Spinal Stenosis Surgery

Overview

Spinal stenosis is a narrowing of the spinal column’s canal leading to pain due to pressure on the spinal cord and other nerves. It is typically seen in middle-aged people or older with narrowing from arthritis, bone spurs or trauma.

Symptoms include:

• Numbness or weakness
• Cramping in arms or legs
• Difficulty walking
• Pain in the neck, back or legs

Spinal stenosis surgery reopens the spinal canal to alleviate the pressure and pain. 

There are three types of spinal stenosis surgery.

Spinal Stenosis Surgery Types

• Laminectomy

This is most common type of surgery where bone, ligament segments and spurs that are pinching the nerves are removed.

• Foraminotomy

The vertebrae sections where the nerve roots branch out are expanded.

• Spinal Fusion

Occasionally done in conjunction with a laminectomy, spinal fusion joins some vertebrae together so that spinal motion is decreased, using rods or metal screws.

All other options should be considered and exhausted prior to considering surgery since the actual surgery doesn’t address the medical conditions like arthritis, which caused the spinal canal to narrow to begin with.  Symptoms may recur after surgery. 

In addition, there are surgical risks including possible infection, excess bleeding with blood clots and possible nerve damage.

Surgery should only be considered if the alternative options do not give the pain relief needed to function on a daily basis.

Alternative Options

There are three main options to consider which chiropractors and physical therapists can help with.  They involve lifestyle changes, exercises, and pain medications.

1. Lifestyle Changes

• Weight loss is highly recommended as it aids in strengthening muscles and makes walking easier. The weight loss also helps in decreasing the strain on the spine.
• Consider smoking cessation programs and avoid smoking (and vaping), which helps the healing process.
• Keep diabetes under control with proper medication and a healthy diet. 

1. Physical therapy/Exercises

• Chiropractors and therapists can work with you and instruct how to perform specific exercises to strengthen back and abdominal muscles and control pain. Chiropractors can adjust your spine to improve activities and movements while lowering pain.  Traction may also be used to create more space for the nerves.
• Acupuncture may ease pain by putting pressure on specific body areas. Tiny, flexible needles are inserted through the skin in this process.
• Consider chair Yoga, massage and Tai Chi.

1. Pain Relievers

Nonprescription medications like acetaminophen (Tylenol), naproxen (Aleve) and ibuprofen (Motrin, Advil) have been found to decrease pain.

Your doctor can inject cortisone (steroid) into the spinal canal to reduce pain and inflammation in your back in the short term.  Occasionally the relief is permanent.

Epidural injections are sometimes used where pain-numbing medication is inserted into the epidural space  just outside of the membrane protecting the spinal cord).

 

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SOURCES:

National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Questions and Answers about Spinal Stenosis.”

American Academy of Orthopaedic Surgeons: “Lumbar Spinal Stenosis.”

Uptodate.com: “Lumbar spinal stenosis: Treatment and prognosis”

Mayo Clinic: “Stress Management — Tai chi: A gentle way to fight stress.”