Lumbar Stenosis

Lumbar stenosis refers to a narrowing of the spinal canal in the low back. The most common causes include degenerative arthritis of the spine joints, a herniated intervertebral disc, and slippage of one vertebrae on another (spondylolisthesis). Narrowing of the spinal canal exerts pressure on the nerve roots that travel down and supply strength and sensation to the legs.

Lumbar stenosis classically causes pain that radiates down one or both legs, often beginning in the buttock. There may also be muscle weakness, numbness, or tingling in the affected leg. Symptoms may be brought on by activity or walking, and some patients find relief by, resting, bending forward, or lying down. Severely affected patients can have bowel or bladder dysfunction, including incontinence. Lumbar stenosis is also a common contributor to back pain.

Treatment of lumbar stenosis is focused on removing pressure from the affected nerve roots. This can be accomplished directly by performing a laminectomy and/or indirectly by changing the alignment and spacing of the vertebrae with a lumbar fusion.

A spinal fusion should be considered when there is evidence of abnormal movements of the vertebrae ("instability"). There is an alphabet soup of techniques for fusing the lumbar spine: ALIF, OLIF, TLIF, PSF, PLIF, and so on. Fundamentally, a fusion involves inserting metal hardware and bone graft to limit motion of a segment of the spine. Once the affected segment is immobilized, the goal is for your vertebrae to grow across it, stabilizing it permanently. If a fusion is needed, I will review with you possible techniques along with their benefits and drawbacks.

If you live near Denver and are suffering from lumbar stenosis, please consider meeting me in consultation to learn more about your treatment options.