Stenosis

What is spinal stenosis?

As we get older, wear and tear within the spine can lead to narrowing of the spinal canal. As people age, the bands of tissue that support the spine may get thick and hard, resulting in more pressure and less space available within the spine. This narrowing is called stenosis. Spinal stenosis can put pressure on the spinal cord or other nerves, causing pain and other symptoms.

What causes spinal stenosis?

The most common cause of spinal stenosis is wear-and-tear changes in the spine related to aging. Other causes of spinal stenosis include:

• Arthritis
• Bone diseases
• Calcium deposits on ligaments
• Disc bulges
• Genetic predisposition
• Spinal tumors
• Spinal injuries

What are the symptoms of spinal stenosis?

In some people, spinal stenosis causes no symptoms. In other people, symptoms of spinal stenosis may appear slowly and get worse over time. Signs of spinal stenosis include:

• Pain in the neck or back
• Numbness, weakness, cramping, or pain in the arms or legs, particularly when walking or standing
• Pain going down the leg
• Foot problems
• Bowel or bladder problems

How is spinal stenosis diagnosed?

Spinal stenosis can be difficult to diagnose because its signs and symptoms resemble those of many age-related conditions. Your physician will conduct a physical examination to determine where your pain is coming from and review your medical history carefully.

Your physician may use a variety of diagnostic tools to confirm spinal stenosis, including:

• Diagnostic imaging, such as X-rays, MRI (magnetic resonance imaging), and CT scans
• Injections
• Electromyography (EMG) testing to assess nerve conduction

How is spinal stenosis treated nonsurgically?

There are many nonsurgical treatments for spinal stenosis. Your doctor may prescribe:

• Medication
• Injections
• Physical therapy
• Self-care, including rest and bracing

Surgery may be eventually considered when extensive nonsurgical treatment no longer is effective.

What can I do at home to help relieve symptoms?

In many cases, changing posture and using spinal injections can control the symptoms for a long period of time. Pain can be relieved by flexing forward and bending over. Taking anti-inflammatory medicines may be beneficial, especially ibuprofen products like Advil or Motrin.

What are the surgical treatment options for spinal stenosis?

If conservative treatments are ineffective, surgery may be considered. Surgery is reserved only for the cases where everything else has been tried or the pain is so severe that you cannot do the most basic of daily activities.

The most common surgical options for spinal stenosis are:

• Laminectomy
• Fusion surgeries, including transforaminal lumbar interbody fusion, oblique lumbar interbody fusion, anterior lumbar interbody fusion, and posterolateral spinal fusion

Laminectomy

The goal of laminectomy is to relieve the pressure on the spinal nerves that is causing your symptoms.

How laminectomy works

• Your orthopedic surgeon will make an incision near the center of your spine.
• After the spine is accessed, the lamina (the “roof” of the vertebra) is removed.
• Through this incision, any bone spurs and damaged disc material are removed.
• Then, the incision is closed with sutures.
• As you heal in the weeks following surgery, the muscles and ligaments of the back will fill in the space where the lamina used to be.

Learn more about laminectomy

Transforaminal Lumbar Interbody Fusion

The goal of a transforaminal lumbar interbody fusion (TLIF) is to relieve the pressure on your spinal nerves and restore spinal stability.

How is a TLIF performed?

• First, your surgeon will make a small incision in the skin of your back over the vertebra(e) to be treated.
• After the spine is accessed, the lamina (the “roof” of the vertebra) is removed.
• The facet joints, which are directly over the nerve roots, may be trimmed to give the nerve roots more room.
• The nerve roots are then moved to one side, and the damaged disc is removed from the front (anterior) of the spine.
• A bone graft is then inserted into the disc space. The bone graft material acts as a bridge, or scaffold, on which new bone can grow.
• Screws and rods are inserted to stabilize the spine while the treated area heals and fusion occurs.
• Your surgeon will then close the incision.

Learn more about TLIF

Anterior Lumbar Interbody Fusion

As with a TLIF, the goal of anterior lumbar interbody fusion (ALIF) is to restore spinal stability. The procedure differs from a TLIF in that the surgeon accesses the spine from the front of the body rather than the back.

How is an ALIF performed?

• First, your surgeon will make a small incision in the skin of your stomach, accessing the vertebra(e) to be treated from the front of the body.
• The damaged disc is removed from the front (anterior) of the spine.
• A bone graft is then inserted into the disc space. The bone graft material acts as a bridge, or scaffold, on which new bone can grow.
• Screws and rods may be inserted from the back to stabilize the spine while the treated area heals and fusion occurs.
• Your surgeon will then close the incision.

 Summit Orthopedics offers comprehensive spine expertise

Summit’s spine care team is recognized by the National Committee for Quality Assurance for the comprehensive expertise of our patient-centered care. Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.

Start your journey to a healthy spine. Find your spine expert, request an appointment online, or call us at (651) 968–5201 to schedule a spine consultation.

Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.

More resources for you

• Visit our Spine Exercise Libraryfor options to help ease neck and back pain
• See Summit’s treatment optionsfor neck, back, and spine care
• Check out additional information on Summit’s approach to spine care