SPINAL STENOSIS
Spinal stenosis is a condition in which the spinal canal is narrowed, which can lead to pressure on the nerves in the back. This article will provide you with insight about spinal canal stenosis in the lumbar spine, its symptoms, causes and effective treatment methods to help you lead a pain-free life.
What is spinal stenosis?
Spinal canal stenosis in the lower back (lumbar stenosis) is a constriction of the spinal canal. This can put pressure on the nerve canal and the nerve roots, resulting in pain, numbness and weakness in the lower back, legs and feet.
Symptoms of lumbar stenosis (constriction in the lower back)
What are the symptoms of spinal stenosis? You may experience the following:
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Pain in the lower back and/or legs, especially when walking or standing for long periods of time.
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Numbness, tingling or weakness in the legs and feet.
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Decreased physical activity and mobility.
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Your maximum walking distance becomes increasingly shorter.
Causes of spinal stenosis
Aging: Wear and tear of the spine due to aging can lead to a thickening of the ligaments and the formation of bone spurs, which can restrict the spinal canal.
Degenerative changes: Degenerative changes in the spine, such as arthritis and degenerative disc disease, can contribute to the compression of the spinal canal.
Stenosis as seen in an MRI
This MRI scan of the lower back shows the spine from the side, with the vertebrae visible as a series of stacked blocks. The intervertebral discs are located between these vertebrae, and the nerve canal runs vertically through this structure.
Stenosis (at the levels L2/3, L3/4, L4/5 or L5/S1) is diagnosed when the nerve channel is pinched, not only by a bulging intervertebral disc but also by a thickening of the small joints (also known as facet arthritis) and the ligament between the bones of the spinal column. This narrowing results in the pinching of nerves, which isparticularly noticeable during movements such as walking. As you try to walk some more, the pressure increases until you are forced to stop. To find relief, you must stop, sit down and bend over to create more space in the nerve canal.
Treatment of spinal canal stenosis in the lumbar spine
The treatment of lumbar spinal canal stenosis can vary depending on the severity of the condition and the patient's symptoms.
Conservative treatment: Lumbar spinal canal stenosis can often be treated through conservative methods such as painkillers, physical therapy and lifestyle adjustments. Physical therapy can help strengthen the back muscles, improve posture and relieve pressure on the nerves.
Injections: Corticosteroid injections can be used to reduce inflammation and swelling in the spinal canal, which can help relieve pain.
Surgery: If conservative treatments are not effective or if the spinal canal stenosis is severe, surgery may be necessary.
Traffic jam on the nerve highway
Drs. Patrick Simons explains stenosis by answering the following questions he has been asked by patients in the past.
How does spinal stenosis occur?
“I sometimes compare the spine to a house. Imagine the spinal canal as a beautifully decorated living room. The furniture is all neatly in place and it all goes together perfectly. In a new house, everything functions perfectly. As the house ages, the floor warps and the ceiling starts to sag. At first the doors are harder to open, eventually the cupboards creak and everything is stuck shut.
This is sadly what happens to the aging spine. The nerve channel becomes clogged, the joints - the ceiling - thicken and take up more space.
The floor - the intervertebral disc - protrudes and presses downward. The result is that just when the nerves should be moving, namely while walking, it becomes increasingly difficult and the walking stamina decreases significantly. The walking distance becomes shorter and shorter, and people seek relief by sitting down. Cycling is still possible because you are slightly bent over. This creates more space in the nerve canal, so that you do not experience any symptoms while biking.
Stenosis is a typical condition experienced by people of advanced age. The key is to consider stenosis surgery when the time is right, before patients are too old or too ill. In the field of medical literature, there is a consensus that stenosis will not go away on its own, as a herniated disc often does, but that it will worsen with age and that a microscopic surgery is the best solution.”
How is the spinal stenosis surgery performed?
During the surgery, just enough tissue must be removed to make room for the nerves again. Surgery should take as little time as possible and the patient should be back on their feet again quickly. Because stenosis often occurs in multiple places, the key is to use an MRI scan to see which specific area needs surgery. On the same day, 5 hours after the operation, the patient should be able to get back out of bed, since the elderly in particular know that prolonged physical inactivity is harmful.
Surgeries to treat stenosis will increase as the population continues to age. At our neurosurgical clinic in Cologne, we are well prepared for the increased demand and we don’t work with waiting lists. This helps us to guarantee quick treatment.
However, just like with other treatments I believe ‘less is more’, which is why we only opt for surgery when it is necessary.
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The Day of the Surgery
The stenosis surgery takes place under general anesthesia and is performed by an experienced team of surgeons and anesthesiologists. The procedure is minimally invasive, which means that only a small incision is needed. This minimizes the risk of complications and speeds up recovery.
Risks
As with any surgery, there are risks, ranging from general health risk factors such as diabetes and high blood pressure to specific surgical risks such as infection and blood loss. You will be fully informed about these risks before you consent to the surgery.
After the surgery
The most important goal is to eliminate the source of the pain and improve your quality of life. Postoperative care is aimed at resuming daily activities as quickly as possible. Remaining in a state of fear and inactivity is not conducive to recovery.
pain free in 3 simple steps
Our international team is ready to help you
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fill in the contact form and one of our specialists will respond within 24 hours. A consultation can be planed within a week.
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Besides a detailed interview a neurological examination takes place and a MRI is made. Your therapeutic options are discussed right away.
Our German efficiency makes it possible to do this with in a few hours
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If a spinal surgery is the best option you wil meet our anesthesiologists right away and the operation can be performed within a day or two.
Frequently Asked Questions about
spinal stenosis
What is spinal stenosis?
Spinal stenosis is a condition where the space inside the spine becomes narrower, often due to age-related changes. This narrowing can press on the spinal cord or nerves, leading to pain, numbness, or weakness—usually in the lower back and legs.
What are the most common symptoms of spinal stenosis?
Symptoms often include lower back pain, heaviness in the legs, difficulty walking for long periods, numbness or tingling in the legs or feet, and relief when bending forward or sitting down.
How does spinal stenosis affect walking?
As nerves become compressed, the legs may feel heavy, tired, or weak, particularly during walking or standing. Many people find they need to stop and rest frequently, especially during longer walks.
How is spinal stenosis diagnosed?
Diagnosis begins with a physical exam and detailed medical history. An MRI or CT scan is often needed to confirm the narrowing of the spinal canal and assess the severity.
Why do I feel better leaning forward or pushing a trolley?
Bending forward opens up the spinal canal slightly, relieving pressure on the nerves. This is why many people find it easier to walk while leaning on a shopping trolley or walking uphill.
Can spinal stenosis get worse over time?
Yes, especially if left unmanaged. However, many people maintain a good quality of life with the right treatment and adjustments to daily activities.