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 zur Spinalkanalstenose

Wir haben die häufigsten Fragen rund um Spinalkanalstenose zusammengetragen, beantwortet von unseren medizinischen Expertinnen und Experten.

Haben Sie weitere Fragen, die Sie hier nicht beantwortet finden? Sie können uns dazu gerne kontaktieren – wir sind gerne für Sie da.

Ein ziehender Schmerz auf der Rückseite des Gesässes und/oder der Beine, der beim Gehen kontinuierlich zunimmt, kann ein Erstsymptom einer Spinalkanalstenose im Lendenbereich sein. Auch das Abklingen des Schmerzes in sitzender, eventuell leicht nach vorne gebeugter Position kann auf eine Spinalkanalstenose hindeuten.

Wenn sich die Beschwerden durch nicht-operative Massnahmen nach einer gewissen Zeit nicht verbessern lassen, ist eine Operation zur Erweiterung des Spinalkanals angebracht. So wird «Platz geschaffen» – die Methode ist sehr erfolgreich und führt fast immer zu einer deutlichen Schmerzreduktion. Häufig sind die operativen Eingriffe sehr gezielt und eher klein – nur bei Wirbelgleiten (s. weiter unten) ist die OP etwas komplexer.

Vor allem die Schmerzen lassen sich mit gezielter Physiotherapie und medikamentöser Behandlung in den meisten Fällen gut in den Griff bekommen. Obwohl bei einem Drittel der Betroffenen die Symptome wieder verschwinden, ist oft nicht absehbar, ob die Spinalkanalstenose fortschreitet – wichtig ist, sich frühzeitig für eine Operation zu entscheiden, wenn die Beschwerden zunehmen.

Die Spinalkanalstenose ist eine fortschreitende Erkrankung. Im Gegensatz zur Diskushernie, die sehr wohl ohne Operation ausheilen kann, nimmt die Verengung des Spinalkanals grundsätzlich immer weiter zu.

Je enger der Spinalkanal wird, desto grösser auch die Wahrscheinlichkeit, dass eine Schwäche in den Beinen auftreten kann. Allerdings tritt diese in der Regel schleichend auf und ist im Anfangsstadium – in der Regel – nach der Operation reversibel. Wenn Sie also unsicher sind und noch etwas zuwarten möchten, ist das in der Regel medizinisch vertretbar. Sobald aber Lähmungserscheinungen auftreten, sollten Sie sich zeitnah nochmals von uns hinsichtlich einer Operation beraten lassen.

Ob neben der immer durchzuführenden Entlastung des Spinalkanals (mikrochirurgische Dekompression) auch eine Versteifung mit Schrauben und Stäben durchgeführt werden sollte, ist individuell zu entscheiden. In vielen Fällen reicht die Dekompression vollkommen aus, vor allem bei eher kleinen Eingriffen.

Liegt aber zusätzlich zur Einengung auch eine Instabilität vor (z. B. ein Wirbelgleiten), würde die alleinige Entlastung des Spinalkanals diese noch verstärken und rasch zu einer erneuten Einengung führen. Daher analysieren wir vor der Operation sehr genau, ob eine zusätzliche Stabilisation notwendig ist und besprechen ausführlich mit Ihnen, welche Vor- und Nachteile daraus für Sie entstehen.

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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