Treatment for Stenosis of the Spine
Stenosis is the abnormal narrowing or constriction of an opening or passageway in the body. Stenosis of the spine refers to the narrowing of the spinal canal — a painful condition that causes the spinal cord or nerves near the spinal cord to be pinched or compressed. When compressed, these nerves cause chronic back pain and leg pain — even paralysis in extreme cases — and usually require open back surgery or minimally invasive spine surgery to alleviate the pain. Stenosis of the spine can occur in the cervical, thoracic and lumbar regions, but the cervical and lumbar regions are the most commonly afflicted.
In the lumbar region, when the sciatic nerve — the largest nerve in the body — is affected, individuals will experience sciatica — a burning sensation often accompanied by numbness and tingling radiating from the lower back and upper buttock down the back of the thighs and leg. Extremely painful, sciatica can make walking, sitting for long periods of time and even sleeping extremely difficult. Lumbar spinal stenosis is the most common reason for open back surgery and minimally invasive spine surgery in the United States.
In cervical stenosis of the spine, the spinal cord is compressed, making it more dangerous than lumbar spinal stenosis. Compression on the spinal cord can lead to major body weakness and paralysis. Both lumbar and cervical stenosis of the spine occur primarily in adults 60 and older due to degenerative changes in the spine.
Depending on its severity, spinal stenosis may be managed by non-surgical treatments such as exercise and epidural injections, but when walking or routine activities become too difficult, decompression surgery is usually recommended to release pressure on the spinal nerves or spinal cord.
There are two primary types of decompression surgery — traditional open back surgery and minimally invasive spine surgery. Traditional open back surgery is performed under general anesthesia. During the procedure, the surgeon makes an incision to view and remove the material compressing the nerves or spinal cord. This may require cutting surrounding tissue, muscle and bone to access the affected nerves or area of the spinal cord.
Minimally invasive spine surgery is the most common type of decompression surgery performed today. It involves a much smaller incision and physicians utilize endoscopic cameras and lasers to magnify, view and precisely remove the compressing material. Minimally invasive spine surgery is performed under local anesthesia on an outpatient basis and often takes less than an hour.