Spinal ailments are some of the major causes of chronic pain, and are caused by a variety of conditions.
Spinal stenosis is a fairly rare condition in which the spinal canal can start to narrow, exerting pressure on the spinal cord and nerves. This causes numbness, tingling, and often pain in the arms, legs, torso or back. It often requires spinal stenosis surgery.
Spinal stenosis most commonly occurs in those above 50 years of age and can be categorized into two main types—Lumbar Stenosis and Cervical Stenosis.
Lumbar Stenosis- This affliction targets the spinal nerve roots in the lower part of the back, often producing symptoms of sciatica—tingling, weakness or numbness that radiates from the lower back and spreads to the hips and legs.
Cervical Stenosis- Rarer than lumbar stenosis, cervical stenosis is characterized by pain in the neck and is often more dangerous than lumbar stenosis. Compression of the spinal cord can lead to serious problems—often even paralysis.
The treatment involved in spinal stenosis can be fraught with dangers, and must be ventured into only with a qualified and experienced medical professional. Cervical spine surgery recovery can take three months to a year.
Neurological surgery and spine surgery are extremely invasive and critical procedures, as the target area is the spinal cord. A minor slip by the physician can cause extreme complications, including patient paralysis.
Here are 10 important things to keep in mind if you are contemplating corrective surgery to treat spinal stenosis:
- Spinal stenosis surgery is often seen as the last resort in treatment.
Physicians don’t often recommend spinal stenosis surgery unless all other options have been exhausted.
Your doctor will most likely try to treat spinal stenosis with other, non-invasive options like exercise, physical therapy and perhaps, a back or neck brace, before resorting to surgery.
Some considerations physicians keep in mind when recommending stenosis of the spine surgery are:
- If the patient has been suffering pain from a long time
- Whether stenosis has caused numbness or loss of sensation in the limbs
- Loss of control over bowel movement
- Loss of strength and control in the arms and legs.
- Spinal stenosis can often be treated non-surgically.
Exercise, physiotherapy and physical constrictions can often clear up mild cases of stenosis, without requiring surgery.
Doctors may prescribe one of more of the following, non-invasive modes of treatment.
- Medication to alleviate pain
- Exercises to correct spinal narrowing
- Medicines to reduce swelling
- Physical therapy with a qualified physiotherapist
- Limits on physical activity
- A brace or similar constrictive instrument for the back.
Spinal cord stimulation is also a mildly invasive, but very effective form of treatment that can help in alleviating spinal stenosis symptoms.
- Prepping for surgery.
Spinal stenosis surgery often requires specialized blood tests, ECG, urinalysis, cardiovascular, pulmonary, and other tests to determine the patient’s health condition.
In addition, patients may be asked to follow a special diet before surgery, refrain from smoking and the use of anticoagulants such as Coumadin and Aspirin, as these can interfere with the natural process of blood coagulation.
- Reasons you could need spinal stenosis surgery.
Surgery should be considered only if you :
- Have exhausted all other treatment options.
- Suffer from chronic and extreme pain.
- Have low motor strength or loss of sensation in your arms and legs.
- Have little to no control over bowel movements.
- Surgery Techniques.
Spinal stenosis surgery is done to free up areas for your spinal cord and the nerve roots. This is called decompression.
The two main surgery techniques that are often employed in spine surgery are:
- Decompression– tissue pressing against a nerve structure is removed, making more room for the spinal canal.
- Stabilization– limits motion between the vertebrae.
- Open Spine Surgery or Minimally Invasive Spine Surgery?
Surgery usually performed by means of a deep incision in the back is called open spine surgery; the minimally invasive procedure is performed via several, smaller incisions requiring the use of a microscope, endoscope, and a tiny camera.
Minimally invasive surgery is by far the safer option; however, severe cases of spinal stenosis may require open spine surgery.
- Risks associated with surgery.
The potential risks associated with spinal stenosis surgery are:
- Injury to spinal cord/nerves
- Anesthesia risks
- Pseudoarthrosis (this is where the bony fusion doesn’t heal as well as it should)
- Bone graft site pain
- Instrument breakage or failure.
- Surgery Outcomes.
Spinal Stenosis surgery yields good results: 80-90% of patients report alleviation of pain levels. However, it doesn’t cure the condition instantly.
Patients may require pain medication for 2-4 weeks and additional time before returning to normal physical activity.
- Recovery Period.
The recovery period for spinal stenosis surgery is usually three to six months, but it can last up to a year.
Your doctor will probably instruct you on carefully sitting, standing and moving, to avoid any strain on the spine.
The body needs time to heal after surgery, so it is advisable to avoid heavy lifting, sports or physical exertion during the recovery period.
Pain alleviation techniques and exercises can help here. However, be sure to consult your doctor before starting any sort of physical exercise, therapy or medication.
- Alternative treatments.
Non-conventional treatments for spinal stenosis include chiropractic adjustments and acupuncture. These can be undergone in conjunction with regular treatment methods.
Another proven way of treating stenosis is SPS (Spinal Cord Stimulation). Most patients having undergone the procedure report a 50 to 70 percent alleviation in pain, and studies suggest that SPS may affect the emotional perception of pain, as well.
Living with chronic pain can be punishing, and is never pleasant. Surgery is one of the ways out; however, other, non-invasive treatments can be just as effective.
Being aware of the risks, outcomes, and realities of stenosis surgery is an important part of the treatment and learning process. Never accede to a surgery unequipped with knowledge and research into the condition, its treatment, and the physician’s credentials.
To be forewarned is to be forearmed. Happy recovery!