Lumbar spinal stenosis is a narrowing of the spinal canal where the spinal cord travels from the brain down to the end of the spine. The spinal cord ends around the first or second lumbar vertebrae in most people. Below that level, the cord splits off into many smaller branches called the cauda equina. Equina means horse. The cauda equina with its many separate nerves resembles a horse’s tail.
Anything that obstructs or fills in the spinal canal can cause stenosis. That could be a tumor, infection, bone fragments from a fracture, disc material from a herniated disc, or inflammatory process. The most common cause of stenosis is age-related.
Over time as the discs start to degenerate and break down, the vertebral bones compress together. This puts more load and pressure on the spinal joints. The constant rubbing of the joints together causes bone spurs to form called osteophytes. The spinal ligaments start to thicken, get caught between the bones, and push against the spinal cord.
Spinal stenosis can also develop as a result of tiny fractures in the supporting column of the bones. The main body of the vertebra shifts forward over the vertebra below it. This condition is called spondylolisthesis.
Degenerative spondylolisthesis tells us the problem has developed over time due to age-related changes. One of the most common age-related changes is osteoporosis (decreased bone density). Post-menopausal women are affected by this most often. In fact the ratio between women and men is 6:1 (for every six women with this condition, only one male is affected).
Although preventing the problem isn’t always possible, there is treatment for it that can be effective in minimizing symptoms and keeping it from progressing (getting worse). Conservative care is usually tried first. That might include bed rest, antiinflammatory medications, pain relievers, physical therapy, and steroids when necessary. If conservative care fails to help, then surgery to stabilize the spine may be the next step.
To get a better understanding of your own condition, ask your surgeon to show you the X-rays or other imaging studies and explain what’s going on in your body. With this knowledge you will be able to make reasonable decisions about your own plan of care.