Dr Lee treats all conditions of the lumbar spine.
Spinal stenosis is a degenerative condition where there is narrowing of the lumbar spinal canal, commonly caused by bony overgrowth (bony spur or osteophyte) or a thickening of spinal canal ligaments (ligamentum flavum) causing compression of spinal nerves.In spinal stenosis, spinal nerves can be compressed at different sites within and external to the spinal canal.
Central stenosis occurs when spinal nerves are being compressed centrally within the spinal canal. Patients typically experience pain in both legs, which can feel worse when in an upright position and better when leaning forwards. In addition, patients may experience a constant numbness and tingling sensation in their feet.
Foraminal stenosis occurs when the spinal nerve is being compressed exiting the spinal canal. Patients typically experience a shooting pain down one side of the leg, similar to sciatica pain, and may also experience numbness and tingling in certain parts of the leg supplied by the spinal nerve.
Rarely spinal stenosis may cause severe compression of the nerves resulting in weakness of muscles in the legs.
Dr Lee focuses on obtaining an accurate diagnosis before implementing a treatment plan.
Most lumbar spinal conditions may not require surgery. Dr Lee may recommend a course of non-operative treatment for lumbar stenosis such as pain management, physiotherapy, lifestyle modification and epidural injections. An injection is performed typically to confirm the diagnosis of lumbar stenosis and to determine the level of symptomatic involvement, especially if multiple levels are affected. The injection will also help relieve some of the painful symptoms of lumbar stenosis. If non-operative treatment fails, then surgery may be required.
Very rarely, lumbar stenosis can become a serious problem. Please seek urgent medical attention if you experience any of the following:
- Weakness in the legs
- Difficulty urinating or controlling urination
- Loss of control of bowel movement
- Numbness in the genital area
Dr Lee performs the following surgeries for spinal stenosis treatment:
Laminectomy involves removal of the bony arches at the back of the lumbar vertebrae. The goal of lumbar laminectomy is to generate more room for the spinal nerves, relieving the compression. Post-surgery, patients may experience improvement in their leg pain, however decompression surgery may not necessarily relieve their back pain.
Spinal fusion involves the joining of two or more spinal segments to prevent motion. Spinal fusion may be performed for lumbar stenosis when there is evidence of severe foraminal stenosis, spinal deformity or instability such as degenerative spondylolisthesis or retrolisthesis.
Degenerative spondylolisthesis or retrolisthesis is when one part of the spine slips out of its normal position and over the other parts. This condition is often associated with foraminal stenosis.
Multiple surgical techniques exist for spinal fusion, these include:
- Anterior Lumbar Interbody Fusion (ALIF)
- Oblique Lumbar Interbody Fusion (OLIF)
- Lateral Lumbar Interbody Fusion (LLIF/XLIF)
- Transforaminal Lumbar Interbody Fusion (TLIF)
- Posterior Lumbar Interbody Fusion (PLIF)
Dr Lee will discuss these treatment options with you further should surgery be required.
Dr Lee has extensive experience performing spinal fusion surgery, and experience using the latest minimally invasive spinal surgical techniques. In addition, Dr Lee is also proficient with intraoperative navigation for spinal surgery.