What is spinal stenosis?
Spinal stenosis is where the space in the centre of the spine (spinal canal) narrows. The spinal canal contains the nerves that leave the lower end of the spinal cord (see figure 1).
A combination of arthritis in the spine, thickening of the ligaments, and bulging of the discs can cause this to happen. The nerves can get trapped in the spinal canal or where they leave the spine, causing weakness or pain in your legs.
What are the benefits of surgery?
You should be relieved of any pain or weakness in your legs.
Are there any alternatives to surgery?
If you only have mild symptoms, you may not need any treatment. Your symptoms are unlikely to get worse quickly. A few people will even get better with time.
If you have pain down your leg that is caused by pressure on a nerve in your lower back (sciatica), you can have a steroid injection in your spine.
What does the operation involve?
You will usually have an MRI scan, to confirm the diagnosis and help your surgeon to plan the operation. A variety of anaesthetic techniques are possible. The operation usually takes between an hour and an hour and a half.
Your surgeon will make a cut in the centre of your lower back. They will remove enough bone and ligament tissue from the back of the spine to free the trapped nerves.
Your surgeon may need to join the bones using a bone graft. Sometimes they will need to use metal screws and rods.
What complications can happen?
1 General complications of any operation
- Infection in the surgical wound
- Unsightly scarring
- Blood clots
- Difficulty passing urine
- Chest infection
- Heart attack or stroke
2 Specific complications of this operation
- Continued pain or numbness
- Numbness between your legs, loss of normal bowel and bladder control and, in men, problems with having an erection
- Tear of the thin membrane that covers the nerves in your spine
- Infection in the spine
How soon will I recover?
You will normally be able to start walking on the first day after surgery. You should be able to go home after three to five days.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.
Most people make a good recovery from surgery. However, you may still get backache because of wear and tear in your spine.
Spinal stenosis can sometimes come back.
Spinal stenosis causes pain or weakness in your legs. If your symptoms are severe, a spinal decompression operation should relieve your symptoms and help you to return to normal activities.
Paying for your operation
Lumbar Spinal Decompression costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
Illustrations: Mr Stephen Milner DM FRCS (Tr. & Orth.)
Author: Mr Stephen Milner DM FRCS (Tr. & Orth.)
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