Lumbar Spinal Stenosis

11/05/2022 最終更新日時 : 03/10/2024 webmaster
We will provide information on surgical methods for lumbar spinal stenosis, the length of hospital stay, and whether the procedures are covered by insurance.

Lumbar Spinal Stenosis

What is Lumbar Spinal Stenosis?

The spine has a canal called the spinal canal that runs through the back of the vertebrae and intervertebral discs, providing a pathway for nerves. Over many years, as the spine supports the body, it can deform, leading to a narrowing of this canal. When the spinal canal narrows in the lumbar region, it is referred to as lumbar spinal stenosis. This condition gradually increases after the age of 50, and it is said that about 10% of people in their 70s have mild spinal stenosis, making it a relatively common condition.

Symptoms

When the spinal canal narrows, the nerves passing through it, such as the cauda equina and nerve roots, become compressed, leading to sciatica (nerve pain in the lower limbs), numbness, and weakness (paralysis). In some cases, in addition to numbness in both legs, other symptoms may include a burning sensation in the groin, a feeling of incomplete emptying after urination (residual urine sensation), constipation, and other bladder and rectal symptoms. These symptoms mainly occur upon waking and while walking. As a result, lumbar spinal stenosis often causes intermittent claudication, a condition where the patient is unable to walk long distances continuously and must alternate between walking and resting. If walking aggravates leg pain and numbness, or if lower limb symptoms are accompanied by urinary abnormalities, lumbar spinal stenosis is suspected.

Treatment Methods

Depending on the presentation of symptoms and the location of the stenosis, lumbar spinal stenosis can be classified into cauda equina type, nerve root type, or mixed type. Cauda equina type often requires surgery. However, conservative treatments such as medication (to promote nerve recovery or relieve nerve pain) or block injections (sacral epidural or nerve root blocks) may also be effective in some cases.


For those who do not experience improvement with conservative treatment, we recommend surgery.

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Surgical Methods

Surgical methods are broadly divided into decompression surgery and fusion surgery. At our hospital, we strive to perform minimally invasive endoscopic surgery for decompression procedures whenever possible. Fusion surgery is indicated when there is instability or deformity, such as scoliosis, in the area of nerve compression. Fusion surgery is further divided into posterior surgery and anterior-posterior surgery, as outlined below.

  1. Minimally Invasive Posterior Lumbar Interbody Fusion (Mini-open TLIF + PPS)

This fusion surgery involves decompressing the spinal canal through a small midline incision, inserting an artificial spacer between the vertebrae, and then inserting screws through another small lateral incision.

  1. Minimally Invasive Anterior-Posterior Fusion (XLIF/OLIF + PPS)

This fusion surgery involves making a 5 cm incision in the side of the abdomen to insert an artificial spacer between the vertebrae, followed by screw insertion through a small incision in the back. One of the advantages of this method is that it indirectly decompresses the nerves without directly exposing them.

There are also surgeries that combine both procedures ① and ②. (See Figure 3)

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Surgery Video

About Endoscopic Surgery

FESS (Full Endoscopic Spine Surgery)
Full endoscopic spine surgery is the least invasive endoscopic procedure, performed using an 8mm endoscope. By irrigating the surgical site with water from the camera, the procedure provides a clear view and allows for precise hemostasis.

MED, MEL (Micro Endoscopic Discectomy, Micro Endoscopic Laminectomy)
These endoscopic procedures, including micro endoscopic discectomy and laminectomy, are performed through an approximately 16mm incision. Our hospital has over 20 years of experience with these surgeries and has built a wealth of expertise.

MED

BESS, UBE (Biportal Endoscopic Spine Surgery, Unilateral Biportal Endoscopic Surgery)
This is the latest endoscopic surgical technique, performed by making two incisions of approximately 5 to 8mm. A camera is inserted through one incision, with water irrigation similar to FESS, while surgical instruments are inserted through the other incision. In recent years, this method has become widely practiced, especially in Asia and the United States.

In some patients, the intervertebral disc may collapse, and bone deformation can lead to nerve compression. In such cases, spinal fusion surgery with screw insertion may be necessary.

Disease Name
Lumbar Spinal Stenosis
Body Part
Back and Chest、Lower Back and Buttocks、Lower Limbs
Symptoms
Difficulty in Applying Strength to the Hand or Foot、Dizziness and Walking Impairment、Intermittent Claudication、Lower Limb Pain and Numbness
Type of Disease
Other Issues
Lumbar Spondylolysis and Spondylolisthesis
Lumbar Disc Herniation