Spinal Stenosis Surgery

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Spinal Stenosis, Back Surgery

Published: 06 December 2015

When should Surgery to treat Spinal Stenosis considered?

Spinal stenosis is most common in the over 65 age group. It is a condition where the spinal canal is narrowed and compresses the spinal cord and nerves.

It is primarily associated to the effects of degeneration with aging, and can also be due to disc lesions, osteoporosis or tumours. It can be also associated with a condition called spondylolystheis or ankylosing spondylitis. It can also be a congenital condition especially if in the lumbar or cervical spine regions.

The most common symptoms of spinal stenosis symptoms is back pain and leg pain when standing or walking, usually eased by sitting down. (Read more about Spinal Stenosis Symptoms here). Not all spinal stenosis conditions deteriorate over time and not all sufferers suffer with severe symptoms. However some of you do!! The severity and duration of your spinal stenosis symptoms will dictate whether you have conservative or surgical intervention as your treatment of choice.

In my opinion, surgery for spinal stenosis should only be considered if your quality of life has been severely affected and you have exhausted conservative physiotherapy methods of treatment and management. (see Treating Spinal Stenosis for examples of what can be done to treat and relieve the effects of Spinal Stenosis)

What Spinal Stenosis surgery involves

The aim of all surgical treatments for spinal stenosis is to decompress the pressure on the spinal cord or spinal nerves either directly or indirectly by widening the spinal canal. To do this, an x-ray or MRI will be normally be taken of your back and the surgical team will analyse the images and identify the areas that need intervention and the best type of surgical techniques to be used. There are various forms of decompression surgeries used, the most common one I see is laminectomy. Foraminotomy and microendoscopic surgery are also used but less frequently in my experience. However they are available.

The aim of surgery in spinal stenosis is to decompress the compressed part of your canal. Surgeons will remove disc or scar tissue that is compromising the canal at you stenotic level. They may also stabilise a bone to another bone where misalignment of the bone is the compressing structure. The results of this surgery are varied and healthcare professionals hold many different opinions on it’s effectiveness.

My opinion on surgery and spinal stenosis is that if all conservative measures have been exhausted and your quality of life is poor, you should consider it. If you have to go for surgery to treat Spinal Stenosis, then listen closely and work with the team around you. Discuss with them what you can do to prepare for surgery that will help the operation and recovery. Following surgery, physiotherapy is essential in the rehabilitation and if you fully complete the exercise programs you have been given, you increase your chances of a fuller and longer lasting recovery. Do not think that once your surgery is complete that time will resolve your problem.