Lumbar spinal stenosis is a very common spinal condition that affects the elderly. The average age of patients who suffer from this condition is 65 years old. This is due to degeneration of the spine, mainly involving the intervertebral discs and facet joints, which results in narrowing of the spinal canal and nerve compression.
Patients tend to complain of backache with radiation of the pain down to their buttocks and calves. Their symptoms can also be exacerbated by prolonged walking. Hence many patients will notice a reduction in their walking distance with time. This condition is the commonest reason for spinal surgery in the elderly.
The most common cause of spinal stenosis is osteoarthritis. This is the gradual wear and tear that happens to your joints over time. Spinal stenosis is common because osteoarthritis begins to cause changes in most people’s spine by age 50. That’s why most people who develop symptoms of spinal stenosis are 50 or older. Some people are also born with a spinal canal that may be narrower than others.
Other conditions that can cause spinal stenosis:
The diagnosis of lumbar spinal stenosis is clinically suspected when patients present with classical symptoms such as backache and radiation of pain down the legs.
To confirm the diagnosis, we will start with a physical examination followed by a MRI scan of the lumbar spine.
Your doctor will assess your posture, movement, and strength to evaluate how your spine and muscles are functioning.
An X-ray helps detect signs of fractures, degenerative changes, or issues in the bones of the spine.
An MRI provides detailed images of soft tissues like discs, muscles, and nerves, helping identify conditions such as herniated discs or nerve compression.
A CT scan allows us to visualize the bones more clearly.
In patients with minimal symptoms and no neurological deficit of their legs such as weakness, this condition can be treated conservatively with a course of physiotherapy and oral painkillers. They may even consider going for an epidural steroid injection to the spine for a quicker relief of their symptoms. Most patients will experience an improvement in their condition with just conservative treatment alone.
However, in patients who still experience significant symptoms or weakness of their legs despite physiotherapy, surgery should be considered. Surgery can be in the form of laminectomy, which is decompression of the spinal nerves alone, or laminectomy with lumbar fusion, which is instrumenting the spine with screws. Lumbar fusion is performed when it is noted that there is inherent instability of the spine. Both surgical options can be performed using minimally invasive (“keyhole”) techniques.
There are a variety of pain treatment options available, ranging from non-surgical methods to surgery, depending on the severity of your condition.
In some cases, surgery may be necessary if other treatments have not provided sufficient relief or if you are suffering from conditions such as a herniated disc, spinal stenosis, or severe nerve compression. Surgical options might include:
We work closely with trusted insurance partners to make your treatment seamless. Contact us, and we’ll guide you through the process at every step of the way.
Dr. Marcus Ling is a Senior Consultant Orthopaedic Surgeon with a special focus on minimally invasive and motion-preserving spinal surgery. A dedicated clinician and educator, he has led advancements in spinal care while mentoring future surgeons. Known for his compassionate approach, he prioritises patient well-being, ensuring expert, personalised treatment for every individual. Dr. Ling is also one of the few surgeons that can perform awake spinal fusion without the need for general anaesthesia. This approach minimises downtime, allowing patients to be discharged within 24 hours of surgery when possible.
Reach out to our team today to explore your treatment options, schedule an appointment and start your journey towards enhanced health and mobility.
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