The spinal column, or the vertebrae, consists of 24 separate bones along with the fused bones of the sacrum and coccyx. The vertebral column is a strong, flexible rod that protects the spinal cord, supports the head, and provides an attachment for the ribs. There are four major components of the spine: the vertebrae, joints, discs, and nerves.
What happens to the structure of the spine as people age?
Intervertebral discs have a fiber-like ring (annulus) and a gelatin-like center (nucleus). In youth, the nucleus is about 70 percent fluid. As people age, the nucleus of the disc begins to "dry up," reducing the effectiveness of the shock-absorbing quality of the discs. As this protection is lost, daily activities can stress the vertebrae, causing the development of bony spurs. Bone spurs can cause the center canal that encases the spine and the side canals, which protect the nerves, to become narrowed.
What is lumbar canal stenosis?
Lumbar canal stenosis is the narrowing of the spinal canal or the tunnels through which nerves and other structures communicate with that canal. Narrowing of the spinal canal usually occurs due to changes associated with aging that decrease the size of the canal, including the movement of one of the vertebrae out of alignment.
The narrowing of the spinal canal or the side canals that protect the nerves often results in a pinching of the nerve root of the spinal cord. The nerves become increasingly irritated as the diameter of the canal becomes narrower.
What are the symptoms of lumbar canal stenosis?
The symptoms of lumbar canal stenosis include pain, numbness or weakness in the legs, groin, hips, buttocks, and lower back. Symptoms usually worsen when walking or standing and might decrease when lying down, sitting, or leaning slightly forward.
How is lumbar canal stenosis diagnosed?
The diagnosis of lumbar canal stenosis is based on a thorough medical history and clinical exam. At times, imaging and EMG tests might be helpful in confirming a diagnosis.
What are the treatment options?
Since the aging of the spine is a natural and irreversible process, non-operative treatment options are aimed at removing pressure from the nerves to allow them to function more normally. Removing pressure from the nerves, in turn, will help relieve the pain associated with lumbar canal stenosis. Non-operative treatment options include physical therapy, medicine, and pain therapy.
When is surgery necessary?
A surgical procedure called a laminectomy is used treat lumbar canal stenosis for people who have progressive symptoms that could cause serious damage. Surgery also might be prescribed to treat people who have persistent symptoms, despite medical treatment. During a laminectomy, the central tunnels of the vertebrae are opened and nerve pressure is relieved.
>A newer surgical procedure involves the placement of a bullet-shaped metal spacer (x-stop) between vertebral spinous processes, mechanically optimizing the diameter of the spinal canal.