Spinal stenosis is an abnormal narrowing of the spinal canal that can place restrictive pressure on the spinal cord and nerve roots in the back. Although not all individuals with stenosis experience significant difficulties, at its worst the condition is extremely painful and debilitating. In many advanced cases, doctors recommend surgery to relieve the damaging pressure of stenosis. While surgery may indeed provide at least some relief, it is best understood as a partial solution to a complex medical problem.
Nonsurgical Options
Surgery for spinal stenosis is generally considered only after nonsurgical methods of relief have failed. If you have received a spinal stenosis diagnosis, but have not exhausted nonsurgical options, your quest for treatment should begin there. Options for nonsurgical treatment include regular exercise, organized physical therapy, anti inflammatory medications, lumbar traction, steroid injections, chiropractic manipulation and acupuncture. Spinal stenosis is a very individual ailment, and treatments that work well for one patient may not work at all for another. Consult your doctor for a full explanation of your options, and discuss which of them may be appropriate for you.
When Surgery is Indicated
If you have exhausted nonsurgical options, there are additional choices for you to make. First, doctors generally recommend surgery only in those cases where the effects of uncontrolled stenosis have significantly degraded quality of life. If you are in this category, you likely have pain that allows you to walk only for very brief periods of time. Since spinal stenosis is degenerative; your condition will not improve on its own. Given these circumstances, surgery may be the only reasonable option.
Surgical Options
The general purpose of stenosis surgery is relieving pressure on the spinal cord while retaining the strength and integrity of the spine and surrounding muscles. There are several types of surgery that will achieve this objective. Your doctor's preference and your particular situation will determine which option is right for you.
Decompressive laminectomy is a procedure in which the entire back sections (lamina) are removed from the spinal bones to allow more room for the spinal cord. It is performed either as an open surgery or as a laparoscopic procedure. In either case, extensive complications from surgery are possible, including infection, blood clots and nerve deterioration.
Laminotomy is a more limited procedure in which only parts of the lamina are removed. While post-surgical healing may be quicker, the dangers of laminotomy are more or less identical to those of laminectomy.
Fusion is a procedure to stabilize the spine by surgically joining two or more spinal bones. It is sometimes performed along with a laminectomy.
Postsurgery Prognosis
While each of these procedures may lessen your stenosis-related pain, they also carry limitations beyond the potential risks of the operation itself. Recovery from such invasive surgery can take several months, and will require a commitment to extensive rehabilitation. Additionally, surgery cannot stop spinal stenosis, only relieve its effects. Even after surgery, your symptoms very well may return. In order to get a full picture of your outlook for recovery, consult your doctor and surgeon.
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