Lumbar spinal stenosis, known as lumbar stenosis disease, is frequently seen in patients over 50 years of age. With advancing age, the fluid content of the intervertebral discs decreases, the disc height disappears, and these hardened tissues bulge towards the spinal canal. In addition, with the deterioration of the cartilage tissue in the joints at the back of the spine, thickening of the bone structures and ligaments called ligaments occurs and increases the narrowing of the canal. If this degeneration continues, slippage or even scoliosis-like bending may develop between the vertebrae. Lumbar narrow canal may not always cause complaints. The typical complaint is pain in the legs that increases with walking. This may be accompanied by symptoms such as numbness, tingling, and weakness in the legs. These complaints are relieved by sitting and leaning forward. However, as the disease progresses, the walking distance becomes shorter. In addition, urinary incontinence, loss of neurological strength in different degrees (motor weakness) in the legs can be seen as advanced symptoms.
Surgery in lumbar stenosis disease is applied only to patients whose pain cannot be relieved by non-surgical methods. Surgery should also be performed on people with progressive leg weakness or bladder and bowel control problems. Surgery may be the best option for patients whose walking distance is shortened and their quality of life is reduced. Since the narrow canal is the result of narrowing of the bony canal, the aim in surgery is to open the bony canal and provide sufficient space for the nerves. This procedure is called lumbar decompression surgery or laminectomy. When applied, surgery will relieve leg pain and, less effectively, lower back pain. Patients are allowed to return to most of their normal activities within weeks. Post-operative rehabilitation may be recommended to assist in returning to normal activities. Different surgical techniques can be applied in lumbar canal narrowing. In appropriate cases, it will be sufficient to shave only the thickened bones and ligaments that narrow the canal. In these cases, it may not be necessary to wear instruments called platinum among the people. However, in patients with advanced and multiple distance stenosis, the stability of the waist may deteriorate after this shaving procedure. In the following periods, it may cause deterioration in the alignment of the lumbar vertebrae (spondylolisthesis). In such cases, spinal fusion surgery should be performed to fix the related vertebrae in addition to decompression surgery. Fusion is usually done with a posterior approach. In addition to screwing, if there is a loss of height in the distance, it may be necessary to put a cage (TLIF, etc.) in the intervertebral space.
