Foraminal stenosis between the L5 and S1 vertebrae involves a narrowing (stenosis) in a passageway (foramen) located in the lower spine where nerve roots branch off the spinal cord and travel down the legs. More specifically, the L5 and S1 vertebrae mark the location where the last vertebra of the lumbar spine (L5) meets the top of the sacrum (S1), forming a junction known as the lumbosacral joint.
Not only are the L5 and S1 nerve roots the most commonly pinched nerves in the lower back, but these nerves also feed into the sciatic nerve – a long nerve that travels from the lower back, through the buttocks, down each leg and into the feet. When foraminal stenosis, or narrowing, is present in the L5 and S1 spinal segments, the sciatic nerve can become pinched or pressured, leading to sciatica, which involves pain, tingling, cramping and numbness that starts in the lower back and travels through the pelvic region, buttocks and typically down one leg to the hamstring and bottom of the foot.
In a normal spine, the bony vertebrae have bilateral foramen (or holes), which allow sets of spinal nerves to branch off the cord on the right and left and pass through to the body. If one or more of the foramina becomes constricted, a spinal nerve root can become compressed, causing pain and interruption in the nerve’s signals. Lumbar foraminal stenosis (in the lower back) is particularly common and troublesome because it can pinch the sciatic nerve as it leaves the spinal column, leading to intense burning, traveling pain through the buttocks, leg, calf and toes, as well as tingling, numbness and muscle weakness.
Foraminal stenosis at the L5 and S1 level can be caused by many issues, including:
- Degenerative disc disease
- Arthritis of the spine
- Herniated, bulging, or ruptured discs
- The presence of a tumor, bone spur or other growth
A physician will typically try to first treat chronic lower back or sciatica pain with a non-surgical treatment plan. In the event that a combination of physical therapy, pain medication and the application of heat and ice are ineffective, surgical treatment becomes an option. The traditional approach to addressing foraminal stenosis has been open back surgery, but at Laser Spine Institute, our surgeons offer several minimally invasive, outpatient alternatives.
Our procedures decompress nerves by carefully removing the bone and tissue causing the foraminal stenosis. Patients also benefit from a much quicker recovery and less pain than with an open back procedure.
Contact Laser Spine Institute today for a complimentary review of your MRI or CT scan and to learn more about the minimally invasive spine procedures currently available to help you find meaningful pain relief.