Surgery For Spinal Stenosis

Spinal Stenosis Surgery

The vast majority of people afflicted with spinal stenosis neither need nor want surgery.  Although the disease is effectively permanent and may never significantly improve even with all the right therapies and treatments, spinal stenosis rarely gets so bad that surgery is the only way that a patient can expect to live a normal life.  In fact, a significant number of people with spinal stenosis don’t suffer from any pain or ill effects whatsoever, and such people will only discover they have the condition if they get into an accident which “triggers” the symptoms to start appearing.

The Alternatives To Surgery For Spinal Stenosis

Spinal stenosis, which is what happens when something starts unnaturally pinching the nerves of the spinal cord, is most commonly the result of:

  • Osteoporosis (the loss of bone density due to age)
  • Osteoarthritis (the wearing away of protective joint cartilage due to age)
  • Rheumatoid arthritis (the swelling of joint tissues due to age).

Other possible causes include spinal tumors, physical trauma, and birth or genetic defects, but by far the single biggest cause is simple old age.

Because of this, spinal stenosis usually progresses slowly when it progresses at all, allowing for plenty of time to try all kinds of non-surgical treatments.  For instance:

  • Avoidance.  You’d be surprised how much pain you can avoid by simply leaning forward and relying on a cane or a walker when it comes time to walk around.
  • Exercise.  It’s good to have some consistent physical exercise to keep in shape even in the face of arthritis and spinal stenosis.  These conditions may limit mobility, however, so it’s good to plan your routine with the help of a physical therapist or a similar expert.
  • Acupuncture.  No one’s exactly sure how it works or why, and it doesn’t seem like that riddle is going to be solved anytime soon, but until then acupuncture does seem to be able to provide at least some temporary relief from spinal stenosis.
  • Chiropractic.  Along with traditional exercise, a person with spinal stenosis may be able to benefit from the gradual stretching and gentle manipulations of chiropractic biophysics, a variation which demands more exercise and development and fewer direct readjustments than regular chiropractic.
  • Medication.  Anti-inflammatories could help in the form of ibuprofen, along with just about any and every kind of painkiller.  Still, in this case medication can only treat the symptoms and not the disease.
  • Steroid injections.  Rather than build muscle mass, these injections lower the inflammation at the site of the spinal stenosis.  Unfortunately, these injections don’t last very long, and if you get too many in too short a time the steroids will corrode the bone and the cartilage, ruining both.
Chiropractic Manipulations Are An Alternative To Spinal Stenosis Surgery In Some Cases

The Surgical Options

If you actually are one of the five percent of people for whom surgical options exist, and if you and your doctor have both agreed that surgery is the only good, workable alternative to permanent disability, crippling pain, or complete paralysis and the loss of any sensation, then you may have a variety of surgical solutions to choose from based on your situation.

The most common spinal stenosis surgery is called a laminectomy, and it involves removing part of or all of the spikey backside of the affected vertebrae.  These sections protect the spinal canal through which the spinal cord runs, and as such they do need to be replaced afterwards, with metal protectors, but this can fix the problem by “decompressing” the spinal cord so that it’s no longer being pinched.

Other spinal stenosis surgeries also concentrate on providing more room for the spinal cord and nerve roots.  The foraminotomy procedure involves cutting or grinding out a bigger opening for a specific nerve root as it leaves the spine, and the laminotomy cuts a hole in the back part of the vertebra, a useful procedure if that particular bone is the root of the problem.  Finally, the laminoplasty procedure only applies to cervical stenosis and involves cutting half as much as a laminectomy and then then stopping and propping the bones open with metal splints.

Depending on the circumstances, you may also end up considering a spinal fusion.  If several vertebrae are partially removed in the process of decompressing the spinal cord, your surgeon may have to fuse them together with bone grafts in order to make that part of your spine stable.  In the process, this fusion will also permanently reduce your ability to bend over.

The Surgical Drawbacks

While permanently exposing a section of your spinal cord may bring a permanent end to your spinal stenosis woes – though it doesn’t always – this option comes with a variety of drawbacks and issues even beyond spinal fusion, which explains why so few are willing to commit to surgery.  These drawbacks include:

  • General anesthesia.  If the anesthesia is mishandled for even a short while, it can cause a patient to wake up in the middle of surgery or else drop off into a coma.
  • Infection.  Hospitals always do their best to provide sterile environments, but they remain havens for infections both mild and serious.
  • A failure to heal.  Fusing your vertebrae is bad enough, but if the bone grafts fail to fuse properly your situation could get worse.
  • Spinal cord injury.  Your spinal cord is extremely important and tends to have trouble healing, which is why you have to go to such lengths to keep it safe.  But if the surgeon cuts just a little too deep, you’ll be paralyzed whether you like it or not.
  • Cost.  Considering the delicate work, you need the absolute best of surgeons on the job with the latest in equipment, and that can cost a pretty penny.  Your insurance policy might not cover the expense, or it might do so only after a hefty deductible and a significant copay.

Overall, while surgery may seem like an attractive solution to spinal stenosis at first glance, the number of risks involved aptly explain why it’s only reserved for the worst case scenarios.  Unless you actively can’t afford to deal with the stenosis a single minute longer, you’re better off learning to adapt to your new condition.  And if you live in Vancouver and you think an expert chiropractor could help you out, don’t hesitate to contact Advantage Chiropractic and ask for Dr. Stuart Kilian.

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