Stenosis of the Lumbar Canal: Understanding the Issue
Lumbar refers to the lower part of the spine, specifically the region in your back between your ribs and your pelvis. It’s often referred to as the lower back or the lower spine. The lumbar spine is made up of several vertebrae, which are the individual bones that make up your backbone.
Lumbar canal stenosis occurs when the space within the spinal column of the lower back becomes narrowed. This narrowing can result in compression or pressure on the nerve structures that pass through this area. Such compression can lead to various symptoms and discomfort.
Common Causes of Lumbar Canal Stenosis:
The primary cause of lumbar canal stenosis is the natural aging process, called as degenerative spine or spondylosis which can lead to changes in the spine’s structures over time. In Ageing spine, combination of structural changes like disc prolapse, osteophytes, facetal hypertrophy, ligamentum flavum hylertrophy and intervertebral disc height reduction produces stenosis
This is commonly seen in elderly males who were active and did lot of physical activities in their middle age, however it can have other common causes too as follows:
Tumours: Abnormal growths can develop within or around the spinal canal, contributing to the narrowing.
Trauma: Injuries to the spine, such as fractures, can lead to misalignment or dislocation of the vertebral bones, causing narrowing.
Infections: Pus, infected bone and disc can compress the nerves
Symptoms and Effects:
The compression of nerve structures due to lumbar canal stenosis can result in various symptoms, including:
Pain:
Typically, pain is felt in the lower back and may radiate down the legs. This discomfort might worsen when standing or walking and improve when sitting or bending forward.
Numbness and Weakness:
Nerves that control sensation and muscle function can be affected, leading to numbness, tingling, or weakness in the legs or buttocks.
Difficulty Walking:
Some individuals may experience difficulty walking, often described as a feeling of heaviness or fatigue in the legs. (neurogenic claudication) This can lead to a tendency to lean forward or use objects (Walking stick) for support.
Bladder or Bowel Changes:
Severe cases might lead to changes in bladder or bowel function, although this is less common.
Managing Lumbar Canal Stenosis: Treatment Approaches
Effective management of lumbar canal stenosis involves considering various treatment options based on the severity of symptoms and individual health factors. Here are the approaches commonly used:
Non-Surgical Treatments:
Physical Therapy:
Targeted exercises and stretches can help improve flexibility, strengthen supportive muscles, and alleviate symptoms.
Pain Management:
Over-the-counter pain relievers, anti-inflammatory medications, and muscle relaxants may offer temporary relief from discomfort.
Lifestyle Modifications:
Adjusting daily activities, such as avoiding prolonged standing or walking, and maintaining a healthy weight can reduce stress on the affected area.
Assistive Devices:
Using devices like braces or canes can help support the lower back and improve mobility.
Epidural Steroid Injections:
Injections of anti-inflammatory medications into the affected area can provide short-term pain relief.
Surgical Options:
Laminectomy:
This surgical procedure involves removing a portion of the vertebral bone to create more space within the spinal canal, relieving pressure on the nerves. Conventional old surgery
Laminotomy:
Similar to a laminectomy, but a smaller portion of bone is removed, often targeting a specific area of compression.
Spinal Fusion:
In cases where there’s instability or a significant amount of vertebral bone is removed, spinal fusion may be performed to stabilize the spine.
Minimally Invasive Surgery:
Techniques like endoscopic surgery or microdiscectomy involve smaller incisions and reduced muscle disruption for quicker recovery. Recent Advanced surgery. Gold standard treatment is microscopic decompression
Choosing the Right Treatment & How Dr Ramachandran handles such Cases:
Only a Handful of Spine surgeons in the world are using microscopic surgeries. Dr Ramachandran’s spine training is from both orthopedic and neurosurgical principles with well versed microsurgical techniques. He uses microscope for this type of surgery where entire neural structures are decompressed through a small incision of an inch, and both sides of spinal nerves are decompressed from one side (Lumbar Internal Decompression) which is the gold standard treatment accepted worldwide. This makes recovery faster among the elderly with minimal blood loss, lesser Hospital stay like a day care procedure.
Conclusion:
Lumbar canal stenosis can be effectively managed with a combination of non-surgical and surgical treatments. Dr. Ramachandran has a myriad of Spine surgeries to his experience which helps him to understand your specific condition and make an informed decision that aligns with your health goals.
Whether it’s through conservative methods or surgical intervention, relief from lumbar canal stenosis is possible, enabling you to regain comfort and resume your daily activities.