Lumbosacral stenosis is a narrowing of the spinal canal at the junction of the lower (or lumbar) spine and the pelvis (or sacrum).
The narrowing of the spinal canal results in the compression of and damage to the nerve roots and blood vessels in that region. The actual spinal cord ends in the lumbar spine, well above the lumbosacral junction, so lumbosacral stenosis doesn’t directly affect the spine. Instead, it affects the nerves that come from the spine and pass through the area, including the sciatic, pelvic, and pudendal nerves.
Lumbosacral stenosis is usually an acquired condition, occurring in middle-aged to older pets. Congenital cases also rarely occur. Breeds that are predisposed to lumbosacral stenosis include German Shepherds, Golden Retrievers, Labrador Retrievers, Boxers, English Springer Spaniels, Great Danes, Irish Setters, and Airedales. Small dogs and cats can also be affected, though it is much rarer in these pets.
Signs of lumbosacral stenosis are slowly progressive. Pets may have trouble rising or be reluctant to jump and play. They may stumble with their rear limbs and wag their tails less. These early signs are easily confused with other conditions, such as arthritis or degenerative myelopathy. As the compression continues, weakness will worsen and progress to include fecal and urinary incontinence.
Lumbosacral stenosis is often diagnosed presumptively instead of definitively. Your veterinarian will take into account your pet’s history, breed, clinical signs and the results of her physical and neurologic exam findings and may offer a diagnosis of lumbosacral stenosis based on that. Even with X-rays, lumbosacral stenosis can be difficult to diagnose, and further imaging, such as an MRI or CT scan, may be needed for a definite diagnosis.
The treatment of lumbosacral stenosis varies from conservative medical therapy to surgical intervention, depending on the severity of disease. Mild, intermittent pain can be treated conservatively with four to six weeks of rest and pain management, including the use of anti-inflammatories or steroids and other pain medications.
Surgical management should be considered for pets with neurologic deficits, severe pain, and when medical therapies have failed. The type of surgical correction performed will depend on the patient as well as the surgeon’s preference.
Pets with mild signs have a good chance of recovery with rest and pain medications, though some of these patients will eventually need surgery. Pets have a fair to good recovery rate when surgical intervention occurs before significant neurologic signs develop, but recovery rates drop significantly if fecal and urinary incontinence have already occurred.
It’s a given that aging pets will inevitably slow down in their later years, but if your pet is showing signs of lumbosacral stenosis, make an appointment with your veterinarian. The last thing you want is for your pet to be in pain, and your veterinarian can address these needs as well as set up a referral if surgical intervention is needed.