Saarland University Medical Center and Saarland University Faculty of Medicine
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Spinal stenosis

Spinal stenosis is an abnormal narrowing of the spinal canal due to "wear and tear" (degeneration). Thus, it occurs notably in older age. Compensatory e.g. bone attachments and thickening of the ligamentous structures occur due to wear-related biomechanical changes in the segments of the spine. These changes lead to a total narrowing of the spinal canal, in which the spinal cord is running in the area of the cervical to upper lumbar spine and where the nerve roots run in the region starting from the upper lumbar spine. If these structures are also cramped, typical symptoms occur. For example, patients complain in the case of stenosis of the cervical spine about unsteady gait, pain in shoulder and arms, fine motor skills disorders of the hands, sensory loss, increased muscle tone of arms and legs. In the final stages even paraplegia may occur.


Stenosis of the lumbar spine can lead to stress-related pain in the back and the legs. Patients can only walk a limited distance without pain and have to make regular breaks when walking ("intermittent claudication"). Bending over can also bring an improvement. Left untreated it can then result in paralysis, numbness or uncontrolled urine and bowel movements (incontinence).

Conservative treatment methods usually do not lead to the desired result, so the treatment of choice is the surgical removal of these bottlenecks (for example, by milling of bony attachments). Again, the method of operation depends on the location and severity of the stenosis. In the cervical spine, the operation is mostly made in the front and in the lumbar spine it is usually carried out from behind. In case of mechanical instability, stabilization may be additionally required by using screws, plates etc (see below).


Spinal stenosis of the lumbar spine at the L4 /. 5 Left: MRT Visualization axial T2, right: normal findings