Lumbar Canal Stenosis
Lumbar canal stenosis refers to the constriction of nerves in the lower back as a result of wear and tear changes (degenerative changes) and slip disc. The nerves in the lower back are compressed by an overgrowth of bones, ligaments and disc in this condition. This condition usually affects men and women after their 60’s and can be quite disabling.
Patients give a typical history of finding it difficult to walk or stand for a few minutes because of developing pain/tingling/numbness/heaviness in one or both legs. Their symptoms disappear when they sit down or lie down and they can walk again for a few minutes after sitting. They may also describe relief from their problem by stooping (bending) forwards. Occasionally, they may also describe weakness in the legs, foot drop or change in their urine and motion control.
In some patients, this condition usually remains stable over a long period of time. But mostly, it is a progressive condition, with a gradual and slow deterioration in the ‘walking distance’ and the ‘standing time’ of the patient. Rarely, patients may report a sudden deterioration in their symptoms. Physiotherapy and exercises will help many patients and is the initial line of treatment. But if the ‘quality of life’ of a patient is significantly compromised, then a simple lumbar decompression operation can help significantly restore the ‘quality of life’. On the other hand, if a patient has already started developing paralysis because of this problem, it is advisable to go ahead with surgery.
Lumbar Epidural steroid injections have a very limited role in lumbar canal stenosis and may be used in patients who are not fit for surgery to give them symptomatic relief for 3-4 months.
What to expect from a Lumbar Decompression Operation?
The incision size is about 3-5 cm. In this operation, the overgrown bone, disc and ligaments that are compressing on the nerves are removed thereby making more space for the nerves. The typical hospital stay for Lumbar Decompression is 3-4 days. You can expect to walk the next day after surgery. You will be pretty much independent by the time of discharge. You can expect to join back work at 3-4 weeks. Lumbar decompression can be done by Minimally Invasive Spine Surgery (MISS) using small cuts with no external stitches, thereby reducing the hospital stay and blood loss. The success rate for Lumbar Decompression is in the high nineties with a very small complication rate of 1-2 percent.