Lumbar stenosis refers to narrowing of the regions that surround the nerves which exit the spine. The narrowing or stenosis can be “central”, meaning the spinal canal space is decreased, “neuroforaminal” meaning that the exit point of the nerves from the spine is impaired, or stenosis can involve the “lateral recesses”, specific areas within the spinal canal.
Causes for lumbar stenosis can involve congenital problems, such as shortened pedicles, mass issues such as tumors, but most commonly involves degenerative spine disease, better known as osteoarthritis. Osteoarthritic changes include bone spurs which can take up space surrounding the nerves. As we age, our intervertebral discs lose water content and “shrink”. With this loss of disc height, ligaments that support the spine can fold inward and cause stenosis. Wear and tear on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal.
Narrowing in the lumbar spine can cause numbness, weakness or tingling in a leg or foot. In severe cases, nerves to the bladder or bowel may be affected, leading to incontinence.
Procedural treatment for lumbar stenosis can include cortisone injections into the facet joints if they are hypertrophied (the ligaments are thickened/bulging), transforaminal or interlaminar injections. The location of the injection is decided by the distribution of symptoms and imaging findings. Regenerative injections including platelet-rich plasma (PRP) injections are also being used experimentally to provide a healthier environment to promote healing in the lumbar region.