Spinal canal stenosis is a narrowing of the spinal canal. It typically causes pain in the back and legs when walking. Patients can initially consider conservative measures. If these do not help, an operation can eliminate the spinal canal stenosis.
You can find further information and selected spinal canal stenosis specialists and centers here.
The spinal canal is the bony recess within the spinal column in which the spinal cord is located. It is formed by the vertebral bodies lying on top of each other. Important nerve tracts run through the spinal cord. The spinal nerves branch off from the spinal cord between the individual vertebrae.
Structure of the spinal canal from the vertebral bodies © Alexandr Mitiuc | AdobeStock
Spinal canal stenosis, also known as spinal stenosis, occurs when the spinal canal is narrowed or constricted. This creates pressure on
and can lead to various symptoms. The most common symptoms are back pain and neurological sensations such as numbness or tingling.
Depending on the section of the spine affected, symptoms can occur in the arms and legs.
The narrowing of the spinal canal does not affect the entire spinal canal, but rather occurs in certain sections. The lumbar spine is usually affected by spinal canal stenosis. The greatest axial load of the body acts on it. This is usually associated with pain in the legs.
Older people between the ages of 60 and 80 are most frequently affected by spinal canal stenosis.
Spinal canal stenosis can be congenital, but this is extremely rare. More frequently, spinal wear and tear(spondylosis) is the cause of the disease. This includes
As the intervertebral discs lose their height and buffering effect due to wear and tear, the vertebral bodies tend to ossify. The video shows an example of disc wear and its consequences:
A bulging or herniated disc can also further constrict the spinal canal.
Heavy work and incorrect loading over a longer period of time cause the body to strengthen the bones. This is also the case with the spinal canal, where osteophytes (bone spurs) then form.
Progressive degenerative changes and poor posture, such as scoliosis, can also trigger spinal canal stenosis.
A further cause can be a previous intervertebral disc operation that has not been optimally treated. In most cases, however, those affected already have a genetic predisposition.
The characteristic symptom of spinal stenosis is periodic back pain. It often radiates into one or both legs. Cramp-like pain in the calf muscles is also a common symptom.
The pain often only occurs when standing and walking. To relieve the pain, sufferers bend forward. The pain subsides when lying down or sitting.
Back pain is the main symptom of spinal stenosis © artstudio_pro / Fotolia
Those affected often suffer from a general feeling of weakness. This is not caused by the muscles, but is due to nerve compression in the spinal canal. Paralysis can also occur.
If the spinal canal stenosis worsens as it progresses, it can result in paraplegia. Fortunately, however, this is extremely rare.
As a rule, paraplegia only occurs if the spinal canal is constricted very quickly and completely. The body then has no time to compensate for the narrowing, as is the case with normal spinal canal narrowing.
As part of the medical history , the doctor first asks about
Imaging procedures, such as
can then confirm the diagnosis. The condition of the intervertebral discs and vertebral bodies can be clearly seen on these images.
A neurological examination records the patient's exact complaints. This enables the doctor to determine the location and extent of the spinal canal narrowing.
Peripheral arterial occlusive disease(PAD) has similar symptoms to spinal stenosis. This is a cardiovascular disease. To differentiate between the two, the vascular system is also examined in detail. In technical terms, this is referred to as intermittent claudication and not spinal claudication.
Many patients do not feel severely affected by spinal canal stenosis. Conservative measures usually help here.
The more clearly the symptoms determine everyday life, the more urgent individual therapy becomes.
Physiotherapy and medication can have a soothing effect and stabilize the general condition. In the case of severe and most severe pain, the patient receives precisely controlled pain therapy with opioids. Appropriate drugs include tramadol or morphine.
Spinal canal stenosis is often accompanied by other spinal disorders. Injection therapy as interventional pain therapy can therefore be a combined treatment method. The video shows how facet infiltration works:
Aids such as a rollator relieve the strain on the back and also enable longer walking distances on foot. This is useful to keep the muscles in motion overall.
A corset also stabilizes the vertebral bodies in their position and can help the patient. However, a corset always leads to muscle loss relatively quickly and should therefore only be worn infrequently.
Surgery is the next treatment step if
The procedure is performed microsurgically under a surgical microscope. It is usually performed by a neurosurgeon or a spinal surgeon.
The surgeon removes the thickened and protruding bone formations and ligament structures. This is known as decompression, i.e. reducing the pressure on the nerves.
The pain-relieving effect usually occurs very quickly. The patient can therefore be fully mobilized again quickly.
In cases of spondylolisthesis, the spine is often fused(spondylodesis). The surgeon connects the affected vertebral bodies together and fixes them in position.
After the operation, the fixed vertebral bodies can no longer move. As a result, the spinal canal is free again, but the patient also loses a certain amount of back mobility.
The operation usually requires a short stay in hospital. After two to three weeks, the patient can start physiotherapy.
Further check-ups are necessary after one and three months. These should take place in the clinic or, if this is not possible, at a back specialist of your choice.
At the check-up after three months, a muscle test is carried out. If the muscles are not strong enough, a special training program can be created.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
