MEDICAL SURFARI: THE AGING BACK AND LUMBAR SPINAL SENOSIS

Degenerative spinal stenosis is a narrowing of the spinal canal which may compress the spinal cord or nerves within the canal. This condition may develop at any level of the spine but commonly affects the lumbar spine (low back).

If you have this condition you may have dull aching pain in your back, buttocks and legs as you stand or walk. This aching discomfort may radiate into one or both legs and may be associated with leg weakness and/or numbness or "pins and needles" that is worsened by further walking or standing. These symptoms and signs are often eased by a brief rest period either sitting or lying down.

People who have lumbar spinal stenosis often report relief if they bend at the waist, lean forward on a shopping cart or wheelchair when they walk.

Who gets this condition?

Lumbar spinal stenosis is occasionally seen in younger people from developmental causes, but is most common in people over 50 or 60. This condition is becoming more common as the segment of our population over this age continues to increase.

Literally, tens to hundreds of thousands of senior people have many of these symptoms that limit their ability to fully enjoy their lives. Like many others they attribute their aches and pains to other causes and the result is lost vitality.

Successful treatment is possible

Medical, physical and surgical treatment for lumbar spinal stenosis is available. Anti-inflammatory medications are often prescribed to temporarily reduce inflammation within the nerves and associated muscles. Physical therapy may successfully restore strength and flexibility to muscles that improve posture and stabilize the spine which may decrease the constriction and compression of the nerves in the spine.

Surgery for lumbar spinal stenosis is reserved for people who have been unable to get acceptable longterm relief of their symptoms. It involves removing the thickened bone spurs and ligaments causing the constriction and compression of the nerves. Clearly, the majority of patients who have this surgery are pleased with the degree of relief that they gain and they go on to enjoy renewed vigor and vitality -- often able to do activities that they had been unable to do for years.

World Wide Web Resources

More and more people are making the sojourn into cyberspace for everything from weather forecasts to medical information. The breadth of web resources on medical topics seems to be ever-expanding. The following sites will give readers who would like to know more about low back pain and lumbar spinal stenosis the resources to better understand the signs, symptoms, diagnostic tests and treatments for these disabling conditions.

Neurosurgery://On-Call

http://www.neurosurgery.org/pubpages/index.html

Here's one of the "biggies." It features a variety of services to physicians as well as the public. Among these is a feature on lumbar stenosis. This site is sponsored by the American Association of Neurological Surgeons and Congress of Neurological Surgeons.

Patient's Guide to Low Back Pain

www.sechrest.com/mmg/back/backpain.html

This one is loaded with graphics and animated images, even demonstrating the operation often done for lumbar stenosis. It also has a lot of information on spinal anatomy, anatomy diagnosis and treatments of low back pain.

Center for Minimally Invasive Innovative Micro-neurosurgery

www.neuronet.pitt.edu/groups/ctr-innov/Welcome.html

This site from the University of Pittsburgh Medical Center presents new surgical techniques for spine disease and especially for spinal stenosis. These new techniques are on the growing edge of neurosurgery and are designed to minimize tissue injury by using smaller incisions, endoscopes and less retraction of nerves, tissue, etc. This is a site to keep your eye on as it brings us innovative new operations.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbssemissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.