Lumbar Spinal Stenosis

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What are the symptoms?

Gradual onset of leg pain, weakness, pins and needles and numbness typically brought on by standing or walking 200m or less and relieved by bending forwards or sitting. Night symptoms may be brought on by lying on the back and relieved by sleeping on the side and curling up.

What is the prognosis and treatment options?

Symptoms may fluctuate over weeks or months, however, most individuals see a gradual deterioration over time, with a loss of walking distance and quality of life.

Physiotherapy and epidural steroid injections can variably produce relief of symptoms for months or longer.

Severe spinal stenosis is best treated with surgery which most likely involves a posterior lumbar decompression. This generally has a success rate of more than 80%. If the spinal stenosis is accompanied by a vertebral slippage ‘degenerative spondylolisthesis’ it is often necessary to fuse this part of the spine to prevent further spinal instability and recurrent stenotic symptoms. A standing x-ray of the lumbar spine should be requested by the surgeon to assess this.