About Lumbar Spinal Stenosis
Lumbar spinal stenosis refers to narrowing around the spinal cord as well as the regions that surround the nerves which exit the spine. The narrowing or stenosis can be “central”, meaning the central spinal canal space is decreased, “neuroforaminal” meaning that the exit point of the nerves from the spine is impaired, or stenosis can involve the “lateral recesses”, specific areas on either side of the spinal canal. Lumbar spinal stenosis can be caused by several factors including shortened pedicles, thickened ligaments, and herniated discs, however most commonly, lumbar spinal stenosis develops over time from degenerative arthritic changes. As we age, our intervertebral discs lose water content and “shrink”. With this loss of disc height, ligaments that support the spine can fold inward and cause stenosis. Additionally, wear and tear on the joints and bones that stabilize the spine can lead to the formation of bone spurs, which can also narrow the spinal canal.
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Symptoms of Lumbar Spinal Stenosis
Symptoms of lumbar spinal stenosis include numbness, weakness and/or tingling in the legs or feet. In severe cases, nerves to the bladder or bowel may be affected, leading to incontinence. Occasionally, patients may develop leg cramping when standing or walking for long periods of time. This inability to walk for extended periods of time is called neurogenic claudication. Patient’s may also have difficulty standing up straight and may need to hunch forward. This posture is sometimes called the “shopping cart sign” and may be due to worsening lumbar spinal stenosis.
Treatments for Lumbar Spinal Stenosis
Procedural treatment for lumbar stenosis can include lumbar epidural steroid or cortisone injections into the epidural space which can help decrease the amount of inflammation around the spinal cord and nerves. Another procedure that may be helpful for patients is the MILD (minimally invasive lumbar decompression) procedure. This is a minimally invasive outpatient procedure that removes portions of the hypertrophied ligamentum flavum and bony arthritis to make more room around the spinal cord. This is a non-surgical procedure that does not involve the use of hardware or large surgical incisions. It is a novel approach to treating lumbar stenosis that can be very helpful for those patients wishing to avoid surgery. Additionally, Regenexx regenerative medicine treatments have shown promise in reducing hypertrophied ligamentum flavum and minimizing stenosis. When paired with platelet-lysate epidurals patients have shown improvement in nerve related pain as well as increased ability to walk and stand.
If you have been diagnosed with spinal stenosis or have symptoms of this condition, visit our interventional spine specialists at Ospina Medical. We offer advanced treatments for spinal conditions aimed at improving your pain, function, and quality of life while minimizing the need for unnecessary surgery. Contact our clinic in Midtown Manhattan to schedule your consultation today.