Spinal canal stenosis - narrowing of the spinal canal

Inside our spine, the spinal cord runs through a canal formed by the vertebrae. If this spinal canal is narrowed in the lumbar vertebrae, it presses on the spinal nerves located there - this is known as spinal canal stenosis. The narrowing usually occurs at an advanced age and leads to back pain that can radiate into the legs and cause feelings of paralysis. Our specialists at the Clinic for Rheumatism and Pain and the Spinal Surgery Department will support you with their combined knowledge and provide you with holistic treatment for spinal canal stenosis.

Spinal canal stenosis is one of the most common back problems and occurs more frequently in people over the age of 60.
Spinal canal stenosis is one of the most common back problems and occurs more frequently in people over the age of 60.
(Shutterstock)

When the spinal canal narrows


What is lumbar spinal stenosis?

Our spine is a complex and highly mobile supporting organ consisting of vertebrae, intervertebral discs and facet joints. The spinal nerves, which make up the sciatic nerve, are located in the area of the lumbar spine. This most mobile part of the spine often wears out the fastest: As a result of thickening of the ligaments, arthrosis of the small vertebral joints, bulging discs and increased mobility in a vertebral body segment, the spinal canal becomes increasingly constricted. As a result, the nerves that run from the brain via the cervical, thoracic and lumbar spine to the sacral region in the spinal canal are compressed, leading to pain in the back and legs with additional symptoms of paralysis.

Important to know

Find out everything you need to know about spinal canal stenosis and find out about the various treatment options we offer.

Walking becomes a problem

The symptoms of spinal canal stenosis can vary greatly and are often unspecific at the beginning: the disease often begins with a pulling sensation along the back of the legs or a feeling of tiredness in the legs when walking, which becomes worse the further you walk.

This is accompanied by pain in the lower back radiating into the buttocks and legs. numbness and tingling sensations in the legs are also typical. The walking distance of those affected is constantly shortened. Walking often improves again after standing still for a short time, sitting down or bending forwards and it is possible to walk a little further.

Cycling is often easier than walking and sitting is more comfortable than standing. Pain can also occur when lying down.

If only individual nerves in the spinal canal are compressed, the symptoms are more specific: this can manifest itself as a loss of strength in a muscle or a change in the sensitivity of the skin in a certain area.

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How do you recognise a narrowing of the spinal canal?

The diagnosis begins with a detailed interview (medical history) and a physical examination of the patient.

The best solution if spinal canal stenosis is suspected is imaging using magnetic resonance imaging (MRI). If this is not possible, a computerised tomography scan (CT myelography) should be performed. The MRI or CT shows the narrowing of the spinal canal very clearly and provides information on whether the narrowing is more central or external in the area of the outgoing nerves. This also makes it possible to assess the ligaments, intervertebral discs and small vertebral joints. In the latter case, it is important to clarify whether there is osteoarthritis with bony attachments.

In addition, a standing X-ray is always taken of the patient in order to detect any additional instability and include it in the treatment planning.

A detailed treatment plan is only drawn up once all these steps have been carried out. The entire spectrum of examinations and investigations required to clarify spinal canal stenosis is available at Bethesda Hospital - you are in the best of hands with us.

What can be done against arthritis?

Bethesda Hospital initially offers physiotherapy and interventional pain therapy as treatment options. The latter includes infiltrative measures in which cortisone is injected directly into the spinal canal. This is done in conjunction with local anaesthetics and under imaging control (epidural steroid injection). The rheumatology pain specialists carry out these steps carefully and with a great deal of experience.

In addition, pain treatment is carried out in stages with medication, which enables those affected to cope well with increasing pain in everyday life. Thanks to the excellent interdisciplinary cooperation, neurology is also involved in some cases for electrophysiological nerve/muscle testing. The Department of Psychiatry and Psychotherapy is also there for those affected if their pain is causing them mental distress.

However, if the disease progresses, it is time to consider an operation and put yourself in the hands of the spinal surgery department at Bethesda Hospital.

Are you unsure whether you suffer from spinal canal stenosis? Then make an appointment for an examination!

What can be done against arthritis?

If there is a narrowing of the spinal canal that does not recede or even progresses, a definitive and lasting solution can only be achieved with an operation that widens the spinal canal again. This involves a so-called "microsurgical decompression": During this minimally invasive operation (keyhole surgery), spinal surgery specialists free the spinal nerves from the surrounding tissue that is compressing them.

If there is additional instability, the surrounding vertebrae are stabilised with screws so that the spinal canal stenosis does not develop again in the same place. Patients are only minimally restricted in their mobility as a result of this procedure. If rehabilitation is necessary, this can be carried out directly in-house in the relevant department.

Bethesda Hospital offers state-of-the-art methods for spinal stenosis operations - these include conservative treatment methods as well as microsurgery (minimally invasive procedure), computer-assisted navigation for implants and the latest anaesthetic techniques. From the first consultation, during the entire course of treatment and also during aftercare, patients are cared for by the treating spinal surgeon.

Are you unsure whether you suffer from spinal canal stenosis? Then make an appointment for an examination!

Most common reason for back surgery in old age

Spinal canal stenosis is one of the most common back problems. It affects slightly more women than men. Spinal canal stenosis occurs more frequently in people over the age of 60.

Spinal canal stenosis | Diagnosis programme on telebasel

Why does walking suddenly become a pain? Patients whose nerves in the spinal canal are constricted often complain that they can no longer walk for long. In the current programme, we talk about the phenomenon known as spinal canal stenosis.

Gerhard Koch talks about his experiences with spinal canal stenosis and how he is doing today after his operation.

FAQs on spinal canal stenosis

We have compiled the most frequently asked questions about spinal stenosis, answered by our medical experts.

Do you have any other questions that are not answered here? Please feel free to contact us - we will be happy to help you.

A pulling pain on the back of the buttocks and/or legs, which increases continuously when walking, can be an initial symptom of spinal canal stenosis in the lumbar region. If the pain subsides in a sitting position, possibly slightly bent forwards, this may also indicate spinal canal stenosis.

If the symptoms cannot be improved by non-surgical measures after a certain period of time, an operation to widen the spinal canal is appropriate. This "creates space" - the method is very successful and almost always leads to a significant reduction in pain. The surgical interventions are often very targeted and rather minor - only in the case of spondylolisthesis (see below) is the operation somewhat more complex.

In most cases, the pain in particular can be managed well with targeted physiotherapy and medication. Although the symptoms disappear again in a third of those affected, it is often not possible to predict whether the spinal stenosis will progress - it is important to decide in favour of an operation at an early stage if the symptoms increase.

Spinal canal stenosis is a progressive disease. In contrast to a disc hernia, which can heal without surgery, the narrowing of the spinal canal always progresses.

The narrower the spinal canal becomes, the greater the likelihood of weakness in the legs. However, this generally occurs gradually and is usually reversible in the early stages after the operation. So if you are unsure and would like to wait a little longer, this is usually medically acceptable. However, as soon as symptoms of paralysis appear, you should consult us again promptly regarding an operation.

It must be decided on an individual basis whether the spinal canal should be decompressed (microsurgical decompression) and stiffened with screws and rods. In many cases, decompression is completely sufficient, especially for relatively minor procedures.

However, if there is instability in addition to the narrowing (e.g. spondylolisthesis), relieving the spinal canal alone would exacerbate this and quickly lead to renewed narrowing. We therefore analyse very carefully before the operation whether additional stabilisation is necessary and discuss the advantages and disadvantages for you in detail.

The experienced specialists at Bethesda Hospital will be happy to support you.
The experienced specialists at Bethesda Hospital will be happy to support you.

The specialists on the subject of spinal canal stenosis

The clinical picture of spinal canal stenosis falls within the specialist area of our Clinic for Spinal Surgery and the Clinic for Rheumatology & Pain Medicine. Our experienced specialists will be happy to help you - let them advise you individually on the right treatment for your needs.

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