Lumbar spinal stenosis is the narrowing of the spinal canal from ligamentous overgrowth or disk herniations, leading to compression of the spinal cord or nerve roots.
Though stenosis can cause back pain, it typically causes neurogenic claudication, or pain, numbness, or weakness in the legs that worsens with ambulation and is relieved by leaning forward or sitting down. Severe spinal stenosis can cause paralysis or bowel or bladder incontinence.
Though conservative nonsurgical treatments such as steroidal and nonsteroidal anti-inflammatories, narcotic analgesics, epidural and facet injections, and physical therapy may be helpful in managing symptoms, symptomatic lumbar stenosis eventually must be addressed surgically with a lumbar laminectomy.
For patients with lumbar stenosis and lumbar instability, the laminectomy may be followed by a lumbar fusion procedure such as an ALIF, PLF, PLIF, TLIF, or XLIF along with minimally invasive lumbar instrumentation with screws and rods.