Spinal canal stenosis / spinal claudication

If the spinal canal stenosis causes a bottleneck for the nerves, spinal claudication can occur. In this case, a constriction of the nerves in the spinal canal means that it is no longer possible to walk long distances at a stretch. Typically, the narrowing of the spinal canal as a result of nerve irritation is accompanied by diffuse painful radiation into the legs. The walking distance is sometimes reduced to a few hundred meters. The pain improves spontaneously by sitting down or by bending the trunk strongly. In the long term, this often leads to an unconscious posture of rest. Diffuse numbness or weakness in the legs are also typical symptoms. Spinal canal stenosis is progressive and progresses at different speeds, i.e. the severity and extent of the symptoms increase. However, neurological deficits such as paralysis are rather rare.

Spinal canal stenosis, i.e. the narrowing of the spinal canal, is usually caused by degenerative changes due to bone protrusions, old large herniated discs or spondylolisthesis.

According to current studies, surgical treatment is superior to conservative therapy. Nevertheless, all available methods of conservative treatment should be used at the beginning of therapy. These include avoiding major physical strain while maintaining mobility, as well as pain and anti-inflammatory medication, physiotherapy and physical therapy, and possibly also an orthotic treatment to relieve pain.

If the symptoms are persistent, infiltrations close to the spine (PRT, epidural injections) are used under fluoroscopy to reduce swelling. If the conservative treatment measures have no positive effect when applied consistently over a period of at least 6 weeks, or if neurological deficits occur, surgical treatment is indicated. In the case of paralysis, surgical intervention should be performed promptly. The focus of surgical therapy is on function-preserving "minimally invasive" microsurgical widening of the spinal canal using a microscope.

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