Spinal stenosis is also a degenerative disease that we see frequently and is divided by segment into cervical, thoracic and lumbar spinal stenosis. Spinal stenosis As spinal microarthritis and disc degeneration worsen, the spinal canal (which contains the spinal cord and nerves) also becomes narrowed, where one of the bulky ligaments that span the intervertebral space (the ligamentum flavum) becomes shorter and thicker, and these structures compress the nerve structures within the spinal canal. Symptoms and diagnosis This compression or narrowing causes leg pain when walking or standing, and sitting or lying down usually relieves the pain; these symptoms are known as neurogenic claudication. This has the same symptoms as radiating pain in the lower extremities due to impaired circulation in the limb, hip arthritis or diabetic neurological dysfunction and must be differentiated. Spinal stenosis can be definitively diagnosed with a CT or MRI scan, and sometimes electromyography and nerve conduction testing are used to identify the presence of diabetic neuritis. Treatment Non-surgical treatment consists of anti-inflammatory and analgesic medications, exercise and physical therapy. Sometimes local anesthesia or steroid injections are used within soft tissues such as muscle ligaments or the spinal canal near the nerve roots (epidural). If these measures do not relieve the symptoms, decompression surgery is required for the affected vertebrae. This surgery is so effective that patients can walk farther and stand longer without any pain after surgery. The surgery involves removing the top of the spinal canal to allow nerve root decompression (laminectomy) and enlarging the space in the spinal canal where the nerve root exits (foraminal enlargement). If there is instability, the associated spine needs to be fused. It is important to remember that spinal fusion is a fusion of the vertebrae together with bone grafting material from the pelvic bone (iliac bone) or bone bank. In most cases, screws and metal rods are used in the implant fusion to help keep the operated segment stable. The length of stay is usually shorter without fusion and longer with fusion. Especially in patients who were weak before the surgery, it is necessary to restore strength and activity through rehabilitation exercises during the short hospital stay. The details of post-discharge care, starting normal physical and sporting activities, driving, use of braces, etc. will be determined by the physician on a patient-by-patient basis.