Schedule an Appointment! 214-556-0565

Lumbar Spinal Stenosis

Lumbar spinal stenosis is a narrowing of the spinal canal located inside the vertebrae of the lower back, known as the lumbar vertebrae. As this canal becomes narrower, it can put pressure on the spinal cord and nerves around it, causing lower back pain and leg pain, as well as numbness, tingling and weakness in the legs.

While most people aren’t severely disabled, lumbar spinal stenosis can cause pain, numbness or weakness, most often in the legs, feet and buttocks.

Southwest Scoliosis Institute’s orthopedic surgeons, Dr. Richard Hostin, Dr. Ioannis Avramis, and Dr. Shyam Kishan, are all board-certified, fellowship-trained surgeons with years of experience treating patients with complex spine conditions – including lumbar spinal stenosis.

Lumbar spinal stenosis primarily affects older adults (50 and older) and is usually the result of normal age-related causes like wear and tear, arthritis, or a combination of both. Other conditions that can lead to lumbar spinal stenosis include:

Symptoms

Lumbar spinal stenosis can occur with and without symptoms, but when symptoms do occur, they tend to worsen over time. The most common symptoms include:

  • Back pain
  • Pain radiating down into the buttocks and legs (sciatica)
  • Numbness or tingling sensation in the legs and/or feet
  • Muscle weakness in the legs and/or feet

Often, the pain and other symptoms associated with lumbar spinal stenosis decrease when sitting or leaning forward, and it will usually get worse when standing up straight and walking.

In severe cases, a lumbar spinal stenosis can lead to a loss of bladder or bowel control. While this is rare, it can be an indication of a serious condition knowns as cauda equina syndrome that requires immediate medical attention.

Diagnosis and Testing

Your physician at Southwest Scoliosis Institute will look carefully at your medical history before performing a thorough physical examination, during which they will specifically look for any signs of limited mobility and/or pain in the lumbar spine. The physician will also look for any difficulty balancing, as well as any reductions in muscle reflexes, loss of sensation, or muscle weakness that may be the result of spinal cord being compressed by the disc.

If the physician suspects you have lumbar spinal stenosis, they will confirm this through a combination of X-ray imaging, computed tomography (CT) scans or magnetic resonance imaging (MRI). X-rays can show whether there in an issue with the bones of the spine, such as bone spurs, loss of bone height or spondylolisthesis, but CT and MRI scans are usually necessary to determine if there is a problem with the soft tissue of the spinal cord and surrounding nerves.

Southwest Scoliosis Institute uses an advanced digital X-ray imaging system that can take high-quality images of patients in just seconds. This system can also capture X-rays of patients while in a standing or seated position, and it’s conveniently located inside our Dallas location, meaning you and your physician can review the X-rays immediately after they are taken.

Treatment for Lumbar Spinal Stenosis

Not all patients with lumbar spinal stenosis will require surgery, and often their condition can improve with the help of nonsurgical treatments. In addition to managing pain and inflammation with non-steroidal anti-inflammatory drugs (NSAIDs), your physician at Southwest Scoliosis Institute may recommend physical therapy and/or exercises specifically designed to strengthen the muscles in the back and stabilize the spine. The physician may also discuss using epidural steroid injections to decrease swelling in and around any affected nerves.

Surgical Treatment

If nonsurgical treatment does not relieve your symptoms or they worsen, the physician may recommend surgery. There are several surgical procedures that can be used to treat cervical spinal stenosis, all of which are designed primarily to relieve any pressure on the spinal cord and nerves.

Surgery for Lumbar Disc Herniation

The most common surgical treatments for lumbar spinal stenosis are:

  • Decompressive laminectomy or laminotomy. The most common procedure to correct lumbar spinal stenosis, a laminectomy involves removing all or part of the lamina, the back of the vertebra that covers the spinal canal. In some cases, only a small hole is needed to relieve the pressure on the spinal cord, this is referred to as a laminotomy.
  • Foraminotomy. The foramen is the passage that nerves go through to pass from the spinal cord to the rest of the body. In this procedure, the surgeon removes any bone or tissue that is obstructing this passage to relieve the pressure on the nerves and spinal cord.
  • Lumbar Interbody Fusion. Typically used when there is compression of the spinal cord and nerves as a result of a lumbar disc herniation or degenerative disc disease. In this procedure, the surgeon removes all or part of the affected disc and then performs a spinal fusion procedure to stabilize this section of the spine to hold it in place and allow the bones to heal properly.

Many of these surgeries are performed using minimally invasive techniques. To do this, the surgeon makes a tiny (3- to 15-millimeter) incision and uses specialized instruments with magnification to do the surgery. Surgeries performed with minimally invasive procedures are often done on an outpatient basis, meaning many patients are able to return home the same day as their surgery.

“Spinal stenosis is a condition we most typically see in patients over 50 years of age. Some treatments include exercise and physical therapy, lumbar traction, anti-inflammatory medications, and sometimes epidural steroid injections. If patients do not respond to conservative treatment modalitites, surgery can be helpful to open up the space available for the nerves.” – Dr. Richard Hostin

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0565 to make an appointment.