Spinal stenosis

Spinal stenosis, a narrowing of the spaces within your spine,  through which the spinal cord passes, usually occurs due to wear and tear in the lower or upper back area, due to osteoarthritis. This narrowing can cause pressure on the spinal cord and the nerves coming out of it, and consequently discomfort, pain and even weakness of the back and lower limbs.

The goal of treatment is to relieve stress and control the symptoms that limit you.

When is the procedure performed?

The choice of treatment for stenosis depends on the location and degree of stenosis, as well as the severity of the symptoms that developed due to it. In mild cases, treatment through a combination of exercise, lifestyle changes, injections or medications, can help control symptoms and prevent deterioration.

In advanced cases of stenosis, the doctor may recommend surgery to release the pressure from the canal.

The course of the surgery

During the operation, the surgical team produces an opening in the back in order to reach the narrowing area. The tissues that narrowed the spinal cord passage in the canal are then removed.

In the case of a part of the vertebra, an operation called a laminectomy or laminotomy may be performed, in which part of the vertebra is removed to reduce the narrowing.

Another possible surgery is a laminoplasty, where the space in the spinal canal is widened. In the case of wider parts, an operation called 'vertebral fusion' may be performed.

Another option that may suit certain patients is surgery with a minimally invasive approach. In this approach, smaller openings are made and tiny tools are used to treat the narrowing, which can shorten the recovery time.

The surgery can be performed under general or local anesthesia and lasts from an hour to several hours, depending on the surgical technique chosen.

Preparation for surgery

Before the operation, an orthopedic specialist will examine you, your medical file and the preliminary exams that have been performed on you. You will sometimes be asked to perform additional imaging tests, such as MRI or CT, that can help the surgeon plan the surgery with the most appropriate approach for you.

In addition, an anesthesiologist must perform an evaluation before the operation in order to select the appropriate method of anesthesia. You should be in complete food fast mode as per the instructions of the medical staff.

Recovery after the procedure

After surgery, hospitalization is usually needed for several nights, although it is at times possible to begin walking after a short recovery. If the recovery is good, you can be discharged home within about three days, in accordance with the recommendation of the surgeon.

Returning to routine activities and work is conditional on the recommendations of the attending physician and the pace of your personal recovery. It is important to maintain a posture that facilitates recovery of the back while sitting and walking, and to perform physical therapy as recommended by the medical staff.

Possible complications

Various studies have shown that in spine surgeries the percentage of complications is lower the richer the surgeon's experience is in the field. Surgical treatment allows relief of symptoms in most cases of spinal canal stenosis. However, for some people the symptoms do not improve and sometimes even worsen.

Other possible complications include local infection, damage to one of the membranes that cover the spinal cord, development of a blood clot in the veins of the legs and sometimes even neurological damage.