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The connection between the vertebral bodies, the facet joints and the spinal processes comes about through vertebral arches - the canal created in the middle is the spinal canal through which the spinal cord runs. A narrowing of this canal is referred to as spinal canal stenosis; if the nerve windows are narrowed, this is referred to as a so-called foraminal stenosis.

In many cases, the cause of spinal canal stenosis is long-term stress on the spine and wear and tear on the structures. The narrowing of the spinal canal can be due to various changes, including, among others, bone thickening in the spinal canal, arthrosis of the facet joints with an increase in size, chronic herniated discs, spondylolisthesis, thickened parts of the joints with cavities and thickening of the ligaments of the spine.

Underlying causes:

Because the intervertebral discs have shrunk, the ligaments along the spine are less streched and lose their elasticity. This can cause the entire spinal structure to become latently unstable. The vertebral bodies can move against each other (vertebral sliding) and compress the spinal canal.

Symptoms:

The symptoms of spinal canal stenosis can vary greatly from patient to patient. The symptoms depend, among other things, on the exact location of the spinal canal stenosis.

Spinal stenosis is most common in the lumbar spine. Patients experience pain in the lower back and legs, and the legs are often affected by radiating sensoric or motor disorders. The pain often builds up when walking, so that over time it is hardly possible to walk longer distances without taking breaks. The narrowing of the spine can also lead to sensory disorders such as numbness and sensory disturbances.

Complaints associated with spinal canal stenosis in the cervical spine area include neck pain and muscle tension in the neck area, radiating pain to the shoulder and arms, numbness in the arms and hands and fine motor problems.

Furthermore, spinal canal stenosis can also affect the function of other organs and structures.

Therapy:

For many patients, spinal canal stenosis has no direct impact on well-being and can be treated well with conservative treatment.

Possible conservative treatments for the treatment of spinal canal stenosis include physical therapies, infiltrations (facet infiltrations, intradural ifniltrations), drug therapies and back training/physiotherapy.

With the help of these and other conservative measures, the symptoms can be noticeably improved in many cases, but conservative therapy cannot change the narrowing of the nerves; this is only possible with surgery.

Operation:

Surgical treatment can be considered if symptoms persist for several weeks or if the symptoms do not noticeably improve with conservative treatment measures.

An operation is necessary if the spinal canal stenosis leads to nerve failure (with symptoms of paralysis), numbness and functional disorders and/or if the ability to work, the ability to do activities and the quality of life are impaired by the compression of the nerves.

There are several surgical approaches available for the operation. The type and extent of an operation are always adapted to the individual needs and initial situation of the patient. If possible, I always carry out operations in a minimally invasive manner, with the aim of ensuring that the operation represents the least possible burden and that the patient recovers from it as quickly as possible and is pain-free and independently mobile again as quickly as possible.