Lumbar stenosis is a condition where the space available in the spinal canal is reduced, most often due to a degenerative process. As part of this process, joints in the spinal column (facet joints and intervertebral discs) may undergo degenerative changes, the consequence of which may be compression of nervous tissue. This compression may produce a classical constellation of symptoms called neurogenic claudication.
A lumbar decompression is indicated when there is stenosis (narrowing) of the vertebral canal and consequent neurogenic claudication.
Patients typically present with lower extremity (including buttock) pain and heaviness associated with walking. This pain may improve with rest and flexion of the spine ( bending forward).
Non -Operative Treatment
This includes non-operative measures including: pain-killers, physical therapy and occasionally corticosteroid injections. Operative indications include: intractable pain, protracted symptoms and precipitous decline in function as a consequence of a worsening neurological deficit.
These include dural injury (fluid sac injury), infection, instability of the vertebral column and adjacent segment disease.
This involves a small incision in the back, obtaining access to the constricting bony and soft tissue structures. These structures are precisely excised with high speed surgical tools under microscopic magnification and illumination. It is sometime necessary to supplement the spine with implants to prevent spinal instability.
Post Operative Instructions
Link to microdiscetomy and decompression