Spinal stenosis occurs when the space within the spinal column narrows. This causes tightness around the nerves traveling within the spinal column. This condition is most common in people over the age of 50, and the most common cause is spinal arthritis. As a result of arthritis, ligaments can thicken and bone spurs can develop. These abnormalities crowd the nerves, leading to pain and disability.
- Radiating pain or heaviness in the leg(s) with walking or standing
- Low-back pain
- Numbness and tingling that radiates down the leg(s)
- Neck stiffness and pain that becomes worse with activity
- Weakness or numbness within the arm(s) or hand(s)
- Pain in the back of the head with headaches
- Difficulty with balance
TREATMENTS FOR SPINAL STENOSIS
There are nonsurgical and surgical treatment options available for spinal stenosis. Both treatment types are performed by our back, neck, and spine specialist at Orthopaedic Specialists.
While there is no cure for spinal stenosis, in some cases, medication, physical therapy (traction), injections, or regular exercise can provide relief to patients. Over-the-counter medications, such as Tylenol, Advil, Motrin, or Aleve, may relieve pain. Epidural steroid injections, in many cases, provide a great deal of relief for patients. These may be temporary, but depending on the patients’ medical status and activity level, they may be appropriate.
Laminotomy (Minimally Invasive)
Each vertebra of the spine consists of a vertebral body on the front side and a bony canal on the back side. In between each of these is a disc. The back part of the spine, or the bony canal, houses the spinal cord and nerves. The back side of the canal or “roof” of this canal is referred to as the lamina. Minimally invasive laminotomy involves the removal of a small area of this lamina on either one or both sides of the spinal nerves to allow for decompression of the nerves. The procedure takes approximately 30 minutes and is done on an outpatient basis. Patients are allowed to return to activity as tolerated immediately, letting their postsurgical pain guide them.
Laminectomy (Minimally Invasive)
Minimally invasive laminectomy is a surgical procedure that removes the entire lamina, or bony “roof” to the spinal nerves. The goal of this procedure is to alleviate pressure on the nerves. This procedure is one of the most successful procedures when performed on the appropriate patient. The procedure takes approximately one hour. Patients are typically able to go home on the same day of surgery. Because of the minimally invasive approach used by our back and neck surgeon, Dr. Michael Dolphin, patients are allowed to return to activity as tolerated, allowing their postsurgical discomfort to guide them.
Anterior Cervical Discectomy With Fusion (Minimally Invasive)
Cervical stenosis can be relieved through the front of the neck (anterior approach) to alleviate pain, numbness, and tingling resulting from nerve root and spinal cord pressure. This procedure is utilized in situations where bone spurs are causing nerve compression. Careful surgical technique allows for removal of the bone spurs, relieving the nerve/spinal cord compression. When performing this procedure, stabilization of the disc space is then performed in the form of a fusion. Typically, a plate and screws made of metal are inserted to provide immediate spine stabilization while the bone fusion is healing. Dr. Dolphin performs this procedure with a minimally invasive approach, through an incision approximately one inch in length, allowing for a quicker recovery and also the ability to do the procedure on an outpatient basis.
Posterior Cervical Laminoforaminotomy (Minimally Invasive)
Dr. Dolphin performs the posterior cervical laminoforaminotomy procedure for isolated cervical stenosis caused by bone spurs in specific locations of the neck. The patient is positioned in a sitting position, and utilizing a muscle-sparing approach, the bone spur is removed. This relieves the pressure on the nerve(s), improving the numbness and radiating pain down the arm. The cervical laminoforaminotomy is a minimally invasive procedure that relieves pain and numbness without performing a fusion. Compared to the cervical fusion, this allows for a completely normal range of motion after surgery as well as less chance for future neck deterioration.