Prof. Dr. Erkan Kaptanoğlu


Lumbar Narrow Canal (Lumbar Spinal Stenosis)


This very common narrow canal disease (lumbar stenosis) occurs when the structure of the discs, spine joints, and ligaments between the vertebrae deteriorates over time. As the patient gets older, the discs harden, and the bones and joints become thicker and wider. The spinal canal is narrowed by the growth of discs and facet joints. Symptoms show up after this canal, which contains the spinal cord and nerve roots, that make our legs move and feel, narrows down and crushes the nerve structures. This condition is called lumbar narrow canal (lumbar stenosis).

In this disease, colloquially known narrow canal, complaints begin especially when walking. The numbness, tingling, and pain sensation that begins in the legs and feet and patients being forced to stop and rest on their way are among the most important symptoms of narrow canal disease. Especially encountered in older women with weight problems, narrow canal disease can cause damage such as gait disorders and paralysis if not treated.

Narrow canal disease may be seen in three different parts of the spine: the neck, waist, and the back, and it occurs as a result of the aging of the spine. It is usually seen in older ages and is especially common in women who are overweight. Symptoms of the disease in the lower back may often be confused with the herniated disc. Patients who have a numbness, tingling and burning sensation, pain and weakness in the legs and feet should consult a doctor.


Lower back pain is usually the initial complaint. Recently emerging leg pains are often added to long-term lower back pain. Lower back and leg pain frequently begins with walking and increases over time. Numbness, cramps, and weakness of legs are added to these pains. The symptoms usually get worse after standing or walking for a long time.

The findings may fluctuate by increasing and decreasing at times, but overall, there is gradual deterioration over time. This deterioration may occur over many years or rapidly within months. Because of discomfort in the lower back and legs, the walking distance becomes shorter. The patient has to stop to relieve the pain. Urinary and fecal incontinence is rare. The lumbar narrow canal may not always show symptoms. Although some patients have severe stenosis, they may not have any complaints. Sometimes, it can emerge with very serious symptoms.

  1. The patient’s complaints, history of the disease and examination are very important in terms of diagnosis.
  2. Narrowed disc spaces and enlarged facet joints can be seen in X-ray films. Deteriorations in facet joints, deterioration and displacement of the vertebrae, and scoliosis may be encountered.
  3. Lower back tomography can provide detailed information about the structures of the vertebrae.
  4. Magnetic resonance imaging (MRI) provides detailed information about soft tissues such as cartilage, nerve tissue, ligaments and the connective tissue between the vertebral structures.
  5. All of these examinations provide information on the extent and level of stenosis and the compression of nerve roots.
Treatment Options
Medical Treatment for Narrow Canal Patients Without Complaints

Narrow spinal canal disorder progresses in a quiet manner and manifests itself at later ages. According to the findings, surgical or nonsurgical treatments are applied on the patients. We can summarize this stage as follows: after the patient has complaints, the patient goes to see a doctor, they are examined and then radiological examinations are performed. If MRI, tomography and X-ray results also support the clinical findings, the patient is diagnosed with narrow canal disease. Protective treatment or surgical operation is decided according to the stage of the disease. In fact, only a small portion of the patients with narrow canal disease actually need surgery.

If the patient does not have any symptoms that will decrease the quality of life such as pain, aching, numbness, and the patient is able to walk for long distances, surgery is not recommended for these patients. In this case, medication is administered. Muscle relaxants, painkillers, and anti-inflammatory drugs can be used. Physical therapy’s goal is to strengthen the lumbar muscles, increase the mobility of the waist and thus reduce the complaints. Injections to the spine may be useful. Non-surgical treatment methods cannot correct the narrowing of the spinal canal alone but may provide pain relief.

Operation With Microsurgery Is Possible

With advanced technology, different techniques can be applied in narrow canal operations. The purpose of surgical treatment involves opening the bone structure of the canal and providing the necessary space for the spinal cord and the nerves. This method is called lumbar decompression surgery or laminectomy. In classical surgery, the back of the spine is usually removed and relaxed. However, in some cases, screws can also be used to prevent spine slippage.

The spine is usually relieved through a small opening with microsurgery operations, which is increasingly gaining traction in the recent years. Nerves are relaxed by extending the spinal canal through a small skin incision from one side in the microsurgical method. Patients who undergo this operation usually recover more easily during the healing process. However, this method cannot be applied to every narrow canal patient. The doctor must make a decision according to the condition of the disease.

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