Lumbar Spinal Stenosis Treatment in Fort Myers
Lumbar spinal stenosis occurs when the spaces within the lower spine become narrowed. This narrowing can place pressure on the nerves that travel into the hips and legs, making it difficult to stand, walk, or remain active.
Dr. Franco Vigna treats lumbar spinal stenosis using both nonsurgical and surgical approaches. The recommended treatment depends on the location of the narrowing, degree of nerve compression, spinal stability, and severity of the patient’s limitations.
What Causes Lumbar Spinal Stenosis?
The spinal canal and surrounding openings provide space for the nerves. These areas may gradually become smaller because of age related changes within the spine.
Common contributors include:
- Arthritis and enlarged spinal joints
- Bone spurs
- Thickened spinal ligaments
- Bulging or herniated discs
- Loss of disc height
- Vertebral slippage
- Spinal curvature or deformity
- Previous injury or surgery
Several of these changes may occur at the same time.
Symptoms of Lumbar Spinal Stenosis
Spinal stenosis commonly causes pain, heaviness, numbness, or weakness in one or both legs. Symptoms may become worse while standing or walking and improve when sitting or leaning forward.
Patients may also experience:
- Lower back discomfort
- Cramping or burning in the legs
- Reduced walking distance
- Difficulty standing upright
- Problems with balance
- Weakness in the feet or legs
- Sciatica or radiating leg pain
The pattern of symptoms is often referred to as neurogenic claudication.
Diagnosing Spinal Stenosis
Dr. Vigna evaluates the patient’s walking tolerance, strength, sensation, reflexes, balance, and spinal movement. MRI imaging can show the location and severity of nerve compression.
Standing X-rays may be used to evaluate alignment, instability, scoliosis, or spondylolisthesis. CT imaging may provide additional detail when necessary.
Treatment for Lumbar Spinal Stenosis
Nonsurgical care may include physical therapy, medication, activity modification, walking aids, or image guided injections. These treatments may reduce symptoms but cannot physically enlarge a severely narrowed spinal canal.
When symptoms significantly restrict walking or quality of life, surgical treatment may include:
Laminectomy
A laminectomy removes part of the bone and thickened tissue covering the spinal canal to create more room for the nerves.
Laminotomy or Foraminotomy
These procedures create additional room within a specific portion of the spinal canal or nerve opening.
Decompression With Fusion
Fusion may be added when stenosis occurs with instability, vertebral slippage, deformity, or painful abnormal movement.
Minimally Invasive Decompression
Selected patients may be treated through smaller incisions with less disruption to surrounding muscles.
Frequently Asked Questions
Why do my symptoms improve when I lean forward?
Leaning forward can temporarily increase the available space around the lumbar nerves. This is why some patients feel better while sitting, bending over a counter, or leaning on a shopping cart.