Cartilage discs filled with a gelatinous substance that cushions the vertebrae along your spinal column connect each of your vertebrae. As you age, these discs become less spongy and less fluid-filled, resulting in reduced disc height and bulging of the hardened disc in the spinal canal. Bones and ligaments of the spinal facet joints can also thicken and enlarge due to arthritis, also pushing into the spinal canal. These factors cause the lumbar spinal canal to narrow, a process called “spinal stenosis.”

What are the symptoms?

Surprisingly, many people can have significant lumbar spinal stenosis, but fail to have symptoms. When symptoms do present, they may include:

• Pain or numbness in the back and/or legs usually made worse with standing and walking

• Leg cramps

• Weakness in the legs

• Rarely, bowel and/or bladder problems

These symptoms may come and go, and different people will experience different levels of severity. You may also find that your symptoms worsen with prolonged standing or walking and are relieved with rest or a forward bending “stooped” posture.


How is it diagnosed?

After a physical examination, Dr. Blankenship will either order an MRI to see whether or not spinal stenosis is present, its location, and the extent of the spinal canal narrowing and nerve root pressure. Plain X-Rays will aid in the evaluation of the overall spine condition.


What treatments are available?

Non-surgical treatment.

If the test indicates that lumbar spinal stenosis is present, Dr. Blankenship will try non-surgical, conservative treatments first.

Unless significant or progressive leg weakness develops, or bowel or bladder problems begin to occur, spinal stenosis by itself usually doesn’t represent a dangerous condition in the adult. Therefore, Dr. Blankenship will first design a treatment plan aimed at pain reduction and increasing your ability to function.

This treatment may include anti-inflammatory medications (orally or injected) to reduce swelling, or analgesic drugs to control pain. Spinal injections such as an epidural injection of cortisone may be prescribed, depending on your condition and your level of pain.

Dr. Blankenship will likely prescribe physical therapy to improve your strength, flexibility, and endurance.

It’s important to remember that non-surgical treatments do not correct the narrowing of the spinal canal, but may provide long-lasting pain control and improved quality of life. Once again treating the patient not the patients tests.

Surgical treatment.

As a last resort, surgery is offered to patients whose pain can’t be relieved by non-surgical treatment methods, or for those who develop progressive leg weakness, or bowel or bladder problems.

The goal of surgery for lumbar spinal stenosis is to open up the bony canal that has narrowed to improve available space for nerves. This is called lumbar decompression surgery, or laminectomy. In most cases, this procedure will relieve leg pain, and less reliably, will relieve back pain.

For this type of procedure, patients can return to most activities within weeks, although Dr. Blankenship will most likely prescribe some type of postoperative rehabilitation.

In some cases, spinal fusion surgery may need to be performed in addition to decompression in order to stabilized vertebrae that may have shifted (spondylolisthesis), or have abnormal motion (instability). With the XLIF technique, indirect decompression is accomplished without having to do bony decompression from the back.

To learn more about spinal fusion surgery click here.