Patient Journey: Lumbar Stenosis

Back of person with lower back pain highlighted in red

Lumbar stenosis is a degenerative spine condition caused by the narrowing of the spinal canal. It can cause leg pain and weakness that may need treatment by a specialized spine doctor. Patients in the northern New Jersey area requiring diagnosis or treatment of lumbar stenosis can trust the comprehensive team at Centers for Neurosurgery, Spine & Orthopedics (CNSO). Here, CNSO discusses a typical patient journey for someone with lumbar stenosis.

What Is Lumbar Stenosis?

Lumbar stenosis occurs when the spinal canal narrows to such an extent that it places pressure on the spinal cord or spinal nerves, specifically the nerves through the lower back and into the legs. The spinal canal is an essential part of the spine. It contains the spinal fluid, spinal nerves, and the spinal cord. Typically, the spinal canal has enough space for the contents to pass easily without putting pressure on the surrounding structures. The narrowing of the spinal canal generally occurs gradually.

What Causes Lumbar Stenosis?

The narrowing of the spinal canal that causes lumbar stenosis is most often due to the degenerative effects of aging. As such, the condition is most common in people who are age 60 and older. Joints and ligaments wear down over time and can become deformed or misaligned, crowding into the narrow spinal canal and narrowing it further. Lumbar stenosis also can result from other causes, such as:

Stenosis also may be congenital and affect younger patients, although this is rare.

Lumbar Stenosis Signs and Symptoms

As the spinal canal narrows, it can cause inflammation and compression of the surrounding nerves. Not everyone with lumbar stenosis will have symptoms, but patients with more severely narrowed canals tend to have more symptoms. These symptoms include:

  • Neurogenic claudication: Leg pain or weakness that worsens when standing upright or walking and relieves when bending over or sitting.
  • Sciatica: Pain, numbness, tingling, or weakness that radiates down the leg along the sciatic nerve.
  • Bilateral arm pain, numbness, or tingling sensation
  • Bilateral leg pain, numbness, or tingling sensation
  • Loss of bowel or bladder control:In severe cases, patients may experience an inability to control their bowels or bladder.

Symptoms typically appear on both sides but may be asymmetric. If a patient regularly experiences these symptoms, they need an examination to confirm or rule out lumbar stenosis.

Lumbar Stenosis Diagnosis and Evaluation

Patients with symptoms of lumbar stenosis should seek evaluation from a spine specialist, such as an orthopedic spine surgeon or a neurosurgeon. Lumbar stenosis diagnosis generally involves:

  • Physical examination: The patient is examined for pain resulting from passive and active lumbar extension, weakness, and abnormal reflexes.
  • Diagnostic imaging: Imaging like an MRI (magnetic resonance imaging) or CT scan (computed tomography scan) can be used to visualize the spinal canal and see if it has narrowed.
  • Neurological assessment testing: Neurologic assessments on patients with lumbar stenosis are typically standard, but neurosurgeons also can use them to find any abnormalities.

Specific diagnostic imaging may be ordered for patients with severe symptoms that do not improve through physical therapy or medications.

Treatments for Lumbar Stenosis

Lumbar stenosis has no cure but can be managed with treatment options. Treatments for patients with lumbar stenosis depend on the severity of the condition and symptoms. They also include both non-surgical and surgical options.

Non-Surgical Options

Patients with minor cases of lumbar stenosis often can return to normal function without surgical intervention. Management options for lumbar stenosis include:

  • Reduction of certain activities to decrease inflammation
  • Physical therapyto strengthen core, posture, and joints
  • Pain management,including non-steroidal anti-inflammatory medications
  • Epidural steroid injections or transforaminal steroid injections to reduce inflammation at the spinal nerves

Surgical Options

For patients whose lumbar stenosis causes moderate to severe symptoms, spine surgery may be the best solution. The process involves a neurosurgeon or orthopedic spine surgeon widening the narrow spinal canal by removing the bone overgrowth and degenerative deformities.

Back surgery is done most often using a posterior laminectomy approach or a minimally invasive spine surgery technique. In patients who have lumbar stenosis and other spine conditions affecting the anterior portion of the spine, an anterior-posterior surgical decompression may be required.

Whatever treatment options neurosurgeons or orthopedic spine surgeons recommend, patients with lumbar stenosis should be sure to follow any orders and take an active role in the management of their condition.

Lumbar Stenosis Care at CNSO

CNSO provides comprehensive medical care for patients with brain, spine, and nerve conditions. The multidisciplinary team consists of neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists.

These specialists work together to create personalized treatment plans and provide care for patients throughout northern New Jersey. CNSO takes a conservative approach to care, opting for non-surgical treatment options like pain management and physical therapy before recommending surgical interventions.

Contact a Spine Specialist Today

Whether a patient suspects they have lumbar stenosis or they already have a diagnosis, they should meet with a spine specialist to develop a treatment plan. At Centers for Neurosurgery, Spine & Orthopedics, the dedicated team offers diagnosis and treatment of lumbar stenosis at multiple convenient locations across northern New Jersey. To learn more about lumbar stenosis treatment, contact CNSO today.

Centers for Neurosurgery Spine & Orthopedics