Lumbar Canal Stenosis: Symptoms and Modern Minimally Invasive Treatment

We feel privileged to be treating your patient, and I hope we have done justice to you, your practice and of course the patient. I think at the end of the day we all have one common goal — we want to see our patients happy. Otherwise you, me and Jivo would not be here on a Sunday evening, leaving our families aside, if we did not have this goal.

I always joke about this with my orthopedic fellows. I've had an orthopedic training program for the last 13 or 14 years, and not even one of them has opted for spine surgery as a career — they're very happy doing a knee replacement, arthroscopy, or a fracture nail instead. Spine surgery has evolved so much that the moment they look into the scope, everything is very tiny, and that can be discouraging — it looks very uphill. It takes a little while to enter the system and understand what's going on through keyholes; one has to be patient, because it has a steep learning curve and the margin of error is not there. So for the last four years I've run a dedicated fellowship national training program for spine fellows — once they're selected and come to me, they don't have the option to go to any other theatre, because they're now committed to spine surgery for the rest of their life.

It is the symptom pattern of lumbar canal stenosis, involving progressively shorter walking distances, leg numbness and a choking feeling in the legs.

Age-related narrowing of the spinal canal, which compresses the nerves inside it.

Typical patients are 65 to 70 years old and describe a walking distance that has shrunk over time, from two or three kilometres down to as little as 50 to 200 metres.

When patients do not respond to medical treatment, flexion exercises and physiotherapy over two to three months.

It used to be treated with open laminectomy, a debilitating procedure that cut muscle and removed a large amount of bone, often leaving patients bedridden for weeks. Today the same decompression is performed with endoscopic and microscopic tubular techniques, with patients sitting up and walking the same evening in some cases.