One of the most common conditions that may require spinal surgery is called “stenosis,” a word that you may see on your MRI report. Most people have some degree of stenosis in their vertebrae that causes discomfort and pain, and can compromise quality of life to a degree that requires surgical intervention.
While stenosis is a chronic condition that can be very painful, the good news is that surgical outcomes are generally excellent when someone fits the protocol criteria. Let’s discuss what it is, how it is diagnosed and how it can be addressed through surgery at New Jersey Neck & Back Institute, P.C.
The word “stenosis” means narrowing. It can mean narrowing of any passage in the body, but spinal stenosis means that passages in the spine are more narrow than they should be and can put pressure on nerves
The pressure can cause neck or back pain or nerve dysfunction with pain, numbness, tingling or weakness in the arms or legs.
If spinal stenosis is severe enough, it can interfere with bowel or bladder function, gait or coordination.
After an evaluation by your physician, you may be prescribed X-rays, CT scans or an MRI. Spinal stenosis is revealed with these images and your doctor will determine the location and severity of the stenosis. There can be more than one area of spinal stenosis in several vertebrae, but only certain ones may be the cause of pain or nerve dysfunction.
While a patient can be born with spinal stenosis, it occurs most commonly in people over the age of 40. Degenerative disc disease, or aging of the spine, in general, can contribute to the onset of spinal stenosis. Changes during aging can create narrowing around the nerves within the spine, with compression that leads to symptoms.
Other less common causes of spinal stenosis include tumors that press on nerves or traumatic injury, which can move bones out of alignment and cause compression.
There are a range of nonsurgical options that your doctor may initially recommend, such as non-steroidal anti-inflammatories, physical therapy, exercise and even injections that deliver a steroid to block the pain. If these measures fail to reduce the symptoms of pain or nerve dysfunction caused by a spinal stenosis, there are surgical options that can be used as a solution.
The goal of surgery will be to alleviate the pressure caused by the stenosis. A laminectomy is often the most common surgical solution for stenosis. This procedure is typically performed through an incision in the back over the affected spinal segments and involves removing part of the vertebrae or bone spurs that are pressing on the nerves.
Sometimes a spinal fusion surgery also is necessary to deal with the instability caused by spinal stenosis. A fusion involves joining two vertebrae together and stabilizing them so pressure on the nerves is eliminated.
Surgical intervention for stenosis in the neck or cervical spine is generally with an anterior cervical discectomy and fusion. This is performed through a small incision in the front of the neck. The cartilage disc between the vertebrae is removed, allowing decompression of the nerves and spinal cord.
Because of the important need for stability in the neck area and the crucial need to make sure the spinal cord and nerves are protected and unobstructed, stabilizing measures such as fusion are necessary.
If a patient fits the criteria, the outcomes for surgery to treat spinal stenosis are very good to excellent, with drastic improvement in quality of life.