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When you are considering spinal stenosis surgery, understanding your spinal stenosis symptoms and what the surgery does will make you more able to participate in the decisions regarding your care.
"cause pressure on the nerves"
Lumbar spinal stenosis, is the most common, and occurs in the lumbar spine when arthritis or overgrown ligaments cause pressure on the nerves. This may result in pain in the buttocks and legs or lower extremity weakness.
In extreme cases people may develop problems controlling their bowels or bladder that requires spinal stenosis surgery. Lower extremity weakness or bowel and bladder dysfunction are symptoms of cauda equina syndrome. If you're having any of these symptoms it is important to see your doctor right away to prevent injury or permanent impairment.
"remove the bones or ligaments that are pressing on the nerves"
Spinal stenosis pain and other symptoms are caused by pressure on the nerves and spinal stenosis surgery is designed to remove the bones or ligaments that are pressing on the nerves. Each spinal stenosis surgery is different because each person is different and has a different set of problems.
Central spinal stenosis causes the nerves to be squeezed in the spinal canal. Surgery for this involves removing the bone, called the lamina, at the back of the spinal canal. Then cleaning out the ligaments to make room for the nerves.
"called a decompressive laminectomy"
Removing the bone at the back of the spine is called a laminectomy, because this is done to decompress the nerves, is often called a decompressive laminectomy.
Foraminal spinal stenosis occurs when the nerves are being squeezed in the foramen as they exit the spinal canal. The foramen is a small opening on each side of the spinal canal between the vertebra where the nerves leave the spinal canal.
"Surgery for foraminal spinal stenosis, called a foraminotomy..."
This opening or hole can become narrowed in cases of degenerative disc disease or spinal arthritis causing pressure on the nerves. Surgery for foraminal spinal stenosis, called a foraminotomy, would require enlarging the foramen to make more space for the nerves.
Central stenosis and foraminal stenosis can occur together and many times people have some degree of both. In these cases the surgeon would remove the lamina, and then clean out the central canal and enlarge the foramen, all in one surgery.
"stenosis at just one level such as L4-5 or at multiple levels"
It is possible to have stenosis in the thoracic and cervical spines, and the spinal stenosis treatment for these will vary, but lumbar spinal stenosis is much more common.
There are multiple levels in the lumbar spine where stenosis may occur. You may have stenosis at just one level such as L4-5 or at multiple levels.
"spinal stenosis occurs between the vertebra"
There are five lumbar vertebra numbered 1-5, but since spinal stenosis occurs between the vertebra, the location of spinal stenosis is referred to as L1-2, L2-3, L3-4, L4-5, or L5-S1. S1 is the first to sacral vertebra.
When your surgeon looks at your MRI or CT scan you'll be able to tell which levels are affected by the spinal stenosis. You may say that he thinks you require surgery L2 to L5, meaning L2-3, L3-4, and L4-5.
"sometimes people develop instability after the surgery"
One of the possible complications of spinal stenosis surgery is instability. If too much bone and ligament is removed the spine may become unstable and require a spinal fusion. This may be done at the time of the first surgery or sometimes people develop instability after the surgery and require a second surgery.
Spinal stenosis surgery is major surgery but in most cases, you will get out of bed and walk with a front wheeled walker, the next day. A physical therapist will teach you exercises to strengthen your back and legs. You may spend 2 to 3 days in the hospital and then have physical therapy at home.
"discuss the details with your surgeon"
Every surgery is different, and recovery time will vary, because every patient is different. You will need to discuss the details of your surgery with the surgeon prior to surgery.
Spine surgery can be very effective at relieving the spinal stenosis symptoms, but the longer you have the symptoms the less reliable your relief. So if you're having symptoms or think you may have spinal stenosis it is important to see your doctor and be evaluated. Early diagnosis and adequate treatment are the keys to a cure.