Spinal Stenosis Surgery Study Yields Improvement for Most
As a follow up to our recent post about smoking and its risk to spine health and recovery following spine surgery, comes an article in the October issue of the journal Spine. The article reported a research study, which found that spinal stenosis patients showed improvement, to varying degrees, following surgery compared with patients treated in non-surgical methods. These findings held true with the exception of patients who were smokers.
What is spinal stenosis?
Spinal stenosis is characterized by a narrowing of the spaces within the bones that make up the spinal canal and the small areas through which nerve roots extend from the spinal cord toward the rest of the body. The condition usually occurs in the lumbar spine, but may also occur in the cervical spine in which case the risks are more serious. Spinal stenosis may arise from various causes but is most often associated with spinal changes that occur with aging such as thickening of ligaments, bone spur growths and vertebral disc breakdown. With less space available for the spinal cord and nerve roots, comes the risk for nerve compression and pain or in more serious cases, loss of function or mobility. In those cases, spine surgery is usually needed.
What treatments should be considered prior to surgery for spinal stenosis?
People who have pain while walking find that leaning forward from the hips alleviates some pressure, otherwise they may need to sit down. Stretching is also helpful as it opens up the area through which nerves need to pass. Lying flat on your back while bringing your knees toward your chest is helpful. If nerve pressure is the result of painful inflammation, anti-inflammatory medication like ibuprofen may help. Muscle relaxants, physical therapy to maintain flexibility, steroid epidural injection and prescription medication are all conventional treatments for this condition.
What spine surgery treatment is recommended for spinal stenosis?
In cases where all other forms of treatment have failed to offer relief, or in severe cases involving nerve damage, spine decompression surgery is warranted. Some procedures include:
- Laminectomy- removing the lamina, the thin bony protective layer covering the spinal canal, providing more room for the spinal cord.
- Discectomy- removing disc material pressing on the spinal cord or nerve roots.
- Foraminotomy- removing foramin (holes through which nerve roots pass) bone
- Spinal Fusion – fusing bone or vertebrae may be required when bone or a vertebral joint needs to be removed to relieve a pinched nerve.
The study published in Spine analyzed data from 419 patients who were treated with surgery and 235 patients who received non-operative treatment. Significant pain and function improvement was found in the surgical patients who were non-smokers. The researchers recommended that smokers headed for spine surgery stop smoking well in advance of the procedure to benefit from surgery.