Lumbar Spinal Stenosis

Definition of Lumbar Stenosis

Lumbar Spinal Stenosis is the irregular narrowing of the canal in the lower back known as the lumbar spine. It usually occurs when a bone or spinal ligament grows/thickens and compresses the spinal nerves. This generates numbness, pain and weakness in the buttocks, legs, and feet, and it typically worsens when patients walk or stand for prolonged periods. When the condition is serious, it may even result in incontinence.

When it occurs in the neck (cervical spinal stenosis), it usually results in completely different symptoms such as numbness in the arms and legs, and clumsiness or unsteadiness.

Causes of Lumbar Stenosis

Here are some of the most common causes of lumbar stenosis:

  • Herniated Disk or Slipped Disc
  • Aging. As we age, the discs located in between the vertebrates deteriorate. This causes the soft cushion on the discs to slip and exert pressure on the spinal nerves.
  • Ligament thickening. There is a spinal ligament that may thicken with age, and this typically causes nerve compression in elderly patients.
  • Bone Spurs (Overgrowth of bone)
  • Osteoarthritis, which causes facet joints (joint in the back) to widen and compress on the nerves.
  • Spinal Injuries
  • Calcification. This is the thickening of the ligaments on the spine, which narrows the spinal canal and squeezes the spinal nerve root.
  • Tumours. They can grow inside the spinal cord and occupy the space in the spinal canal.


Symptoms of Lumbar Stenosis

  • Lower back pain
  • Pain in the buttocks, feet and legs when walking, leaning backward, or standing straight
  • Rigidity in the thighs
  • Loss of bladder or bowel control (in some severe cases)


Risk Factors for Lumbar Stenosis

The risk factors of getting lumbar stenosis rises when you:

  • Are over 50 years old
  • Have a genetic disease that affects the development of bone and soft tissue thickening/calcification
  • Have trauma, scoliosis, spondylolysis, spondylolisthesis and spinal osteoarthritis
  • Have a history of spinal injury or lower back surgery


Lumbar Stenosis Diagnosis

Lumbar Spinal Stenosis can be diagnosed by identifying its symptoms through a physical examination. However, doctors may require imaging tests for confirmation:

  • MRI
  • CT Scan
  • Myelogram (Uses injected dye to detect changes in nerve structures)
  • X-rays


Non-Surgical Treatment for Lumbar Stenosis

Depending on the condition's severity, various options to treat lumbar spinal stenosis are available:

  • Typically, symptoms of lumbar spinal stenosis can be alleviated by simply improving one's flexibility, balance, strength and endurance through exercise and physiotherapy.
  • Some may need to wear supportive devices like a back brace to provide protection and prevent further trauma and strains.
  • Maintaining a healthy weight will also relieve pressure from the spine, reducing the chances of spinal stenosis, herniated disks and other sprains and injuries.
  • Mild to moderate pain may be eased with over-the-counter painkillers and nonsteroidal anti-inflammatory medicines.
  • For more severe cases of spinal stenosis, a higher dosage of medication or opiate is required and prescribed by the doctor. Nerve supplements or nerve stabilizer medications can also help. Corticosteroids and nerve blockers may also be injected to reduce inflammation and pain.


Surgical Treatment for Lumbar Stenosis

Laminectomy or Laminotomy

  • A laminectomy is the most common type of surgical treatment for lumbar stenosis. This releases the compression on the spinal nerve, caused by compression of part of the spinal bone called the lamina, as well as the thickened ligament attached to it.
  • A laminotomy is the micro-decompression or the partial removal of the lamina in order to remove the part of the bone and thickened ligament that squeezes the nerve root.

Facetectomy or Foraminotomy

  • The procedure also removes a part of the spinal structure called the facet, which pinches the nerve root in the spinal canal.
  • A foraminotomy is the procedure that expands the passages where the nerves exit the spinal canal. The process results in the widening of the window/channel for the nerve root, giving it more space, and reducing the compressive symptoms.

Interspinous Process Decompression

  • This is a minimally invasive surgery that involves an implant inserted between two bony protrusions at the back of the spine called the spinous processes.
  • The device keeps the spinal canal open and relieves the compression.

Spinal Fusion

  • This procedure aims to stabilize the spine and at the same time decompress the spinal nerves through a combination of the surgical methods of spinal decompression described above.
  • It may require screws to complete the construct, and aid the patient recover faster through immediate stability.



Co-Founded by Dr Chua Soo Yong, Atlas Orthopaedic Group is your one-stop Orthopaedic Clinic for the diagnosis and treatment of sports injuries, spinal conditions, and upper and lower limb ailments. Dr Chua is an accredited orthopaedic and spine surgeon specializing in both traditional and minimally invasive procedures in the suboccipital, cervical, thoracic, lumbo-sacral and pelvic regions. To schedule an appointment with Dr. Chua Soo Yong, call 6262-0555 or email