Lumbar Spinal Stenosis occurs when either the vertebral foramen or the spinal canal at the level of the lumber vertebrae begins to narrow which then can cause painful nerve compression.
Anything that narrows or constricts the spinal canal can be a cause of lumbar spinal stenosis. The number one cause of spinal stenosis is a result of normal aging process - Degenerative Arthritis. Degenerative arthritis causes spinal stenosis because it causes the normal spinal space to narrow by either bone spurs, degenerative disc disease, or the hypertrophy of lumbar ligaments. Other causes of lumber spinal stenosis are:
Tumors
Infections
Any metabolic bone disorders such as Paget's disease.
Signs and symptoms of lumbar spinal stenosis are commonly severe low back pain, weakness and numbness in the legs, and pain in the legs. Usually symptoms of spinal stenosis worsen with prolonged walking, standing, and bending backwards. Bending backwards increases the narrowing of the spinal column causing symptoms to increase. For this reason, most patient's find more comfort in walking with a walker which allows the posture of the spine to be bent forward which decreases the nerve compression from the spinal stenosis. The symptoms of lumbar spinal stenosis will increase and worsen as time goes on, and can often result in loss of bladder control, loss of bowel function, and decreased sexual sensation.
Diagnosis of lumbar spinal stenosis begins with a thorough physical examination by the patients doctors. This allows the doctor to evaluate the patients symptoms in order to distinguish the symptoms of lumbar spinal stenosis from those of other neurological disorders. Next, the physicians will likely order lumbar spine and possibly hip radiographs. The physician will evaluate the disc height, any bone spurs, and spinal stability. However, the final deciding factors when diagnosing lumbar spinal stenosis are CT scans and MRI scans. These scans along with contrast administration allows for the spinal nerves in the lumbar spine to be visualized in order to see if there is any nerve compression from the spinal stenosis.
Lumbar spinal stenosis can be treated with medications. Anti-inflammatory and cortical steroid medications are the primary form of medicinal treatments geared towards reduced in the compression of nerves as a result of lumbar spinal stenosis. Physical therapy is also a recommended treatment. Finally if medication or physical therapy are not successful in reducing pain and symptoms, surgery is an option.
The main goal of surgery for lumbar spinal stenosis is to remove the structure that are causing the compression of the nerves. This surgery is usually spinal decompression surgery, which is often accompanied with a lumbar spinal fusion surgery depending on the number of compressed structures that need to be removed. Surgery for lumbar spinal stenosis is often more successful in removing the pain and numbness in the legs as opposed to relieving the actual back pain.
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