The Symptoms of Spinal Stenosis
When nerves are compressed they can produce symptoms of pain, numbness or tingling in the area of the leg that the particular spinal nerve supplies. In rare cases they can produce severe pain and even weakness in the legs, such that the ‘legs don’t work’.
In most cases, the symptoms are produced when standing or walking and are relieved by sitting or bending forward, as this can temporarily open up the nerve passages. In rare cases the nerves which control your bladder, bowel and sexual function can be compressed. This is known as cauda equina syndrome(CES) and often requires urgent surgical intervention. Fortunately, immediate spinal surgery is only necessary in a few cases.
Unfortunately, most conservative treatments (manipulation, physiotherapy, medication or injections) are unlikely to be of much long-term benefit, and the symptoms rarely improve permanently without surgery to take the pressure off the nerves (decompression).
The objective of surgery is to remove the material (for example the excess bone and ‘thickened’ ligament) from the back of the spinal canal to give the nerve roots and/or cauda equina more room.
The nature of spinal surgery is not to ‘cure’ and it cannot prevent further degeneration of the spine but is aimed to provide benefit with a good percentage improvement and relief of leg symptoms. Good relief from leg symptoms following decompression surgery usually occurs in approximately 70–80% of cases (up to 8 out of 10 people). This is not necessarily felt immediately, but over a period of time, often several months. Sometimes however, numbness or weakness can persist, even with a technically successful operation. This can occur when people have more extensive stenosis before they have surgery. Rarely, the surgery may make your symptoms worse than they were before. Many patients will also experience some relief from their back pain as well as from their leg pain. However, the results of the operation are not nearly as reliable for the relief of lower back pain. Much of the back pain experienced comes from the arthritis and associated muscular spasms, therefore, decompression surgery cannot eliminate this and it should not be regarded as the main aim of the surgery.
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