Spinal Stenosis?

    The recovery time after surgery for spinal stenosis varies depending on the type of surgery performed and the individual’s overall health. Generally, minimally invasive procedures may have shorter recovery times, often ranging from a few weeks to a couple of months.

    More extensive surgeries, like spinal fusion, might require a longer recovery period, potentially several months to a year. During this time, physical therapy is often recommended to aid in the recovery process.

    Patients need to follow their orthopaedic surgeon’s post-operative guidelines and attend all follow-up appointments to ensure a smooth recovery.