Most people have good results from surgery and are able to return to a normal lifestyle after they heal. People tend to have less leg pain and can walk better afterward. However, surgery doesn't cure arthritis or other conditions that might have caused the spinal canal to narrow in the first place.
If nonsurgical treatment and therapeutic injections have not eased the pain caused by spinal stenosis, doctors at NYU Langone may recommend surgery to relieve pressure on nerves or the spinal cord.
Most patients with cervical or lumbar spinal stenosis respond well to non-surgical treatments (such as medication), so you may not need spine surgery. However, there are situations when you may want to go ahead with spine surgery.
Outlook (Prognosis)
Spine surgery will often partly or fully relieve symptoms in your legs or arms. It is hard to predict if you will improve and how much relief surgery will provide. People who had long-term back pain before their surgery are likely to have some pain after surgery.
Disability: In severe cases of spinal stenosis, a patient can end up permanently disabled. This may be through paralysis, or weakness so severe that it is impossible to stand and move as normal. It is not unreasonable to expect severe stenosis to lead to a person being bound to a wheelchair.
The latest lumbar spinal stenosis treatment has been referred to with many different names, including non-fusion implant and dynamic stabilization system, among others. These names all refer to devices that are used in place of spinal fusion to provide stability and symptom relief.
"Unfortunately, nothing can stop the progression of spinal stenosis, since it is due to daily wear and tear," said Dr. Hennenhoefer. "The symptoms of spinal stenosis typically respond to conservative treatments, including physical therapy and injections."
Success Rates of Lumbar Laminectomy for Spinal Stenosis. The success rate of a lumbar laminectomy to alleviate leg pain from spinal stenosis is generally favorable. Research suggests: 85% to 90% of lumbar central spinal stenosis patients find relief from leg pain after an open laminectomy surgery.
A decompression laminectomy is the gold standard of surgery for treating spinal stenosis. This surgery removes the bony spurs and buildup of bone in the spinal canal, giving more room for the spinal cord and nerves.
Most spinal stenosis cases can be successfully treated without surgery. In fact, an estimated 70% of patients with lumbar spinal stenosis can effectively manage their symptoms with non-surgical treatments alone. Only 10% to 15% of lumbar stenosis patients must undergo surgery for their symptoms.
Many people with mild spinal stenosis find that nonsurgical treatments such as pain medication and physical therapy relieve symptoms and help them remain active. NYU Langone spine specialists work with experts in pain management, rehabilitation, and orthotics to create a treatment plan.
“If back pain is interfering with quality of life, your ability to work or isn't responding to standard treatments, then surgery may be called for.”
Stenosis is considered severe when it causes loss of certain functions or disabilities, or when other treatment options have failed to relieve symptoms. You should consult an expert neurosurgeon to assess your symptoms.
You'll be encouraged to walk and move around the day after surgery and it's likely you'll be discharged 1 to 4 days afterwards. It will take about 4 to 6 weeks for you to reach your expected level of mobility and function (this will depend on the severity of your condition and symptoms before the operation).
It may be four to six weeks before you can comfortably go back to work. Full recovery from spinal fusion surgery can take between six months to a year to resume normal activities.
People with spinal stenosis may experience numbness, weakness or cramping in legs, pain going down the leg, abnormal bowel or bladder function, and loss of sexual function. In severe cases, spinal stenosis may cause partial or complete leg paralysis that requires emergency medical treatment.
All surgery has some risks, such as bleeding, infection, and risks from anesthesia. Risks from surgery for spinal stenosis include damage to the nerves, tissue tears, chronic pain, and trouble passing urine. You may not be able to go back to all of your normal activities for at least several months.
There are several nonsurgical options available to treat spinal stenosis. In fact, most cases of spinal stenosis improve without the need for surgery. Often, finding an effective solution for spinal stenosis requires a combination of therapies, such as medication combined with physical therapy.
As there is no cure for spinal stenosis, early detection, and treatment of the root cause can provide significant pain relief and improve symptoms.
If your stenosis symptoms don't respond to home remedies or conservative treatment, or if the condition is so painful or debilitating that it affects your daily life, then you likely have severe spinal stenosis.
Walking is a good exercise for spinal stenosis. It's low impact, and you control the pace and distance.
Walking, standing, or extending the lumbar area of the spine can cause symptoms to worsen. Sitting or flexing the lower back or neck may relieve symptoms. The flexed position “opens up” the spinal column, enlarging the spaces between vertebrae at the back of the spine.
The two main surgical procedures to treat lumbar spinal stenosis are laminectomy and spinal fusion. Laminectomy: This procedure involves removal of the bone, bone spurs, and ligaments that compress the nerves. Spinal fusion: In this procedure, two or more vertebrae are permanently fused together.
The most common conventional treatments for spinal stenosis at L4 and L5 include: Physical therapy, which may involve strengthening and flexibility exercises, stabilization, joint mobilization, heat or ice therapy, and massage.
While anti-inflammatory medications may ease symptoms, in the long run you may be better off changing your posture and the way you move. Surgery is a good option for some people with lumbar spinal stenosis. But, for some people, physical therapy can often achieve good results with fewer risks.