Lumbar Stenosis and Degenerative Spondylolisthesis

 


Lumbar stenosis is the gradual narrowing of the spinal canal caused by age-related changes of the discs and facet joints in the lower back. This degenerative process is called spondylosis (spinal arthritis). As the stenosis (narrowing) progresses, it can lead to compression (pinching) of the nerves running through the spinal canal. Pressure on the spinal nerves can result in radiating leg pain, numbness or weakness, a condition known as radiculopathy or “sciatica”. In some cases, spondylosis can result in spinal instability, allowing one bone to slip forward on top of the one below, a condition called degenerative spondylolisthesis.

Symptoms

  • Lower back pain with radiation into hips and buttocks
  • Radiculopathy – radiating leg pain or numbness caused by compression of the spinal nerves

Natural History – What happens when the condition is not treated

  • Not all patients with stenosis have symptoms
  • Symptoms may be short-lived and infrequent
  • Patients may develop more persistent and debilitating pain as the stenosis or instability progresses

Three Phases of Treatment:

  • Phase I – Non-Invasive Treatments
  • Phase II – Spinal Injections
  • Phase III – Surgery
  • Goals of Each Phase:
    • Relieve Pain
    • Improve Function

Treatment Options: Phase I – Non-Invasive Treatments

  • Physical Therapy and Regular Home Exercise
  • Core and Back Strengthening
  • Flexibility and Stretching
  • Oral Medications
  • Steroids
  • Non-Steroid Anti-Inflammatories (NSAIDs)
  • Pain relievers
  • Muscle Relaxants
  • Ice and Heat

Treatment Options: Phase II – Epidural Steroid Injections

  • Outpatient procedure
  • Done with x-ray guidance
  • May relieve symptoms, but will not repair the disc
  • 1-3 injections may be needed

Treatment Options: Phase III – Surgery

Surgical Options for Lumbar Stenosis and Degenerative Spondylolisthesis

  • Learn more about Laminectomy
  • Learn more about Minimally Invasive Lumbar Microdecompression (MILM)
  • Learn more about Endoscopic Discectomy and Foraminotomy

Lumbar Fusion