Genetic spinal stenosis describes a loss of vertebral canal patency that is related to congenital or genetic factors. Medical science has long researched bloodline links to various musculoskeletal pain syndromes and structural spinal issues. Spinal stenosis is certainly one condition that has received much attention in this regard. However, since spinal stenosis can be caused by so many different explanations, and often exists due to a combination of contributory factors, linking the development of stenosis to definitive generic factors becomes a convoluted and difficult task to be sure.
This research essay provides evidence of a genetic relationship in many cases of spinal stenosis. We will examine how various manifestations of stenotic changes in the spine can be inherited through the genes and why some people are more susceptible to developing symptomatic versions of the condition due to both physical and mindbody factors.
Definition of Genetic Spinal Stenosis
Spinal canal stenosis is not a disease and it is certainly not contagious or passed directly from parent to child. Instead, stenosis is a normal part of aging, but can also be accelerated or exacerbated by a wide range of possible factors. Genetic predisposition is certainly one reason why a person might develop worse stenosis than the average adult of a given age.
Genetics are complicated and scientists are still learning much about how genes are passed from one generation to the next. We do not have a complete knowledge base on the topic of genetics, but we do understand that when it comes to spinal stenosis, our genes certainly do play an important role in how the spine ages and deteriorates.
It is important to know that genetics influence two completely different types of stenosis: congenital spinal stenosis and developed spinal stenosis. In the sections below, we will detail the current understanding of how both conditions are related to the genes that we receive from our ancestors and how these genes contribute to the occurrence of stenotic spinal changes during our lifetimes.
Congenital Spinal Stenosis
Since babies are born with congenital versions of spinal stenosis, we know that genetics likely play a significant role of causation versus the usual factors that contribute to developed versions of narrowed spinal canals. Congenitally narrowed spinal canals are known to run in family lines, sometimes affecting generation after generation, while other times, being a recessive gene that only shows itself occasionally.
Stenotic changes can certainly be caused by the pre-birth behavior of the mother, with some congenital changes being directly linked to exposure to certain substances during pregnancy. However, in many cases, no exposure or behavior patterns stand out as being abnormal or explanative for the development of congenital stenosis in an infant. In these instances, the chance of an inherited trait being the cause is far greater and can often be traced back in the bloodline through medical records or health histories of relatives.
Congenital stenosis comes in all severities, with some unfortunate infants being born with already compromised neurological structures, while others demonstrate only minor narrowing that is not likely to be diagnosed until much later in life, if ever at all. This less severe type of stenosis seems the most logically linked to genetic patterns, given patient statistics recorded over many years. However, since many cases are never found, and others only found in old age, it is difficult to clarify exactly what role genes play in the development of symptomatic versions of canal impingement due to underlying congenital narrowing.
Developed Genetic Spinal Stenosis
Developed spinal stenosis can be caused by many specific and general aging and injury processes acting alone or in combination with one another. The “average case” of age-related stenosis is not necessarily symptomatic and is caused by the efforts of disc degeneration, spinal arthritis and joint deterioration inherent to getting older. Other structural factors that can cause or contribute to stenosis include ligamentous hypertrophy and ossification, intervertebral herniation, atypical spinal curvature and listhesis misalignments.
We know that osteoarthritis has a genetic link, both in location and severity of expression. However, we also know that lifestyle factors influence this genetic predisposition in significant ways, making it difficult to prove exactly how much arthritis development may be inborn in the genes and how much might be exacerbated by life activity and injury.
Intervertebral disc abnormalities also have genetic markers and identical locations of degeneration or herniation often appear generation to generation. However, lifestyle factors also obviously influence the rate and extent of disc degeneration, in much the same manner as with spinal arthritic development.
There is currently little evidence of some ligamentous problems being linked genetically, but this might be because the condition has not been studied with the same focus as arthritis or disc-related spinal pathologies.
We know that scoliosis and various forms of hyperlordosis and hyperkyphosis have genetic components to their transmission from parent to child. However, in developed versions of these conditions, the causative factors often relate more to the aforementioned arthritic and disc-related changes than to a direct genetic link.
Finally, spondylolisthesis is a condition that is certainly related genetically through the bloodline, with children of affected patients having a greater chance of demonstrating the spondylolysis defect and the eventual development of vertebral misalignment, especially in the lowest lumbar region.
Mindbody Spinal Stenosis
Not surprisingly, one of the least often considered possible genetic links to stenosis exists in the passage of personality genes, as well as in the psychoemotional interactions of parent and child throughout life.
Mindbody variants of back and neck pain are often blamed on coincidental spinal stenosis, even when the symptoms are not actually caused by the canal narrowing. Remember that most mild to moderate stenosis presentations do not cause pain or any neurological deficits at all and even the worst clinical presentations often produce minor or transient expressions.
Children may inherit genes which dispose them towards certain types of personality traits that are known to cause and exacerbate mindbody pain syndromes ranging from anxiety and depression to back pain and headaches to gastrointestinal disorders and many more. These traits include goodism, perfectionism, the drive to succeed, repressed feelings of inferiority, being self-critical, as well as being outwardly overcritical of others. Additionally, since mindbody symptoms can be “learned”, parents with these conditions often teach them unwittingly to their children through their own experiences.
Both of these factors establish clear mindbody genetic links to the development of upper, middle, lower back or neck pain blamed on stenosis, but not the actual development of structural stenosis itself.