| Definitions: Lumbar Spinal Stenosis |
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Definition Lumbar Spinal Stenosis is derived from the word stenosis meaning narrowing. Imagine the spinal canal is a circle. The circle can be average, big or small. Since the spinal nerves travel in the circle at this level of the spine, any narrowing of the circle could put pressure on the spinal nerves. Unless the individual is born with a small spinal canal (congenital stenosis), spinal narrowing occurs most commonly from progressive degenerative changes (acquired spinal stenosis). Diagnosis The diagnosis is usually made from the patient's history, the physical examination performed by the doctor and diagnostic imaging studies. If the narrowing in the spinal canal puts pressure on the spinal nerves, then the patient may complain of pain, numbness, or weakness in the leg or legs. The circle (spinal canal) is narrowest when standing and walking and is larger when sitting. So most patients with lumbar (low back spinal stenosis) will complain of leg symptoms while walking or standing and are relieved while sitting. Some patients progressively bend over as they walk because they have learned that their leg or legs hurt less in that position. Bending forward (flexion) makes the circle (spinal canal) larger and may relieve pressure on the spinal nerves and reduce the symptoms. Non-Surgery Treatment Non-operative treatments include the following: restriction of activity, bracing, medications, physical therapy, alternative medicine, epidural steroid injection, etc. Surgical Treatment Surgery for spinal stenosis involves a careful assessment of how to make the spinal canal bigger but leave the spine stable for everyday life function. This analysis may be simple or complex. Generally speaking, the surgical concept is simple: make the spine larger and take the pressure off the spinal nerves. Prognosis Prognosis in lumbar spinal stenosis depends on the degree of pain and disability. Surgery is successful in the vast majority of patients with significant limitation. |