Lumbar Spinal Stenosis
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of your back, compressing the nerves traveling through the lower back into the legs.
At CalSpine MD, our spine surgeon, Dr. Ball, treats lumbar spinal stenosis frequently, as it is a very common condition affecting the lower back. The lumbar spine (lower back) consists of five vertebrae in the lower part of the spine, between the ribs and the pelvis, connecting your upper spine to the pelvis. If you are diagnosed with lumbar spinal stenosis, Dr. Ball will work with you to find a treatment option that works best for you, whether it involves surgery or nonsurgical methods.
Causes of Lumbar Spinal Stenosis
Most often, spinal stenosis develops due to degenerative changes in the spine, such as with osteoarthritis or degeneration. These changes can narrow the spinal canal, eventually putting pressure on the nerve roots. Disc herniations can also cause spinal stenosis.
Degenerative spinal stenosis is a very common condition. By the age of 50, 95 percent of people will experience degenerative changes in the spine. However, not everyone experiences symptoms.
Other causes of lumbar spinal stenosis include
- Narrow Spinal Canal (Congenital)
- Injury to the Spine, such as Fracture or Acute Disc Herniation
- Spinal Tumor
- Certain Bone Diseases
- Past Surgery of the Spine
- Rheumatoid Arthritis
Symptoms of Lumbar Spinal Stenosis
Symptoms of lumbar spinal stenosis are similar to other common spine conditions, so it is important to get a proper diagnosis so that you can start the right treatment plan.
Lumbar spinal stenosis can cause back pain and radiating pain, weakness, numbness, and/or tingling in the low back, buttocks, legs, or feet.
Many patients with spinal stenosis in the lower back are limited in their ability to walk, whereas leaning forward or sitting improves the symptoms.
In severe cases, spinal stenosis can cause loss of bladder or bowel control. If you experience this, seek immediate medical attention.
Lumbar Spinal Stenosis Diagnosed
To diagnose lumbar spinal stenosis, Dr. Ball will ask you about your symptoms and do a complete physical exam, looking for signs of spinal stenosis, such as loss of sensation, weakness, and abnormal reflexes. Dr. Ball may also order X-rays of your lumbar spine, a CT or MRI scan, a bone scan, a myelogram (a CT taken after injecting dye), or an EMG test (an electrical test of muscle activity).
Treatments for Lumbar Spinal Stenosis
At CalSpine MD, Dr. Ball offers a full range of nonsurgical and surgical treatment options for lumbar spinal stenosis.
Nonsurgical Treatment for Lumbar Spinal Stenosis. Nonsurgical treatment for lumbar spinal stenosis may involve anti-inflammatory medications and steroid injections to decrease pain and inflammation of the nerve roots.
Physical therapy is also helpful for some patients. Many patients with back pain try to reduce their activities in an effort to reduce their pain, but that can lead to muscle weakness, which can instead increase pain. Physical therapy can improve core or truncal strength, endurance, and balance while helping you maintain flexibility in the spine.
If an extended period of nonsurgical treatment does not improve symptoms, surgery may be considered.
Surgical Treatment for Lumbar Spinal Stenosis. At CalSpine MD, Dr. Ball offers a few different surgical approaches for lumbar spinal stenosis. He will review the options with you to help you choose what is best for your lifestyle and current condition.
The most common surgical procedures for lumbar spinal stenosis include laminectomy, laminotomy, or discectomy. Sometimes, spinal fusion is performed if additional stability is required.
During a laminectomy, also called a decompression, Dr. Ball will remove any bone, bone spurs, or ligaments that are putting pressure on the spinal nerves. The back part of the vertebra, called the lamina, is also removed. In some cases, a spinal fusion may also be performed to maintain stability in the spine.
Similar to a laminectomy, a laminotomy involves removing a portion of the lamina just large enough to relieve pressure on the nerve root, rather than removing the entire lamina.
In some cases, spinal stenosis procedures can be completed using minimally invasive techniques, which can reduce recovery times. These procedures may often be performed in an ambulatory surgery center.
After surgery, the recovery process can vary based on the type of procedure chosen by you and Dr. Ball. Procedures involving a spinal fusion will typically have longer recovery times, as it can take weeks to months for the bones to completely fuse together. Generally, most patients are able to return to all normal activities within a few weeks to months of surgery.