Lumbar Spinal Stenosis Treatment Options

The symptoms of lumbar spinal stenosis (LSS) are pretty clear: severe pain when walking more than 50 feet, and relief when bending over or sitting. And the cause is usually clear-cut, too; it’s another sign of aging.

The good news is there are effective outpatient surgical procedures available when physical therapy, chiropractic and other conservative measures have failed to ease the pain of spinal stenosis.

What is Lumbar Spinal Stenosis?

LSS is a degenerative condition that typically comes from a lifetime of the lower spine supporting the supper body. As people age, the discs between the vertebrae, or spinal bones, become worn down. This causes the spinal canal to slowly narrow, effectively squeezingthe nerves that exit the spine. This pressure often leads to tingling, numbness, or sciatic nerve pain that radiates to the buttock, leg and groin. It can be excruciating.

Lumbar Spinal Stenosis Back Pain Treatment

People with LSS typically cannot walk father than 50 feet without feeling this pain and find relief when sitting down or leaning forward. A typical scenario is the older person at the grocery store hunching over a shopping cart to relieve the pain.Left untreated, muscle weakness, loss of reflexes, and sometimes a condition called foot drop can develop.

The goal in treating LSS with surgery is to gently widen the narrowed opening in the spinal canal, giving the spinal cord and nerves more room to function normally. While injections of numbing medication can keep the pain away for a certain period of time, sometimes surgery is the best option.

Minimally Invasive Spine Surgery (MISS)

Skilled surgeons no longer need to treat low-back stenosis with traditional open back surgery, which involves a 5- to 6-inch incision and the cutting of muscles to reach the spine. Instead, specialists can use narrow dilation tubes that spread muscles like a curtain, and tiny endoscopic instruments outfitted with cameras. This approach avoids damage to muscle and tissue.

“A cut or torn muscle is essentially damaged forever. It becomes weak and never functions the same way again,” says Dr. James St. Louis, an orthopedic spine surgeon with Physician Partners of American Minimally Invasive Spine Group. “In minimally invasive spine procedures, the muscle fibers are left intact. There’s less bleeding and pain, and the recovery is days or weeks, not months.”

A laser maybe used in these procedures to ablate pain-causing nerves and shrink bulging discs that cause spinal stenosis.

Foraminotomy – This procedure increases the width of the intervertebral foramen, or opening between a pair of vertebrae in the treatment area. A small tool called a Rongeur is used to remove small slivers of spinal bone.It allows more room for the exiting nerve and alleviates the painful compression.Thisis a minimally invasive outpatient procedure that requires only two or three stitches and allows the patient to go home the same day.

Laminotomy – This procedure targets the lamina, the bony cover of the spinal canal. The surgeon removes a small part of the lamina to relieve pressure on the nerve exiting the spinal cord. In experienced hands, this procedure will not harm the structure of the spine.

Interspinous Process Spacers for Lumbar Spinal Stenosis

Another alternative to traditional surgery is a spacer, which helps keep spinal bones separated while the patient is standing. This small device, implanted by an experienced surgeon, relieves pressure on the spinal nerves. Its effectiveness has been validated by years of clinical research and is FDA approved.

While the idea of “back surgery” may seem scary, minimally invasive procedures are nothing like traditional open back surgery. They are highly effective and safe, allowing the patient to walk out of the surgery center the same day and heal quickly. Most people report a steep reduction in pain and some are immediately pain free.

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Medicare’s Hospital Fines Could Improve Safety for Back Pain Patients

medicare fines for worst US hospitalsA stay in hospital is supposed to help restore us to health but for some patients it can have devastating consequences. Not only can routine surgery, such as common procedures for spinal stenosis, go wrong, hospital-acquired infections have become a major issue in the past few years, especially due to the rise of antibiotic-resistant organisms like methicillin resistant Staphylococcus aureus (MRSA). Now, however, Medicare is rolling out a new system where the worst performing hospitals will be hit with big fines for infections and avoidable injuries. Continue reading “Medicare’s Hospital Fines Could Improve Safety for Back Pain Patients” »

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The Facts About Bone Grafting for Spinal Stenosis Surgery

Spinal StenosisSpinal fusion, one of the most common types of spinal stenosis surgeries, requires a bone graft to facilitate the growth of new bone between two or more vertebrae. The graft is placed between adjacent vertebrae once an intervertebral disc has been removed. Over time, the graft helps the vertebrae to fuse into one solid segment of bone. The goal of this procedure is to stabilize the spine, relieve neural compression caused be the spinal stenosis, and eliminate pain caused by movement at the affected level of the spine. Continue reading “The Facts About Bone Grafting for Spinal Stenosis Surgery” »

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Spinal Stenosis Surgery – Can it Help Treat Symptoms Caused by the Narrowing in Your Spine?

Spinal Stenosis SurgeryIf you’ve been diagnosed with spinal stenosis, surgery will probably not be part of your treatment plan right away, if at all. In fact, most patients with spinal stenosis are able to find relief from a regimen of conservative, nonsurgical treatments, such as anti-inflammatory drugs, pain medication, physical therapy, and others.

So, how do you know when it might be time to start exploring your surgical options?

Continue reading “Spinal Stenosis Surgery – Can it Help Treat Symptoms Caused by the Narrowing in Your Spine?” »

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Considering Herniated Disc Surgery? Make Sure You’ve Done This Before Giving Consent.

Herniated Disc SurgeryBefore consenting to herniated disc surgery, almost every patient suffering from the effects of this degenerative condition should create a checklist of items to consider. In most cases, spine surgery for a herniated disc is considered an elective procedure, which means unless there is a life-threatening condition or a spine specialist considers it a matter of urgency, most people can afford to give the decision and supporting research the time they deserve. Continue reading “Considering Herniated Disc Surgery? Make Sure You’ve Done This Before Giving Consent.” »

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Minimally Invasive Spinal Stenosis Treatment – What Are My Options?

Spinal stenosis treatmentSpinal stenosis treatment in the form of an endoscopic procedure may be an option for people who have attempted several months of conservative (nonsurgical) treatments without finding sufficient relief from their symptoms. Minimally invasive procedures performed through an endoscope offer a variety of benefits over highly invasive open spine surgeries, including the fact that they can be performed on an outpatient basis (no hospitalization). Endoscopic spine surgeries also involve fewer risks and require a much shorter and less painful recovery period than that of an open spine surgery. Continue reading “Minimally Invasive Spinal Stenosis Treatment – What Are My Options?” »

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What to do Before and Immediately After You Consent to Slipped Disc Surgery

Slipped disc surgerySlipped disc surgery should never be agreed to without researching the potential side effects and risks. Surgery is almost always the last resort for someone suffering from debilitating pain and other symptoms associated with a slipped disc (or, more properly, a herniated disc). Of course, if you have begun to consider surgery to alleviate your symptoms, chances are you already have held several – perhaps many – conversations with your physician or back specialist about your options.

You might also have attempted to treat your symptoms with a wide variety of conservative, nonsurgical treatment methods, only to find that your symptoms remain debilitating and your quality of life continues to deteriorate. At this point, it is certainly reasonable to begin your research into slipped disc surgery.


Continue reading “What to do Before and Immediately After You Consent to Slipped Disc Surgery” »

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Spinal Stenosis Surgery – Understanding Your Options

Spinal Stenosis SurgeryIf you’re one of the relatively few patients for whom elective spinal stenosis surgery becomes an option, it’s important to ask your physician about the surgical procedures that may be available to you. The specific procedure or procedures you ultimately choose to undergo will be highly dependent on your unique situation, but most procedures will focus on treating stenosis, or narrowing, in spinal passageways by enlarging the space within the spinal canal to decompress the spinal cord, or within an intervertebral foramen to decompress a nerve root. Continue reading “Spinal Stenosis Surgery – Understanding Your Options” »

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Foraminal Spinal Stenosis Surgery

back-surgery-setting-expectations

Foraminal spinal stenosis surgery is rarely needed urgently and is, instead, often scheduled only if conservative therapies have failed.

Foraminal spinal stenosis surgery is normally treated conservatively for the first six months of symptoms at which point patients who have not improved or found ways to manage the condition may be considered eligible for back surgery. Acute foraminal stenosis causing severe neurological symptoms may necessitate earlier surgery to free trapped nerves and prevent permanent damage and long-term effects of spinal stenosis. Such acute need for foraminal spinal stenosis surgery is rare, however, as the condition tends to develop over time and create earlier milder symptoms of intermittent nerve compression before severe symptoms arise. Continue reading “Foraminal Spinal Stenosis Surgery” »

When is Spinal Stenosis Surgery Indicated?

when is spinal stenosis surgery necessary severe cervical myelopathy mri

Severe cervical myelopathy like this necessitates immediate spinal stenosis surgery.

Conservative treatment for spinal stenosis is the standard approach but patients continuing to experience severe back pain or other symptoms of nerve or spinal cord compression are usually considered for spinal stenosis surgery.

As a general rule, those whose symptoms are severe enough to impact on self-care, such as becoming unable to go on short shopping trips or bathe oneself, are recommended to undergo surgery. Even in these cases, however, there are those for whom surgery is simply too risky due to other health considerations, the potential for complications from anaesthesia, and the risk of infection after spinal stenosis surgery. When is spinal stenosis surgery indicated? That depends on the individual, their symptoms, and a wide variety of factors.
Continue reading “When is Spinal Stenosis Surgery Indicated?” »