[Opinion] Low Back Pain and Leg Numbness: Symptoms and Treatments of Spinal Stenosis

Chief Specialist Byeonggil Son, Department of Neurosurgery, SMG Yonsei Hospital.

Spinal stenosis is a condition where the spinal canal narrows, causing compression of the nerves passing through it and leading to various symptoms. The spinal canal is a passage along the center of the spine through which nerves travel, and when this passage narrows, the nerves are compressed, resulting in symptoms such as lower back pain, leg pain, leg weakness, abnormal gait, and sensory disturbances.

The causes of spinal stenosis can be broadly divided into two categories. The first is aging, where the bones and ligaments that make up the spine thicken and the discs degenerate, leading to narrowing of the spinal canal. The second involves congenital or acquired factors, such as being born with a naturally narrow spinal canal or developing narrowing due to trauma, tumors, or infections.

The most common symptom of this condition is lower back pain. Pain may worsen when standing or walking for extended periods, and pain or numbness radiating to the legs is frequently observed. Leg weakness can also make walking difficult. Additionally, sensory abnormalities may cause unusual sensations in the legs or feet.

Diagnosis of spinal stenosis involves several steps. First, the doctor takes the patient’s medical history and performs a physical examination. Imaging tests such as X-rays, MRI, and CT scans are then used to assess the condition of the spinal canal. MRI is particularly important as it provides detailed views of nerves and soft tissues. Nerve conduction studies may also be performed to evaluate nerve function if necessary.

Treatment can be divided into non-surgical and surgical methods. Non-surgical treatments include physical therapy, medication, and injections. Physical therapy helps alleviate symptoms through muscle strengthening and stretching exercises, while medications such as anti-inflammatory pain relievers and muscle relaxants reduce pain. Pain management techniques like nerve blocks help decrease inflammation and pain, often yielding very good results.

There are various surgical options, with one of the recently highlighted methods being Percutaneous Single-Port Lumbar Endoscopic Decompression (PSLD). PSLD is a minimally invasive surgery involving a small incision of about 1 cm through which an endoscope is inserted to remove bone or ligaments compressing the nerves. This surgery offers advantages such as rapid recovery, minimal bleeding, low risk of infection, and effective pain relief. Initially, endoscopic surgery was applied to patients with mild to moderate spinal stenosis, but with technological advancements, it is now performed even in severe stenosis cases or when spinal instability is not severe, producing good outcomes.

Endoscopic decompression surgery can reduce concerns about surgical treatment in elderly patients with metabolic diseases (such as diabetes, hypertension, heart, and kidney diseases) due to aging. It is a bloodless surgery, eliminating complications related to blood transfusions and providing stable results.

In conclusion, spinal stenosis mainly occurs due to aging and degenerative changes, causing various symptoms. Early diagnosis and appropriate treatment are important, and selecting the optimal treatment method tailored to each patient’s condition is necessary. Minimally invasive surgeries like Percutaneous Single-Port Lumbar Endoscopic Decompression (PSLD), along with non-surgical treatments, can be good options. It is essential to accurately understand one’s symptoms and condition and consult a specialist to develop the best treatment plan.

Neurosurgery Specialist, Director Son Byeong-gil