Lumbar stenosis is a narrowing of the spinal canal in the lower part of the spine. This narrowing places pressure on the spinal cord and/or nerves. While some patients are born with this narrowing, most cases of lumbar stenosis occur in patients over the age of 50 and are the result of aging and “wear and tear” on the spine.
Many patients with lumbar stenosis remain symptom-free until other conditions further compress the spinal canal. Other conditions that can cause compression include:
The symptoms of lumbar spinal stenosis include:
The physicians at our practice care about your health. That is why we will use a combination of techniques and sophisticated technology to help make an accurate diagnosis:
Most cases of lumbar stenosis are successfully treated with non-surgical techniques such as pain medications and anti-inflammatory medications. Severe pain may also be treated with corticosteroids that are injected into the lower back (i.e. epidural steroid injections). Depending on the extent of nerve involvement, some patients may need to temporarily restrict their activities. However, most patients only need to rest for a brief time. Physical therapy exercises will also be prescribed to help strengthen and stabilize the spine as well build endurance and increase flexibility.
If these non-surgical measures do not work, we may recommend surgery. There are a number of surgical techniques that we can use to treat this condition. The goal of each of these surgical treatments is to widen the spinal canal and relieve the pressure by removing the cause of compression.
The most common surgery for lumbar stenosis is called a decompressive laminectomy in which the laminae (roof) of the vertebrae are removed, creating more space in the spinal canal for the nerves. If only a portion of the laminae need to be removed, it is called a laminotomy. If there are herniated or bulging discs, these may also be removed (this is called a discectomy) to increase canal space. Sometimes the foramen (the area where the nerve roots exit the spinal canal) may also need to be enlarged. This procedure is called a foraminotomy.
For those patients who need surgical repair on more than one level, or who have significant spinal instability, spinal fusion may be required in addition to the decompression surgery. This traditionally involves taking a small piece of bone (usually from the hip) and grafting it onto the spine. Spinal implants (called instrumentation) such as screws and rods are used to support the spine and provide additional stability while the fusion is healing.
Your health is our primary concern. Like you, we are eager to see you return to a healthy, pain-free and active life. If you have any questions about your condition, your treatment or your recovery, do not hesitate to call us.