Lumbar Spinal Stenosis
Lumbar spinal stenosis is a condition that results from a narrowing of space in the spinal canal. The normal spine nerves in the lumbar spine are encased in a fluid sac. The lumbar vertebrae protect these nerves. In conditions of advanced wear and tear there is narrowing of this space over time. This results in pressure onto the spinal nerves. This condition usually affects patients who are in the fifth or sixth decade or older.
The narrowing of the spinal canal space is usually a result of many factors. These include:
- disc prolapse
- thickening of the ligament supporting the spinal vertebrae
- hypertrophy of the joints of the spine
- loss of disc height
- the formation of bony spurs
- congenital narrow spinal canal
Lumbar Spinal Stenosis Symptoms
The usual symptoms of this condition are low back pain with pain in the legs that worsens when walking. There may also be sensory problems including numbness or pins and needles. This can result in a progressive difficulty with walking. At times symptoms are more pronounced when standing straight or lying in bed at night.
Lumbar Spinal Stenosis Diagnosis
An MRI scan can diagnose this condition. Although CT scans and static and dynamic x-rays of the lumbar spine may also be conducted. The information from these additional tests contribute to the creation of a treatment plan.
Lumbar Spinal Stenosis Treatment
In conditions where the symptoms are mild, non-operative treatment is an option. This is usually when the spinal canal or nerve root is not significantly compromised.
Non-operative treatments can be quite effective and can include:
- pain relief medication
- non-steroidal anti-inflammatory drugs
In small subset of patients, there might be the option for CT guided injections into the spine. In the presence of moderate to severe spinal canal stenosis, this is usually not recommended.
In conditions where the symptoms of spinal canal stenosis are moderate to severe, treatment will differ. The definitive treatment for this condition is to perform a laminectomy and rhizolysis. This involves making an incision in the back to expose the most affected spinal segment. A channel of bone in the spine and the abnormally thickened ligaments are removed. This makes more space for the spinal nerves. Patients find this surgery to be very effective removing pain and increasing mobility. This type of surgery is performed using microsurgical techniques.
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