What is Lumbar Spinal Stenosis (Canal Narrowing)?
The lumbar spine is made up of five bones called vertebrae that are stacked on top of each other and surround the spinal canal, which houses the spinal cord. There are discs that allow mobility between the vertebrae that make up our spine and absorb the strain from the top levels while ensuring correct transmission to the lower levels, as well as joints and incredibly strong ligaments that connect the vertebrae to each other.With advancing age, the discs lose their flexibility, the ligaments and joints thicken, and the bone structures can become coarser. All these changes lead to narrowing of the spinal canal and compression of the spinal cord and nerves passing through it, preventing them from functioning normally. The most important function of the spine is to protect the spinal cord and the nerves that exit the spinal cord, but it also allows for trunk movements and provides a connection point for the ribs.
What are the Symptoms of Canal Stenosis?
The most common symptom of narrow canal patients is pain, with pain extending from the lumbar area to the legs, tingling and numbness, cramps and loss of sensation, and gait disturbance with loss of strength if the condition is progressed. The most typical clinic of the patients; neurogenic claudication, which we call neurogenic claudication, is numbness and tingling after walking a little way, with weakness in the legs and inability to take steps, and these complaints are reduced by sitting or leaning forward,
In the most advanced stages of the disease, a condition called cauda equina syndrome may occur with symptoms such as urinary and fecal incontinence, sexual dysfunction, weakness, loss of sensation and numbness in the legs. This is a condition that requires urgent surgery.
How is Canal Stenosis Diagnosed?
After a detailed physical examination and a well-obtained history of the disease, the diagnosis can be made to a large extent. In order to confirm the diagnosis and plan the treatment, the patient may undergo tests such as plain or forward and backward bending radiographs, magnetic resonance imaging (MRI), computed tomography (CT) and lumbar myelogram, which show the stenosis in the spinal canal and spinal cord compression in great detail.
How is canal stenosis treated?
If there is no reason for surgery after a lumbar narrow canal diagnosis, non-surgical therapy should be tried first. Medication, training in activities of daily life, and proper exercises are the first steps in the treatment of lumbar narrow canal. Depending on the severity of the pain, various physical therapy methods are used.If there is no response to these treatments, spinal injections or blocks may be performed. If non-surgical treatment methods are not successful and progressive loss of sensation and strength occurs, surgical treatment should be considered. After surgery, the physical therapy and rehabilitation program should be reorganized and continued according to the patient.