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Lumbar SpinalStenosis

spinal_stenosis.jpgLumbar spinal stenosis may or may not produce symptoms, depending on the severity of your case. The narrowing of the spinal canal itself does not produce these symptoms. It is the inflammation of the nerves due to increased pressure that may cause noticeable symptoms to occur. When present, symptoms may include:

  • Pain, weakness, or numbness in the legs, calves, or buttocks
  • Pain radiating into one or both thighs and legs, similar to sciatica
  • In rare cases, loss of motor functioning of the leg
  • In rare cases, loss of normal bowel or bladder function
  • Pain may decrease when you bend forward, sit or lie down.
  • Pain may get worse when you walk short distances.

Treatment - Nonsurgical

Anti-inflammatory medications to reduce swelling and pain, and pain medication to relieve pain. Most pain can be treated with nonprescription medications, but if your pain is severe or persistent, your doctor may recommend prescription medications.

Epidural injections of cortisone may be prescribed to help reduce swelling. This treatment is not recommended repeatedly and usually provides only temporary pain relief. Physical therapy and/or prescribed exercises may help stabilize your spine, build your endurance and increase your flexibility. Therapy may help you resume your normal lifestyle and activities. If non-surgical techniques do not work then surgery may be recommended.

Treatment - Surgical

  • Decompressive Laminectomy in which the laminae (roof) of the vertebrae are removed to create more space for the nerves. A neurosurgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disc. A spinal fusion with or without spinal instrumentation may be recommended when spondylolisthesis or scoliosis occurs with spinal stenosis. Various devices (such as screws or rods) may be used to enhance fusion and support unstable areas of the spine.
  • Foraminotomy: Surgical opening or enlargement of the bony opening traversed by a nerve root as it leaves the spinal canal to help increase space over a nerve canal. This surgery can be done alone or together with a laminotomy.
  • Laminotomy: An opening made in a lamina, to relieve pressure on the nerve roots.
  • Medial Facetectomy: Surgical procedure to remove part of the facet (a bony structure in the spinal canal) to increase the space.
  • Posterior Lumbar Interbody Fusion (PLIF): Removal of the posterior bone of the spinal canal, retraction of the nerves and removal of the disc material from within the disc space, followed by insertion of bone graft and sometimes hardware in order to fuse the bones. This procedure is called an 'interbody fusion' because it is performed between the 'bodies' of the vertebral bones and across the diseased disc space. This procedure typically is performed on both sides of the spine.
  • Transforaminal Lumbar Interbody Fusion (TLIF): Removal of the posterior bone of the spinal canal, retraction of the nerves, and removal of the disc material from within the disc space, followed by insertion of bone graft and sometimes hardware in order to fuse the bones. Similar to a PLIF, but frequently performed from only one side.