As we get older, nothing seems to work as efficiently as in our younger days. This is even true of the spine and the spinal cord within it. Over time the spine can develop degenerative changes that lead to compression of the spinal cord. This condition is called spinal stenosis and can lead to serious problems with the arms and legs, and even result in paralysis in extreme cases.
Stenosis is most common in the lumbar spine. At Texas Neurosurgery, we can perform various surgeries, such as laminectomies, to address the compression of lumbar spinal stenosis.
What is lumbar spinal stenosis?
Your spine is made up of a series of vertebrae with shock-absorbing discs between them. The lumbar spine consists of the last five vertebrae leading into the pelvis. As a person ages the spine can develop degenerative changes in the intervertebral discs and joints that can create a narrowing of the spinal canal or the paths by which the nerve roots exit the spinal canal. This is lumbar spinal stenosis. This tightening can create pressure on the spinal cord or the nerve roots, which then leads to issues with pain in the lower back, buttocks, and legs and loss of movement and coordination in the legs.
Reasons the spinal canal or the foramen (where the nerve roots exit the spinal canal) narrow are numerous. Bone spurs may develop around the vertebrae and facet joints. Degenerative changes in the supporting spinal ligaments may cause them to thicken, shrinking the space in the spinal canal. Arthritis can enlarge the joints. Disc protrusions and bulging or herniated discs can also narrow the spinal canal. Spinal stenosis usually continues to progress as the effects of any or all of these conditions keep narrowing the spinal canal or foramen putting more pressure on the spinal cord or nerve roots.
What kind of surgery is used to treat lumbar spinal stenosis?
The most common surgery in the lumbar spine is called decompressive laminectomy, where the lamina (the back side) of the vertebra is removed to create more space for the compressed nerves. A laminectomy may or may not need spinal fusion or to remove a portion of the spinal disc. A lumbar microdiscectomy aims to remove the portion of a bulging or herniated disc that is causing the stenosis. Microdiscectomies don’t involve fusion.
There are a number of other surgeries or techniques our surgeons may use to treat lumbar spinal stenosis:
- Laminotomy — Removes part, but not all, of the lamina.
- Foraminotomy — Enlarges the foramen, where the nerve roots exit the spinal canal.
- Medial Facetectomy — Removal of part of the facet joint to create more space in the spinal canal.
- Anterior Lumbar Interbody Fusion — Removal of the degenerated disc by entering through the lower abdomen, and then fusing the surrounding vertebrae.
- Posterior Lumbar Interbody Fusion — Removal of the degenerated disc by entering through the back, and then fusing the surrounding vertebrae. Done on both sides of the spine.
- Transforaminal Lumbar Interbody Fusion — Similar to the PLIF, but usually only done on one side of the spine.
If you have the chronic pain in your lower back and legs caused by lumbar spinal stenosis, there’s no reason to simply live with the loss of quality of life. Call the team at Texas Neurosurgery, (214) 823-2052, and let’s have our team of neurosurgeons see how we can help.