Nursing Management of Postoperative Lumbar Spinal Canal Stenosis

Abstract

Spinal stenosis most commonly occurs at L4-5, with 91% of patients experiencing nerve compression at this location. It results from a degenerative process that begins in the intervertebral disc, as viable cell counts, water, and proteoglycan content decrease in the nucleus pulposus. The disc height decreases as the nucleolus pulposus degenerates and the annulus fibrosus bulges. Stenosis is generally classified by descriptive elements, such as etiology (i.e., degenerative or congenital), location (i.e., central, lateral recess, foraminal, or extraforaminal), and severity of narrowing on advanced imaging (mild, moderate, or severe). The primary case study in this case report is LSCS, where the researchers explored the patient’s problems and nursing care. Mr. A (68 years old) was admitted to the 6th floor (Surgery) ward with complaints of low back pain that had been felt for the past 7 months. Pain scale 6-7 (NRS), felt intermittent, sometimes disturbing sleep during the day or night. The pain radiates from the waist to the left leg. The patient is bedridden and cannot walk, and only gets up to a body elevation position of 30 ° for 7 months. The client experienced a decrease in extremity muscle strength. The results of the MRI examination showed the patient had lumbar spinal canal stenosis. The nursing problems experienced by Mr. A were resolved after 6 days of nursing intervention. The patient showed a decrease in pain to a scale of 2-3 (mild pain), improved physical mobility, decreased falls, and decreased knowledge deficit.