1. Symptoms of stenosis. Patients who have developed back pain, leg pain and numbness are showing symptoms of stenosis. Their pain often intensifies when they are standing or walking, so these patients can’t walk for long durations, and when they do walk, they’ll be bending forward. These patients become less physical because of the stenosis, but this de-conditioning also causes pain and suffering.
2. Making the diagnosis. Spine surgeons and specialists usually order a magnetic resonance imaging scan of the spine to accurately detect the stenosis. The MRI will show the space for the nerves, which is an indicator for stenosis. The symptoms come from a narrowness in the spinal canal. Surgeons can identify whether there is a bulging disc, overgrown facet joint or compression from thickened ligaments in the spine using the MRI.
3. Conservative treatment. Before visiting a surgeon, many patients undergo conservative treatment such as over-the-counter medication, which can work well for a period of time. When the medication fails, physicians will order the test for a diagnosis and recommend other conservative treatments, such as physical therapy or epidural and steroid injections. If these methods are not effective, surgeons and patients may consider surgical intervention.
4. Surgical intervention. In the past, spine surgeons might perform a laminectomy where they un-roof the spine by removing the lamina on both sides to give the nerve extra room. However, studies show that removing so much of the spine may be unnecessary. Some surgeons also place a spacer on the back side of the spine to stretch nerves and ligaments so nerves have a few more centimeters, but patients undergoing this procedures risk a failed surgery, and need a decompression anyway.
Minimally invasive surgeries are alternatives to laminectomies. For the procedure, surgeons place a small tube in the side of the spine, remove the lamina, jont, thickened ligament and part of the disc to open up the spine as necessary. The procedure leaves most of the spine intact.
5. Advantages of minimally invasive surgery. One of the unique aspects of the minimally invasive surgery is the conscious sedation that allows surgeons to perform the procedure on an outpatient basis. During the surgery, patients are able to watch the procedure unfold along with the surgeon. Patient are often a little nervous, but as the surgery progresses they are put at ease by the staff and can become interested in what they are seeing. The minimal disruption of the patient’s anatomy also allows patients to begin rehabilitation quicker.
There aren’t many surgeons performing the minimally invasive procedures in surgery centers, but they may become more common in the future. Minimally invasive procedures are often driven by patients who are learning about them on the Internet and wanting their surgeons to perform them.
6. Making spine stenosis surgery cost-effective. The literature shows that there are fewer surgeries being performed now for spinal stenosis, but the majority of procedures being performed are complex surgeries. These complex procedures are more expensive because they include instrumentation and fusion, which minimally invasive procedures do not. There are additional economic benefits for the patient as a result of the decreased rehabilitation period and continued flexibility in the spine. The amount of scar tissue is lessened when you perform the minimally invasive procedure, and there’s not a loss of flexibility, as there is after fusions.
Related Articles on Spinal Stenosis:
Study: Fall Risk for Spinal Stenosis Patients Same as Patients With Knee Osteoarthritis
Study: Spine Surgery Better for Diabetic Patients With Spinal Stenosis, Degenerative Spondylolisthesis
Study: Unilateral Laminectomy Decreases Operative Times, Blood Loss
