With over 200,000 cases of spinal stenosis diagnosed each year, this condition is relatively common. That’s because it’s a condition that often occurs as an individual ages. There isn’t a whole lot you can do in order to prevent spinal stenosis, but you can do quite a bit in order to treat or manage the pain that you experience.
Spinal stenosis is where the different spaces in the vertebrae narrow, compressing the nerves. This can be the narrowing of the main spinal cord canal or even the facet joints that occur between vertebrae along the entirety of the spinal column. While there isn’t a whole lot that can stop this process from occurring, there are a wide variety of treatments available.
Spinal stenosis treatments fall into a couple of different categories. There are options that a minimally invasive and can provide pain relief, such as facet steroid injections. This injections can sooth the nerves and reduce inflammation. However, there are many different invasive spinal surgeries that are used by many specialists in order to treat the problem. Here’s the catch, depending on your specific situation, surgery may not be the best option, and on top of that, it’s exceptionally risky. Invasive spinal surgery should only be used as a very last resort. However, it’s important to be informed about your spinal stenosis treatment options, so the following are six surgery options available to treat severe spinal stenosis.
A lumbar laminectomy is the most common surgical treatment for spinal stenosis in the lumbar spine. This particular surgery can address both facet spinal stenosis and stenosis found in the main canal. A surgeon will typically take a dorsal approach and slice open the area of the lumbar spine from the back. After moving the muscles out of the way, they will then cut the vertebral bone in order to remove the lamina and the spinal process before closing up the surgical site. While this is an effective way to relieve the pinching on the nerves, it also opens up your spinal cord to risk, as there is no longer bone to protect it. This surgery has also been found to be about 80 percent effective in patients that undergo it.
A foraminotomy surgery is very similar to a laminectomy in terms of approach and final goals. However, instead of removing parts of the lamina in the vertebrae, the surgeon will remove bone in the intervertebral foramina in order to relieve pressure on nerves that exit the spinal cord. If the nerve is impinged on too much, it can cause pain and inhibit use. The expansion of the foramina has the possibility to create more space and relieve this pressure, especially if the specific pain site can be identified. This procedure is also the same if a facet is causing the offending pain.
Who would guess that a laminotomy and laminectomy were two different procedures? Here’s an easy way to remember the difference. A laminectomy, as described above, is a procedure to remove the lamina. That’s roughly what the suffix “-ectomy” stands for, the removal of. A laminotomy uses part of the laminectomy procedure and then goes one step further. Once the lamina have been expanded or removed, the surgeon then will access a herniated disc or bone spur that is causing additional pain, and remove it.
Currently there is only one device on the market that provides spacing between two spinal processes that may be “kissing.” This FDA approved device, known as the X-STOP, is implanted between two spinal processes and helps to create additional space from a collapsed disc or other causes of compression. This is one of a handful of surgical options that is less invasive than the others that we’ve described here, however, because it is a newer operation, success rates for pain relief can vary.
Many of these open surgeries we’ve talked about can be done through endoscopic means. Some surgeons favor it because it is less invasive than open surgery. It really depends on the surgeon though, because spinal stenosis can be difficult to gain visibility with through endoscopic means. However, if you can find a talented surgeon with a good track record for the specific surgery you need, you’re going to do so much better with endoscopic surgery over open surgery.
For those who struggle with spinal stenosis in the facet joints, facet replacement devices could be a complete game changer. However, there are currently no devices approved by the FDA as of yet, though many in the works. This device would completely replace a spinal facet, with pretty invasive surgery, but not require a fusion in order to get similar pain relief.
As you can see, there are many different surgical options for spinal stenosis treatment, however, you never want to start with open surgery. Explore your options with the help of the Spine Institute of North America, because you deserve to live a pain-free life. Learn more when you schedule a consultation today!