Lumbar Spinal Stenosis

WHAT YOU SHOULD KNOW:

• Lumbar (LUM-bahr) spinal (SPI-nal) stenosis (ste-NO-sis) is a narrowing of the spinal canal in the lower back. The spinal canal runs in the middle of the spine and contains the spinal cord. Your spine is made up of many vertebrae (back bones) stacked on one another. Between each bone is a disc which serves as cushion. The spinal cord is where nerves that carry messages from your brain go to the rest of the body. Lumbar spinal stenosis may be caused by an abnormal development of the spine, such as in scoliosis (curved spine). Problems in the spine that lead to changes in the vertebrae, discs, or ligaments may also cause stenosis.
  
  
• Common signs and symptoms may include low back pain, and numbness, tingling, or weakness of the legs. You may also feel pain in the buttocks that extends to the thighs or legs. Symptoms may be worse when standing or walking and relieved when sitting down, leaning forward, or bending. In severe cases, bowel or bladder problems may occur. Lumbar spinal stenosis may be diagnosed through a detailed health history and physical exam. Tests, such as computed tomography scan, magnetic resonance imaging, x-ray, and electromyography may be done. Treatment may include medicines, surgery, and therapies. With treatment, more serious problems of lumbar spinal stenosis may be prevented, and your quality of life improved.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Some lumbar spinal stenosis treatments may cause unpleasant effects. You could bleed too much with surgery or get an infection. Your spinal cord or other parts of the spine may be injured. Sometimes, even with treatment, the signs and symptoms of lumbar spinal stenosis may come back. If left untreated, you may develop further problems. The pain may become worse, which may affect your daily activities. The spinal cord may be squeezed or damaged, and may lead to paralysis. Ask your caregiver if you are worried or have questions about your condition, care, or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

• Antianxiety medicine: This medicine may be given to decrease anxiety and help you feel calm and relaxed.
  
  
• Nerve block: A nerve block is a shot of medicine that makes you lose feeling in an area of your body. You may need a nerve block if your pain is not going away, or is getting worse. A nerve block may also be used to make you lose feeling in an area before a procedure is done.
  
  
• NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
  
  
• Sedative: This medicine is given to help you stay calm and relaxed.
  
  
• Steroids: This medicine may be given to decrease inflammation.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Tests:

Certain tests may be done that use a special dye to help organs and structures show up better. Tell caregivers if you are allergic to iodine or shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye. You may have any of the following tests:

• Computed tomography scan: This is also called a CT myelogram. An x-ray machine uses a computer to take pictures of your body. It may be used to look at your bones, muscles, blood vessels, and other tissues. You may be given dye as a shot in your back before the pictures are taken. The dye may help your caregiver see the parts inside the spinal canal better.
  
  
• Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.
  
  
• Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures are taken of your body. An MRI may be used to look at the muscles, joints, bones, blood vessels, or other tissues. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
  
  
• X-ray: This is a picture of your back bones. You may be given dye as a shot into your spinal canal before the x-ray. This dye will help the bone, spinal cord, and other parts show up better on the x-ray. An x-ray to show the contents of the spinal canal using dye is called a myelogram.

Treatment options:

You may need surgery if your pain cannot be controlled by other treatments. It may also be done if your weakness worsens or bowel and bladder problems are present. Surgery done on a part of a vertebra, called lamina, may help decrease the pressure inside the spine. Caregivers may do a laminectomy or laminotomy. Laminectomy is surgery to remove the lamina. Laminotomy is done by making hole or cutting a part of the lamina. Caregivers may also fuse the bones together to make the spine stable.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Lumbar Spinal Stenosis (Inpatient Care)