Stenosis Surgery

Overview

Stenosis is a condition that can develop as a person ages, particularly for people over 50. It is characterized by a narrowing of the spinal canal, which places pressure on the spinal cord and nerves, because there is not enough room for them. It resembles placing a ring on your finger. If the finger becomes injured or inflamed, the ring constricts and causes pain. The pain caused by stenosis is typically focused in the low back area and can shoot down the legs and flare up after walking or exercising.

What causes stenosis?

Narrowing of the spinal canal may be genetic. However, the primary contributing factor to the development of stenosis is degenerative disc disease. As the spine undergoes changes in stability, density and size, this can result in less space for and more pressure on the spinal structures.

When one area of the spine is injured, it is more likely that spinal health in other areas will fail. Conditions that may encourage the development of stenosis include scoliosis, osteoarthritis, rheumatoid arthritis, spinal tumors and trauma.

What are the symptoms of stenosis?

Symptoms of stenosis include a deep aching in the low back, buttocks and thigh, and intense numbness or pain in the legs and sometimes the shoulders. Symptoms can be brought on by walking and exercise. If you have stenosis, you may notice that pain is sometimes relieved by sitting or by a position in which the spine is flexed forward and bending over. Pain is worse when you arch the back.

Consequently, people with stenosis may walk with a hunched over posture and find that their pain worsens when bending backward. Severe cases of stenosis will display more serious symptoms such as loss of bowel and bladder function and numbness in a leg.

What causes spinal stenosis?

Although degenerating discs are the most common cause of spinal stenosis, spinal tumors, injury, bone disease and other conditions can lead to stenosis as well. For example, primary stenosis results from diseases that are present at birth, while acquired stenosis is typically the result of degeneration in the spine.

How is spinal stenosis relieved?

In many cases, changing posture, specialized therapy and using spinal injections can control the symptoms for a period of time. Stenosis can be treated non-surgically for some, but many cases will require surgery in order to create more space around the nerves to achieve permanent relief of symptoms.

Surgery

If surgery is required to treat this condition, minimally invasive surgery may be an option. During surgery, the physician performs a laminectomy which removes a piece of the bone at the back of the vertebrae to gain access to the spinal canal.

Specially designed surgery instrumentation is then used to remove bone spurs and the lamina on the side of the approach. This is referred to as a lumbar laminectomy or lumbar decompression. Minimally invasive lumbar laminectomy generally involves smaller incisions, less pain following surgery, and less blood loss than traditional open laminectomy. Recovery is often faster than with a traditional approach.

Many patients with spinal stenosis are advanced in age. Minimally invasive lumbar laminectomy is easier to recover from than a traditional approach.

In most cases, a minimally invasive laminectomy is performed as an outpatient procedure.