Stenosis means narrowing of anything that is tube-like, as in your spinal canal. The narrowing is due to thickening of some of the ligaments within the canal in combination with disc bulging and facet joint enlargement from arthritis. The result is compression of all the nerves at that level along with their blood supply.
This problem develops slowly over time and is an age-related. Most patients are in their 60’s and beyond, but occasionally younger patients will have this. The main symptoms can include pain, weakness or fatigue, and numbness or tingling that radiates down the legs when standing or walking. These symptoms are relieved by bending over or sitting down. In fact, many patients will have no symptoms at all when sitting. Simply standing still once the symptoms develop will not get rid of them. If the symptoms go away with standing still then we start to think it may be due to arterial insufficiency. Many people have back pain as well but the main complaint is the leg symptoms.
The symptoms usually develop slowly but can have a sudden onset after a fall, a long car or plane ride or playing a lot of golf.
- The first thing prescribed is usually some anti-inflammatories (Motrin or Aleve) possibly physical therapy or cortisone injections in your spinal canal. The cortisone acts as a very potent anti-inflammatory and reduces swelling and makes the nerve less irritable.
- Injections can be very effective or not work at all. In my opinion, there is no sense in repeating injections that don’t work or work for only a week or so. This usually means that surgery will be required to alleviate the symptoms.
- If you only have leg symptoms then a laminectomy is usually the procedure that is recommended and the outcome is quite predictable and successful.
- Spinal fusion is not needed in the majority of cases unless you also have Spondylolisthesis.