Symptoms

The main symptom of spinal stenosis of the lumbar spine is stress-related low back pain. Since spinal canal stenosis mainly occurs in the lumbar spine, this is also where the pain is most often located. The pain does not develop suddenly from one day to the next, but is much more the expression of a creeping process in the context of degenerative changes in the spine.

The pain occurs mainly when walking. It can happen that the pain suddenly radiates into the legs and forces the affected person to stop moving. Pain-free walking is then only possible over a short distance.

This pain-related limping in the context of a spinal canal stenosis of the lumbar spine is called intermittent claudication. The stress-related pain is caused by compression of the nerve roots in the lumbar spine area that supply the leg. Furthermore, a numbness in the legs can occur.

Going downhill or sitting for a longer period of time increases the discomfort, because the lumbar spine is increasingly brought into a hollow back, which increases the narrowing. The complaints decrease in a bent position of the lumbar spine, for example when walking uphill or cycling. A spinal canal stenosis of the lumbar spine can lead to further symptoms such as tingling or burning sensations in the legs.

These sensory disturbances can also manifest themselves in the genital area. When diagnosing spinal canal stenosis of the lumbar spine, the physician uses various diagnostic tools. First of all, the patient interview, the anamnesis, is in the foreground.

Typical symptoms of spinal canal stenosis of the lumbar spine, such as stress-related low back pain, are examined and provide a sound suspicion. Nevertheless, further important examinations follow in order to reliably exclude other diseases and confirm the suspicion of spinal canal stenosis. A physical examination of the spinal column and a blood sample is taken.

The blood sample is used to determine inflammation values, for example. This is followed by an imaging diagnosis, which is absolutely necessary to determine the exact location of the stenosis. Usually, an x-ray is first taken in two planes, which can make changes in the spine visible.

It is particularly suitable for excluding other diseases such as tumors, fractures, abscesses and other processes. Probably the most important and best method for assessing spinal canal stenosis of the lumbar spine, however, is magnetic resonance imaging (MRI) of the lumbar spine, since it allows ligaments, nerves, intervertebral discs and soft tissues to be assessed particularly well. Degenerative processes and constrictions can therefore be seen particularly clearly.

However, computer tomography (CT) is also a frequently used diagnostic tool. CT is particularly important for the assessment of bony structures and is clearly superior to other procedures in this respect. CT is also frequently used for planning operations.

In addition to these non-invasive examinations, there is also a somewhat more invasive diagnostic method, namely myelography or myelo-CT.In this examination, a puncture needle injects contrast medium into the spinal canal. The purpose of the contrast medium is to enable better assessment of constriction and compression. Myelography is particularly important if the CT or MRI does not provide sufficient information for planning surgery.

Do you suspect that you might suffer from a lumbar spinal syndrome? Please carry out our self-test “Lumbar spine syndrome“:The MRI (magnetic resonance imaging) is an important diagnostic tool from the field of imaging to visualize changes in various structures such as the intervertebral discs, nerves, ligaments or the spinal cord. Therefore, it is probably the most important diagnostic tool in spinal canal stenosis of the lumbar spine.

The narrowing of the spinal canal, which contains the spinal cord, and the intervertebral holes, which serve as exit points for the nerve roots, can be made visible in this way. Degenerative changes in various structures can also be assessed in this way. These include, for example, reduced height of the intervertebral discs or abnormalities of the ligamentous apparatus.

However, it should not be assumed that every change in the spinal column that can be detected by MRI also causes complaints. Not every abnormality in the imaging results in a consequence for the patient. What is important is the interaction of symptoms, such as pain, numbness and the like, and the extent of the abnormalities in the MRI.

A weak point of the MRI is the assessment of the bony apparatus. In this point, the MRI is inferior to the CT. Therefore, a CT examination can be a useful supplement to the MRI.