Lumbar Spinal Stenosis is a narrowing of the spinal canal which compresses the nerves traveling through the lumbar spine into the legs. It is usually a degenerative condition seen as part of the normal body aging process that develops when patients are 60 years or older.

Common symptoms include dull to severe aching pain in the lower back or buttocks, radiating into both tighs and legs, that develop with walking or other activity Symptoms are relieved by sitting or lying down, and or by bending at the waist. In rare cases, patients can lose motor functioning the legs, bowel or bladder function.

Diagnostic testing routine include lumbar X rays and CT scan. Magnetic resonance is however the best screening test to evaluate the extent and severity of spinal stenosis. Sometimes, CT myelogram is indicated when MR scan cannot be performed.

Treatments can be either conservative or surgical :

  • Conservative treatments include nonsteroidal anti-inflammatory medication, physical therapy and epidural steroid injections. These approaches generally provide temporary relief.
  • For long term relief, surgery is the treatment of choice, providing pain relief and improved quality of life in more than 74% of patients. Surgery is usually recommended to patients in reasonably good health, when back and leg pain limits normal activity or impairs quality of life, when the patient experiences difficulties standing or walking and when neurologic deficit occur.

Several different surgical procedures can be utilized,depending on the severity of disease. In a small percentage of patients, spinal instability make may it necessary for a fusion to be performed, a decision that is generally determined prior to surgery.

It is crucial that the patient discuss with the surgeon about the techniques, risks, influence of other complicating illnesses and preexisting neurologic deficits, feasability of surgery and results to be expected.

Sometimes, a herniated disc may occur in a patient presenting with silutaneous spinal stenosis wich in case of surgery requires surgical widening of the spinal canal prior to removal of the hernia, to avoid excessive retraction of the nerve roots.