Spinal Stenosis Definition
As mentioned in our page What is Spinal Stenosis? It is a narrowing of the spinal canal and/or the foramen. This canal is the opening through which the nerve roots pass. If the spinal canal is narrowed, the stenosis disorder is called cervical/lumbar central stenosis. On the other hand, If the foramen is the one narrowed, the disorder is called cervical/lumbar foraminal stenosis.
Spinal Stenosis can develop in any area of the spine and it is most commonly caused by degenerative changes in the spine, a collapsed disc, bone spurs, or cysts. This narrowing places pressure on the nerve roots and/or spinal cord, often resulting in pain.
Stenosis Treatment Options
Spinal Stenosis Non-Surgical Treatment
In case of Spinal Stenosis, medications, physical therapy or spinal cortisone injections are indicated for pain relief. Surgery can be considered for those who do not improve with conservative treatment. The most common Stenosis surgery procedures include:
Cervical Laminectomy
Spinous process and lamina are removed to decrease pressure on spinal cord. Instrumentation can be used to ensure stability.
Lumbar Decompression
This procedure involves removing all or portions of the lamina, removing bone spurs and/or enlarging foramen to relieve pressure or compression on the nerve roots or spinal cord. This pressure often is the cause of the pain.
Decompression & Posterolateral Fusion
Often times, in addition to a decompression, your surgeon will perform an instrumented posterolateral fusion by inserting a series of screws and rods coupled with the placement of a bone graft. This fusion provides increased spinal stability.
Anterior Lumbar Interbody Fusion (ALIF)
The surgical approach is from the front of the abdomen. Once the exposure is made, surgical instruments are used to remove the disc material causing the nerve compression. Once this material is removed, an interbody cage or bone spacer is placed at the disc site filled with bone graft. The vertebral bodies above and below are frequently put under compression to aid in the subsequent spinal fusion.
Posterior Transforaminal Interbody Fusion
The same procedure as the ALIF but the approach and exposure are performed from the back. Just as in an ALIF, the disc material is removed and an interbody device is inserted. Compression through the use of pedicle screws is frequently achieved to aid in fusion.