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Lumbar Spinal Stenosis

Degenerative narrowing of the lumbar spinal canal causing neurogenic claudication.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis is the narrowing of the spinal canal at one or more levels that compresses the cauda equina or nerve roots.

Most commonly caused by age-related degeneration: facet joint hypertrophy, ligamentum flavum thickening, disc bulging and spondylolisthesis.

Affects approximately 10% of adults over 65 and is the leading indication for spinal surgery in patients over 65.

Symptoms

Neurogenic claudication: bilateral leg pain, numbness, weakness or fatigue with walking, relieved by bending forward or sitting
Pain typically improves with leaning forward (shopping cart sign) and worsens with extension
Variable low back pain (more often mechanical than radicular)
Radicular leg pain in lateral recess or foraminal stenosis
Weakness, sensory loss or reflex changes in moderate-to-severe disease
Bowel or bladder dysfunction in severe cauda equina compression (rare, surgical emergency)
Neurological examination often normal at rest; deficit may be reproduced after walking

Risk Factors

Age over 50 (peak prevalence in 60s and 70s)
Degenerative spondylolisthesis (especially L4-L5)
Congenital narrow canal (developmental stenosis)
Trauma or previous spinal surgery
Inflammatory arthropathies (rheumatoid arthritis, ankylosing spondylitis)
Paget disease, achondroplasia, fluorosis
Obesity and sedentary lifestyle
Smoking accelerates disc degeneration

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent low back and leg symptoms unresponsive to non-prescription analgesics for over 4-6 weeks
  • Reduced walking distance with leg pain or numbness in older adults
  • New weakness, foot drop, sensory loss or reflex changes warrant prompt neurological evaluation
  • Bowel or bladder dysfunction, saddle anaesthesia or progressive weakness is a surgical emergency (cauda equina syndrome)
  • Failure of conservative therapy after 3-6 months of structured rehabilitation should prompt surgical consultation

Treatment Methods

01
Diagnosis confirmed by lumbar MRI (gold standard); CT myelography for patients with MRI contraindications
02
Initial management: physiotherapy emphasising flexion-based exercises and core strengthening
03
Activity modification, ergonomic education, weight loss and smoking cessation
04
Pharmacological: paracetamol, NSAIDs, gabapentinoids for neuropathic pain; avoid long-term opioids
05
Epidural steroid injections may provide short-term symptom relief in selected patients
06
Surgical decompression (laminectomy, microdecompression) for severe disabling symptoms or progressive deficit
07
Decompression with fusion if degenerative spondylolisthesis with instability is present
08
Minimally invasive techniques (interlaminar microdecompression) reduce blood loss and recovery time
09
Outcomes: 60-80% of patients report symptom improvement at 2 years; results gradually decline over 5-10 years

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.