Spinal stenosis is a narrowing of the canal that carries the spinal cord and nerve roots. It occurs most often in the lower back, as lumbar stenosis, and in the neck, as cervical stenosis, and is mainly a result of wear and tear after the age of 50.
Lumbar stenosis typically causes leg pain and heaviness on walking that is relieved by sitting or bending forward. Cervical stenosis can compress the spinal cord itself, a condition called myelopathy, which affects the hands and balance. Many people with narrowing on a scan have no symptoms. Treatment is guided by how you feel and function, not by the image alone.
Symptoms
- Aching, heaviness or cramping in the buttocks and legs on standing or walking
- Relief on sitting, bending forward or leaning on a shopping trolley
- Numbness or tingling in the legs or feet
- Back pain, which is often less troublesome than the leg symptoms
- A shrinking walking distance
- In the neck: clumsy hands, difficulty with buttons, an unsteady gait, electric sensations on bending the neck
- Bladder urgency or loss of control in advanced cases
Causes and risk factors
With age, discs lose height and bulge, the facet joints enlarge with arthritis and the ligamentum flavum thickens and buckles. Together they narrow the central canal and the side exits for the nerves. A vertebra slipping forward, called degenerative spondylolisthesis, often adds to the narrowing. Some people are born with a narrow canal and develop symptoms earlier. Less common causes are previous surgery, fractures, Paget's disease and tumours. Standing and extending the spine narrows the canal further, which explains why walking provokes symptoms and sitting eases them.
How it is diagnosed
- History and neurological examination: The pattern of walking-related leg symptoms relieved by bending forward is characteristic. Pulses are checked because poor circulation in the legs can mimic it.
- MRI: Shows the degree and the levels of narrowing and the compression of the nerves or cord.
- CT or CT myelogram: For people who cannot have an MRI, or to show the bone in detail.
- Standing X-rays in flexion and extension: Reveal slippage and instability, which influence whether a fusion is needed.
- Nerve conduction studies or vascular tests: Used when neuropathy or arterial disease may be contributing.
Treatment options
- Exercise and physiotherapy: Cycling, flexion-based exercises, core strengthening and weight control. Many people remain stable for years.
- Pain medicines: Paracetamol and short courses of anti-inflammatories. Medicines for nerve pain help only modestly.
- Epidural steroid injection: Can ease leg pain for weeks to months. It does not change the narrowing.
- Decompression surgery (laminectomy or laminotomy): Removes the bone and ligament pressing on the nerves, often through microsurgical or endoscopic approaches. It reliably improves leg pain and walking distance, and improves back pain less.
- Decompression with fusion: Added when there is slippage with instability or a deformity.
- Interspinous spacers: A less invasive option for selected mild to moderate cases. Reoperation rates are higher.
- Surgery for cervical myelopathy: Decompression from the front or the back of the neck is recommended once cord symptoms are established, to stop them progressing.
When it is urgent
New numbness around the genitals or the back passage, difficulty passing urine or loss of bladder or bowel control, or rapidly increasing weakness in the legs may mean cauda equina syndrome or severe cord compression. Go to an emergency department near you at once. Surgery within hours affects the outcome.
Travelling to Türkiye for treatment
Planned decompression for lumbar stenosis suits travel reasonably well. Allow 7 to 10 days for decompression alone and about 2 weeks if a fusion is included, and arrange physiotherapy at home. Bring an MRI less than 6 months old. A careful surgeon will first confirm that your symptoms match the scan, because operating on the image alone gives disappointing results. Progressive cervical myelopathy should be treated without long delays, so choose whichever route gets you operated on soonest.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Will it keep getting worse?
Not necessarily. Over several years about a third of people with lumbar stenosis stay the same, a third improve and a third get worse.
When is surgery worth considering?
When leg symptoms limit your walking and daily life despite 3 to 6 months of conservative care, or earlier if there is weakness or cord compression.
Do I need a fusion?
Only if there is instability, significant slippage or deformity. Decompression alone is sufficient for many people.
How long is recovery?
Walking starts the same day or the next day. Leg pain often improves quickly. Expect 4 to 6 weeks before normal light activity, and around 3 months after a fusion.