What is Lumbar Spinal Stenosis?
Spinal stenosis is a prevalent spinal disorder in the U.S. and across the globe. In fact, the condition affects an estimated 250,000 to 500,000 U.S. residents.
This spinal disorder can occur in the lower, or lumbar, region of the spine, which is known as lumbar spinal stenosis. Or, it may occur in the neck, or cervical, region of the spine, which is known as cervical spinal stenosis. Lumbar spinal stenosis is the most common form of this condition, and it’s the topic of our article.
What is Lumbar Spinal Stenosis?
Spinal stenosis is a common condition, especially among patients who are aged 50 and over. It occurs when the spinal canal abnormally becomes narrower. The word “stenosis” can be traced back to ancient Greek and refers to narrowing, or constriction.
As the spinal canal progressively narrows over time, it strains the nerves that extend outward from the spine and travel into the extremities. This can cause a range of symptoms.
What Are Lumbar Spinal Stenosis Symptoms?
The symptoms of lumbar spinal stenosis can differ from patient to patient. However, pain, tingling, and numbness in the extremities are among the most common signs of this spinal disorder.
Other symptoms of lumbar spinal stenosis may include:
- Numbness or tingling in a foot or leg
- Weakness in a foot or leg
- Pain or cramping in one or both legs
- Lower back pain
There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.
What Causes Lumbar Spinal Stenosis?
Most cases of spinal stenosis occur for unknown reasons. However, the causes of lumbar spinal stenosis are rooted in specific parts of the spine’s anatomy, such as:
- The intervertebral discs
An intervertebral disc is located between each of the bones in the spine. It provides cushioning for the bone and prevents damage by absorbing impact. These discs break down with age and may even become herniated, meaning that the disc interior protrudes from a crack in the disc interior.
A damaged intervertebral disc can take up extra space in the spinal canal, potentially leading to spinal stenosis.
- The facet joints
The facet joints connect the vertebrae of the spine to one another. These joints support a large amount of weight and undergo a significant amount of stress. As a result, they’re vulnerable to wear and tear, as well as various injuries. Damage to the facet joints (and the cartilage within these joints) can trigger spinal stenosis.
- The spinal cord
When the spinal cord and/or the nerve roots become compressed, it may trigger pain and neurological symptoms. When the spinal cord and nerve roots are involved in spinal stenosis, the patient is rarely asymptomatic.
What is Inherited Spinal Stenosis?
The narrowing, or tightening, of the spinal canal, may result from abnormal bone and/or tissue growth. or due to a hereditary disorder. This is referred to as inherited spinal stenosis.
Some people are born with a spinal canal that’s narrower than average. This can cause the patient to experience spinal stenosis symptoms much earlier in life than the average patient. Additionally, patients who are born with scoliosis may experience spinal stenosis.
Scoliosis is an atypical, sideways curve of the spine. It’s commonly recognized and diagnosed in children and adolescents. In patients with scoliosis, the curved spine may place stress on the spinal cord, potentially leading to spinal stenosis.
What is Degenerative Spinal Stenosis?
Degenerative spinal stenosis refers to cases of this condition that are caused by wear and tear on the spine. This is the most common type of spinal stenosis.
Spinal degeneration is a normal effect of aging. It occurs as the intervertebral discs and facet joints weaken from repeated strain over time. Factors including a sedentary lifestyle, poor posture, obesity, injuries, smoking, and other spinal disorders (such as scoliosis) can speed up the process of spinal degeneration.
Effects of aging that can contribute to the development of degenerative spinal stenosis include:
- The cartilage in the facet joints gradually wears down, which increases friction in the spine and may cause bone spurs to form.
- The intervertebral discs become drier, flatter, and weaker. The discs may become damaged, leading to a slipped or herniated disc.
- As the cushioning in the spine from intervertebral discs decreases, the spinal cord and/or nerve roots can become strained.
Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.
What Are The Best Treatments For Lumbar Spinal Stenosis?
Options for spinal stenosis treatment include:
- Spinal stenosis exercises
Various exercises can help with spinal stenosis by improving strength and mobility in the affected areas. You can perform these exercises at home to support your lumbar spinal stenosis recovery.
Examples of spinal stenosis exercises include:
This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine.
- Pelvic tilts
This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine.
- Knee-to-chest exercise
This exercise stretches and helps relieve tension in the lower back muscles. It also flexes the spine, which relieves pain from spinal stenosis by temporarily creating more space in the spinal canal.
- Physical therapy
Physical therapy may improve symptoms of lumbar spinal stenosis by relieving pressure on the spinal cord. For lumbar spinal stenosis, physical therapy typically involves stretches for the lower back, legs, and hips, as well as strengthening exercises for the abdominal muscles, which support the lower spine. Your physical therapist may work with you on mobility exercises to improve your range of motion in the lower back.
Additionally, physical therapy may involve treatments that can help with pain, tension, and inflammation. These treatments include heat/cold therapy, electrostimulation, massage, etc.
Both over-the-counter and prescription medications may be used to reduce pain and inflammation from lumbar spinal stenosis. Talk to your doctor before starting a new medication for spinal stenosis symptoms in the lumbar spine.
Surgery For Lumbar Spinal Stenosis
In extreme cases, surgery for lumbar spinal stenosis may be recommended. Typically, doctors don’t recommend lumbar spinal stenosis surgery unless the patient has first undergone at least 6 months of conservative treatment.
For lumbar spinal stenosis, spinal decompression surgery is often performed. This type of surgical procedure involves removing portions of the vertebrae that are impinging on the roots of nerves emanating from the spine. By relieving this pressure, the procedure gives patients symptom relief and provides the spinal nerves with enough space to heal.
Laminectomy is the most common form of spinal decompression surgery for spinal stenosis of the lumbar region. In this procedure, the surgeon removes all or part of the lamina, which forms the ceiling of the spinal canal. Other types of spinal decompression surgery include foraminotomy and discectomy.
Spinal Fusion in Lumbar Spinal Stenosis Surgery
Following the spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. Over time, the bone graft will cause the vertebrae to permanently fuse.
Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Patients can lose a significant amount of motion in the lower back after spinal fusion.
Alternatives to Spinal Fusion
Spinal fusion alternatives, such as non-fusion implants, can offer stability without limiting the patient’s mobility after spinal stenosis surgery. The TOPS™ System, for example, provides an alternative to spinal fusion that maintains the spine’s full range of motion. It’s been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery.
Patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever. Talk to your doctor about the best course of treatment for your needs.