Lumbar Spinal Canal Stenosis

The spinal cord runs through the vertebral canal – also called the
spinal canal – and the spinal nerves exit from there. In the case of
hereditary or degenerative narrowing of the lumbar spinal canal,
the space enclosed by the vertebral arch is often considerably
reduced. Spinal nerves and emerging nerve roots become
subject to pressure.

Symptoms

Symptoms manifest themselves in different ways, depending on
the site and extent of the stenosis. They include pain, abnormal
sensations, and occasionally paralysis. One of the characteristics of
lumbar spinal stenosis is a shortened stride due to the onset of
symptoms. Sometimes such severe discomfort occurs during
walking that it radiates to the buttocks and the legs and forces the
patient to stand still. Often it is possible to take only a few steps.
The discomfort is relieved by bending forward, sitting down, or
lying down since these movements widen the spinal canal. So, for
example, cycling is often no problem at all.
But if you bend your spine backwards, you create additional
narrowing of the canal and the pain will actually increase.

Cause

There are many possible causes that may give rise to spinal canal
stenosis. It often happens that several factors come together to
promote wear and tear (degenerative changes), for example:

1. Degenerative changes give rise to bony spurs and bony
outgrowths on the vertebrae. These osteophytes can extend in the
direction of the spinal canal and penetrate it.

2. Degenerative changes in the spinal ligaments (e.g. posterior
longitudinal ligament, yellow ligament) over a lifetime lead to
thickening of these ligaments. The space inside the vertebral arch
can also be narrowed in this way.

3. If spinal osteoarthritis occurs, the facet joints can enlarge so
much that they project into the spinal canal.

4. A disc herniation or disc protrusion reduces the diameter of the
spinal canal.

These changes often occur together and cause spinal canal
narrowing. Permanent nerve injury may occur due to the constant
pressure exerted by the narrowed spinal canal.

Healthy spinal canal



Narrowed spinal canal



1- Disc protrusion
2- Yellow ligament thickening
3- Facet joint osteoarthritis/osteophytes


Treatment

“Decompression surgery” releases pressure on irritated nerve
fibres. The extent of the operation depends on the particular
conditions encountered in different patients. The vertebral arch,
bony spurs, thickened ligaments and joints, and herniated or
prolapsed disc tissue can be systematically removed in one or
more spinal segments. Prevention of recurrence of spinal canal
stenosis requires decompression of the affected areas of the
spinal column and sufficient stabilization to maintain flexibility.

A small operation with a big result – this is the new treatment
concept for stabilization of the spinal column with the coflex™
implant.

The coflex™ implant was designed for functional dynamic
stabilization of the spinal column after decompression surgery.

The coflex™ implant focuses on three important factors:

1. Stabilization

One result of a decompression operation may be the loss of
stability in the spinal column. But this loss can be compensated
through the insertion of a coflex™ implant and it also ensures that
the proper height of the segment will be maintained. The
vertebral joint is effectively decompressed and nerve fibres that
were previously irritated are now protected.

2. Maintenance of Mobility

In addition to stabilization, maintaining function – that is,
mobility – is also very important to prevent the advance of the
degenerative process into the adjacent spinal segments. The
coflex™ implant allows itself to be compressed if you bend
backwards and in this way it is functionally dynamic.



3. Less-invasive Treatment

The coflex™ implantation procedure is performed in a less-invasive
manner while still permitting the surgeon to maintain precision and
sureness.

The coflex™ implant is made of a very resilient titanium alloy. This
implant material has proven itself over many years and has
excellent biocompatibility.