Spinal stenosis surgery is used as a last resort for patients whose neck or back pain is severe enough that it limits their ability to work, exercise or participate in sports. Spinal stenosis is often caused by age-related wear and tear, especially in the lumbar (lower back) region of the spine. To learn more about the causes, symptoms and standard treatments of spinal stenosis, visit both our diagnosing spinal stenosis and spinal stenosis treatments pages.
Spinal stenosis surgery options
Spinal stenosis (narrowing) is most commonly experienced in the lumbar, or lower back, region of the spine. That’s because the spinal anatomy of that region is under the most stress related to movement and body weight. Spinal stenosis in the lumbar region can lead to compression of the sciatic nerve, which is the longest nerve in the body; this nerve originates in the lower back and extends through the buttocks, down the back of the legs and into the feet. Sciatic nerve compression can produce a set of symptoms known as sciatica, which can include radiating pain, a burning sensation, tingling, numbness or muscle weakness in the lower back, buttocks, legs or feet. These symptoms usually can be managed with a regimen of conservative treatments, which may include non-steroidal, anti-inflammatory drugs (NSAIDs), exercise and stretching. However, not everyone finds relief using conservative treatment.
Once it is decided that your symptoms are not responding to conservative treatments – a process that typically takes several weeks or months – there are three main types of spinal stenosis surgery that might be recommended.
The first, and the most common, is a laminectomy. Its goal is to relieve pressure on the nerve root that is the source of your pain. During this procedure, a surgeon removes all of one vertebra’s lamina (the thin, bony layer covering the spinal canal and spinal cord) to create more space for the nerves. At this time, bone spurs or herniated discs may also be removed.
The second procedure that can alleviate pressure by opening up the spinal canal is a laminotomy. This is done by removing a portion of the lamina to increase the amount of space for nerves and also to release entrapped nerves.
The third type of spinal stenosis surgery is called foraminotomy. During this procedure, a surgeon cleans out bone, tissue or other blockages that have narrowed the vertebral passageways called the foramina. There is a pair of these passages on either side of each vertebra, and nerve roots travel through them to exit the spinal canal and reach other parts of the body. By cleaning out the bone growths and other tissues that may be narrowing this area, more room is created for nerve roots to pass through.
Spinal fusion risk
Many surgeries for relieving spinal nerve compression include a procedure called spinal fusion. Fusion is used to help the spine regain stability after the surgical removal of bone, disc and other tissues. Fusions, which involve additional steps after a nerve decompression surgery, are more likely to be needed following laminectomy. This is because a whole section of the vertebra, the lamina, is completely removed during that procedure, leaving the spine in a weakened state.
Open back spinal stenosis surgery that requires traditional open spinal fusion carries several risks. These risks are classified under the general condition known as failed back surgery syndrome (FBSS) and could be related to infection, hardware failure, bone graft rejection, nerve damage and other potential side effects and risk factors.
At Laser Spine Institute, our surgeons and medical experts have experienced great success using effective, minimally invasive techniques to treat spinal stenosis. With a quicker recuperation period than other treatments like open back surgery, our minimally invasive, outpatient procedures can help you return to an active lifestyle. Our procedures require smaller incisions, no hardware insertion, no bone graft material and also have a higher rate of success than open back surgeries. If you would like a review of your MRI or CT scan, or want to learn more about our state-of-the-art facilities, contact us today.