INTRODUCTION AND DEFINITION
Lumbar stenosis is narrowing of the spaces that carry nerves through the lower back.
This page provides general patient information rather than an individual diagnosis. Decisions depend on symptoms, examination findings, relevant tests and patient preferences. Two people with the same diagnosis may require different care plans.
CAUSES AND SYMPTOMS
Age-related changes in discs, joints and ligaments can cause leg discomfort with standing or walking, often relieved by sitting or bending forward.
The intensity of symptoms does not always match the extent of changes seen on scans. New significant weakness, walking difficulty or changes in bladder or bowel control require urgent medical assessment.
DIAGNOSIS AND ASSESSMENT
MRI helps locate narrowing; the assessment also distinguishes spinal symptoms from vascular claudication.
Assessment begins with the clinical history and an appropriate examination of strength, sensation and reflexes. X-rays, MRI, CT or nerve studies are used when they can answer a specific clinical question. A scan report alone does not establish the need for surgery.
TREATMENT OPTIONS
Activity modification, tailored exercise, rehabilitation and suitable pain care may help; injections have limitations for some forms of stenosis.
Management depends on the underlying cause, severity, overall health and realistic goals of treatment. Depending on the condition, monitoring, nonoperative care, activity modification, rehabilitation or clinician-selected medication may be considered. No single treatment suits everyone.
SURGICAL PROCESS WHEN INDICATED
Decompression may be considered for disabling walking limitation or progressive nerve dysfunction; fusion is reserved for selected instability-related cases.
Before surgery, the team should discuss likely benefits, alternatives and individual risks. Depending on the operation, complications may include bleeding, infection, anesthesia problems, nerve or spinal cord injury, and persistent symptoms; no outcome can be guaranteed.
RECOVERY AND POSTOPERATIVE PERIOD
Walking tolerance may improve gradually, although nerve recovery varies.
Follow-up, movement restrictions and return to work or sport vary with the procedure and neurological findings. New or worsening weakness, fever, wound drainage or bladder and bowel changes require prompt medical review.