Desert Spine and Scoliosis Center of Mesa, AZ routinely attends to, often bringing significant relief, to patients with lumbar spinal stenosis. Our spine surgeons utilize a number of techniques to deal with this condition.
What is lumbar spinal stenosis?
The lumbar spine forms the lower back. It is made up of five vertebrae, the name for bones of the spine. Each of the nerves of the leg originates from nerves that come off the spinal cord. These nerves, which in way resemble strands of spaghetti, travel downward through the lumbar spinal canal and exit through small openings on the sides of the vertebrae called foramina. These nerves then course through the legs as nerves of the lower limb. These nerves transmit information regarding sensation from the buttocks and lower extremities as well as motor signals that control muscles of the lower limb.
Lumbar stenosis (spinal stenosis) is a condition that can occur in three basic ways:
- The spinal canal (central stenosis) becomes narrowed, constricting the nerves that course downward as they leave the spinal cord. This type of stenosis occurs inside the vertebral structures (spinal column.)
- One or more of the vertebral lateral foramina (foraminal stenosis) may become narrowed. This often causes compression of the thick spinal nerves as they leave at either side of the spinal column.
- A combined syndrome wherein the central canal as well as one or more of the lateral foramina are narrowed.
Lumbar spinal stenosis can cause a variety of symptoms. Some of the most common symptoms include:
- Low back and/or buttock pain.
- Radiating pain down the leg.
- Numbness in the legs that is worsened with walking (termed “neurogenic claudication”.)
What causes the narrowing of lumbar spinal stenosis?
There are a variety of possible causes of lumbar spinal stenosis but of these degenerative, spinal arthritis and degenerative disc disease are the most common. Arthritis typically occurs at the spine as part of the aging process. This can lead to abnormal formation of bone spurs (called “osteophytes”), loss of the normal height of the discs that normally separate the vertebrae (degenerative disc disease), and overgrowth of the ligaments of the spine. Other conditions that might causes or worsen spinal stenosis include spinal tumors, infection and certain conditions that cause abnormal bone formation at the spine.
How is lumbar spinal stenosis diagnosed?
The trained orthopedic spine surgeon will begin with a complete medical history and physical examination. During this interview the surgeon will attempt to distinguish lumbar spinal stenosis from other conditions that may produce similar symptoms. The spine surgeon may order imaging to detect or confirm lumbar spinal stenosis (e.g. X-ray, MRI or CT scan.) In certain cases, nerve tests (e.g. EMG and/or NCV) may be ordered. These tests will be used to identify damage or irritation of the spinal nerves caused by the compression of lumbar spinal stenosis. These tests may also be used to rule out other conditions involving the nerves that may mimic stenosis.
What is the treatment for lumbar spinal stenosis?
Treatment for lumbar spinal stenosis typically begins with conservative (nonoperative) options. This might include medications, physical therapy and even chiropractic. In the event that these measures fail to produce relief, the patient may be referred for steroid injections in the lumbar spine (commonly referred to as epidural injections or “epidurals”.) These are aimed at reducing symptoms by decreasing inflammation and swelling of the spinal nerves. When these measures fail, the patient has bowel or bladder dysfunction or the degree of spinal stenosis is deemed too advanced to consider conservative approaches, surgery is typically the best option.
Spinal Surgery for Lumbar Spinal Stenosis
There are a variety of surgical procedures available for the treatment lumbar spinal stenosis. Desert Spine and Scoliosis Center’s spine surgeons offer a wide range of these. The main purpose of spine surgery is to remove the structures that are compressing the nerves. This type of surgery is commonly referred to as lumbar decompression surgery (e.g. laminectomy, laminotomy, foraminotomy.) Occasionally these methods will be combined with surgical lumbar fusion to prevent instability of the spine if the spine surgeon is concerned about dangerous instability of the spine as a factor.
The details of some of these procedures can be found on this site.
If you are suffering from lumbar spinal stenosis and you are visiting or reside in the metro phoenix, mesa or gilbert areas, our spine surgeons would be happy to meet with you to discuss your options toward finding relief.