With the wear and tear associated with the aging process, the shape of the spine changes and the width of the spinal canal can get narrowed and create pressure on the spinal nerves. This process is known as spinal stenosis and when it occurs in the lower lumbar region of the spine, it’s known as lumbar spinal stenosis.
While degenerative changes in the spine can be seen in around 95% of people by the age of 50, lumbar spinal stenosis is more commonly seen in those above 60 years of age. It’s however been seen in younger people too, but mostly due to developmental issues. India is known to have over a million new cases every year and this number could go up considering the inactive unhealthy lifestyles being practiced these days.
With increasing age, the inter-vertebral spongy discs tend to get hardened, resulting in loss of disc height and its bulging out into the spinal canal. This narrowing of the canal results in compression of nerves radiating out towards the legs and urinary bladder. Along with the bulging discs, ligaments may also thicken and bone spurs may form, all contributing to further inflammation and nerve compression.
Symptoms
The patient may feel pain, cramping or numbness in the legs, buttocks or calves which could get further aggravated upon standing for long periods or walking. The pain could radiate to one or both legs and in rare cases, could even lead to loss of motor function of the legs or loss of bowel or bladder function. Pain will typically improve upon bending forward, sitting or lying down.
Diagnosis
A neurosurgeon will make the diagnosis based on your history, symptomatology and physical examination. This can be further backed up by imaging studies including x-rays, CT scans, MRIs or myelograms.
Treatment
Conservative treatment
In some cases, non-surgical methods can contain the progression of lumbar spinal stenosis and include anti-inflammatory medications, epidural injections, physiotherapy, posture correction, weight management, bone strengthening endeavors and smoking cessation.
Surgical treatment
When conservative therapy doesn’t work, surgery is usually advised taking into account patient’s overall health and any underlying issues. The different types of surgeries recommended according to the patient’s requirements include:
- Decompressive laminectomy with or without fusion
- Laminotomy
- Medial facetectomy
- Foraminotomy
- Transforaminal lumbar interbody fusion
- Anterior lumbar interbody fusion
- Posterior lumbar interbody fusion
- Posterolateral fusion
- Instrumented fusion
The Sita Bhateja Specialty Hospital in Bangalore has an excellent team of highly-specialized neurologists, neurosurgeons and orthopedists who have been intensively involved in the intricate surgical treatments of lumbar spinal stenosis. Paired with the latest minimally invasive surgical techniques, world-class operating theatres and a physiotherapy and rehabilitation center, your treatment here is in the best hands possible.