Spinal stenosis is a medical condition involving the spine: the spinal canal narrows and compresses the nerves and spinal cord. Needless to say, this can be quite painful. There are different causes for this condition, namely aging, spinal disc herniation, osteoporosis, or a tumor. Any of the three parts of the spine—cervical, thoracic, or lumbar—can be affected, and sometimes it can be present in all three. The symptoms are easy to identify and are pretty much the same in each individual. The symptoms and surgery to correct spinal stenosis will be discussed in this article.
Symptoms of Spinal Stenosis
The symptoms are clear-cut and simple: pain, weakness, and tingling in the legs.
Surgery for Spinal Stenosis
After the diagnosis is made that the condition is indeed spinal stenosis, surgery will be the treatment of choice if the stenosis is advanced.
To determine if your spinal stenosis has advanced and if you should have surgery, you should meet the following criteria: non-surgical treatments haven’t been successful for you; you’ve experienced severe pain for a long time; you have pain, numbness, and tingling in the arms or legs; you’ve lost sensation in your arms or legs; you have decreased motor function in the arms and legs; or you’ve lost bladder control.
Things to consider
There are some things to consider before opting to have surgery: 1) it must be exactly known on which part of the spine the surgery needs to be performed, 2) the surgery should not create a new problem, such as the damaging of a different nerve, 3) the surgical approach should be minimally invasive, and 4) the consideration of the patient’s metabolic and physical status is important. However, besides all that, surgery to treat spinal stenosis is often very rewarding and relieving for the patient.
Goal of surgery
The goal of surgery is for decompression: to free up the spinal cord and the spinal nerves.
This is one type of surgery for spinal stenosis. It removes the tissue that is pressing on a nerve, but there are three different kinds of decompression category.
Foraminotomy: This is done if part of a disc or bone spur is pressing on a nerve as it leaves the vertebra (this area is called the foramen). The foramen is made into a larger opening so the nerve can exit without being compressed.
Laminotomy: In this type of decompression surgery, a larger opening is made in the bony plate protecting the spinal canal and spinal cord (called the lamina).
Laminectomy: When a laminotomy is not sufficient, a laminectomy is done to remove all or part of the lamina.
This type of surgery is helpful when one or more discs has slipped out of place (which makes the spine unstable). During the surgery, the surgeon makes it possible for the bones in the spine to fuse together over time; this is done with a bone graft or biological substance. Sometimes wires, rods, screws, or the like will be used to increase stability and help fuse the bones.
The surgery will require a slow and lazy recovery. You’ll be out of bed within 24 hours, but on pain medications for 2-4 weeks, which require you not to drive. You’ll have to be careful about sitting, standing, and rising; restriction of activities is a must. Avoiding contact sports, twisting, and heavy lifting will help you have a smooth recovery. Always report any problems that you have to your doctor after the surgery.
Risks of Spinal Stenosis Surgery
Risks of this surgery include: adverse reactions to anesthesia, injury to the spinal cord or nerves, non-healing of the bony fusion, failure of the condition to improve, instrumentation breakage or failure, infection, and pain in the site of the surgery.