Spinal canal stenosis - narrowing of the spinal canal

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.

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 using 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.

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.

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.