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| Home > Spinal Disorders > Degenerative Spine > Lumbar Stenosis - Overview |
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LUMBAR STENOSIS
Overview
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Symptoms
Back or buttock pain, leg pain, weakness in the lower extremities, numbness or burning in the leg, bowel or bladder incontinence.
General Overview
Lumbar spinal stenosis refers to a set of symptoms related to narrowing of the spinal canal in the low back seen with aging and degeneration. The spinal canal is like a tunnel which runs up and down the human spine. This canal sits directly behind the bony blocks which make up the spine (vertebrae) and contains the nerves (spinal cord and nerve roots) running from the brain to all areas of the body. The nerves exit the lumbar spinal canal and travel through to the legs.
Stenosis is the gradual result of aging and "wear and tear" on the spine as well as a genetic predisposition. With age, the disc space decreases in height and bulges posteriorly toward the spinal canal. The facet joints and ligaments also enlarge and bulge toward the spinal canal. The ligaments of the spine can thicken and harden (calcification). Bones and joints may also enlarge when arthritis develops in the small joints of the spine (facets), and bone spurs (osteophytes) may form compressing nerves and the spinal canal. Spondylolisthesis, the slipping of one vertebra onto another, also may occur and lead to compression.
The symptoms of lumbar stenosis can be very mild or unnoticeable even when significant stenosis is present. This is because the spinal nerves have the ability to accommodate to some degree. If the nerves are being sufficiently pinched in the low back, the patient can experience unremitting buttock or leg pain (radiculopathy). When the neuroforamina are reduced in size due to surrounding buildup of tissue, the nerves react to the pressure by swelling, causing irritation to the nerves.
Alternatively, if enough compression of the spinal canal exists, multiple nerves can be "chocked off" with normal activities such as walking. Generally, patients with spinal stenosis are comfortable if they are sitting, but have more pain down their legs when they walk and the pain increases the more they walk. Standing upright further decreases the space available for the nerve roots, and can block the outflow of blood from around the nerve. Walking while leaning over a supporting object , such as a walker or shopping cart, can help ease the pain. Early in the process of stenosis, the buttock or leg pain is usually intermittent and activity related. When the spinal nerves continue to be squeezed, the damage may become progressive and less commonly, irreversible nerve damage can result. This condition, when it significantly affects the quality of living, can be treated surgically by removal of the offending discs, overgrown ligaments and bone.
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Excerpts of this article (text/graphics) were provided by
"AllAboutBackandNeckPain.com" DePuy Spine ©2003.
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