Estreitamento do espaço por onde passam a medula espinal e as raízes nervosas. Em função da sua localização, diferencia-se entre estenose do canal cervical e estenose do canal lombar. Habitualmente, afeta pessoas com idade superior a 50 anos, embora possa surgir em idades inferiores caso a pessoa tenha sofrido um traumatismo de coluna.
A causa mais frequente é a degenerativa; outras causas: hérnia discal, traumatismos ou tumores de coluna.
Quando o nervo se comprime, manifesta-se com dor, formigueiro, intumescimento e enfraquecimento muscular da zona afetada. Em caso de estenose do canal lombar, a dor piora ao caminhar e alivia-se ao se inclinar para a frente ou ao se sentar. Em casos graves, pode surgir incontinência urinária.
O diagnóstico realiza-se através de questionário clínico e exames de imagem, como radiografia e/ou ressonância magnética.
Deve-se tratar a dor aguda através de analgésicos convencionais, anti-inflamatórios não esteroides e/ou opiáceos. Pode-se utilizar cortisona oral ou através de injeções próximas do ponto de entalamento do nervo. Se a dor se tornar crónica, podem-se associar antidepressivos tricíclicos, anticonvulsivos e tratamento com fisioterapia. Os casos mais graves podem requerer cirurgia para descomprimir a raiz nervosa.
A severidade da estenose costuma ser proporcional à intensidade da dor e correlaciona-se de forma inversa com os metros que uma pessoa pode andar sem sentir dor. Considera-se estenose grave se apresentar dor antes de chegar a caminhar 200 metros e muito grave se a distância for inferior a 50 metros.
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