Prognosis

As a chronic, degenerative disease, spinal canal stenosis is not causally curable. In most cases, it shows a very slow progressive course and the symptoms increase only slightly over the years. However, acute phases with a rapid worsening of the symptoms can also occur, for example when an intervertebral disc is involved or an inflammatory process in the vertebral joints is present.

Depending on the individual starting position, condition and also self-motivation when exercising from physiotherapy, the symptoms can be significantly improved by conservative therapy. Medical therapy with non-steroidal anti-rheumatic drugs such as ibuprofen or diclophenac, which is carried out in addition to physiotherapy, and other possible local therapies with local anesthetics and glucocorticoids can also contribute to a reduction of the symptoms. The conservative therapy serves to alleviate the complaints as long as possible to the extent that surgery and its risks can be delayed as long as possible. Modern surgical procedures are minimally invasive and offer a good alternative if the complaints can no longer be controlled by conservative therapy. Surgery can significantly alleviate the complaints and thus improve the quality of life, but even after the operation, the patient’s cooperation and commitment in the post-operative treatment is crucial.

OP Indications

An indication for surgery for spinal canal stenosis is generally given when the possible positive results of the operation outweigh the disadvantages and risks involved
For example, surgery can be useful for long-term complaints that cannot be adequately treated by conservative methods and that severely restrict the patient’s ability to cope with everyday life and work. These include, for example, long-lasting radiating pain in the leg, severe numbness indicating nerve compression and severe sensations such as tingling or burning sensations.
An absolute indication for surgery is also the cauda equina syndrome, which is caused by a strong bruising of the nerve fibers in the lumbar spine area.It manifests itself, for example, through numbness in the buttocks and thighs, weakened leg reflexes, motor deficits, impotence and urinary and fecal incontinence. In this case, the compression on the nerve fibers must be repaired immediately, otherwise permanent damage may result.