The “Lateral Recess” describes the posterolateral portion of a vertebral spinal canal where at each segment the “descending nerve” starts to track laterally away from the centre of the canal and eventually exits the spinal column in the neural foramen of the vertebral segment below. “Stenosis” means narrowing, therefore “Lateral Recess Stenosis” equates to narrowing of the Lateral Recess, this most commonly causes encroachment and irritation of the descending nerve root. The most common cause of Lateral Recess Stenosis is a posterolateral disc bulge (herniation, prolapse, protrusion, extrusion or sequestration). A potential central disc bulge may be contained by the Posterior Longitudinal Ligament (PLL) thereby forcing the protrusion to the margin of the PLL and into the Lateral Recess.
Typical symptoms of Lateral Recess Stenosis are those of nerve root irritation such as sciatic pain in the leg, or nerve pain in the arm possibly accompanied with feelings of pins and needles or numbness in the patch of skin in the leg served by that nerve (dermatome) and or weakness in the muscles innervated by that nerve (myotome). This is why clinicians perform orthopaedic and neurological tests such as testing reflexes, sensation and muscle power to look for signs of specific and isolated nerve compromise.
Classic symptoms may be accompanied by discogenic spinal pain and local muscle spasm so that a disc bulge in the neck may cause coexisting symptoms such as shoulder pain and in the lower back coexisting symptoms such as buttock pain, “Piriformis Sydrome” and pain around the sacro-iliac joint.
Treatment at the Harley Street Spine Clinic
Wherever possible we aim to offer non invasive solutions for Lateral Recess Stenosis. Appropriate candidates are offered our IDD Therapy Programme involving a course of computerised spinal distraction accompanied by and one to one corrective exercise to promote postural awareness and improve core muscle strength.
More recalcitrant cases may be offered spinal injections in addition before referral for spinal surgery is considered as a last result. Patients who have undergone previous spinal surgery are offered our post-operative spinal therapy programme.