Pros and Cons of Surgical Treatment of Spinal Stenosis.

The decision to have surgery is never easy. Given a choice, we would all rather avoid it. There are many fears and doubts around surgery, many of which are based on misconceptions or horror stories heard from a friend of a friend or on TV. However, the fact is that surgery is often the only thing that can actually heal the patient fully, particularly those diagnosed with spinal stenosis. Unfortunately, it happens that people refuse to undergo a procedure due to misinformation or lack of knowledge. As a result, their condition gets worse, keeping them from living their lives normally. 

Now, is there a reason to fear surgery? In this post, our spine specialist in Fort Lauderdale, Dr. Matthew Hepler sheds light on the pros and cons of surgical treatment of spinal stenosis. Hopefully, this article will help to clear up some misconceptions about spinal stenosis surgery and help you to make a more informed decision.

What is Spinal Stenosis?

Spinal stenosis is a condition wherein one or more of the bony openings in the spine, called foramina, narrow. As a result, the space surrounding the nerves is reduced. This narrowing can occur in the spinal canal where the spinal cord is enclosed. It can also happen in the intervertebral foramina where nerves exit from the spinal canal. Spinal stenosis can also happen in both the spinal canal and intervertebral foramina. Over time, the narrowing constricts the nerves and causes numbness, weakness, tingling, and pain.

What Happens in Spinal Stenosis Surgery?

Surgical treatment for spinal stenosis is often considered when all other non- and less invasive treatments have been exhausted and yet the patient’s symptoms are still not relieved. Spine surgeons will recommend spinal stenosis surgery if:

• Your doctor has determined that pressure on your spinal cord is the cause of your pain.
• Your symptoms are intolerable and they keep you from doing daily activities comfortably and enjoying life in general.
• Maintaining balance and walking have become a challenge.
• You have problems with bowel and/or bladder control.
• Your sexual function is affected.

The ultimate goal of surgical treatment of spinal stenosis is to relieve the nerves which are under pressure. As such, the surgery often involves the removal of the stenotic lesion, which usually includes removing a portion of the lamina (the roof of the spinal canal), the facet joints (the upper corner of the canal), and disc herniations or bone spurs (usually along the floor and bottom corners of the canal) at each stenotic level. 

Now, let’s take a look at the pros and cons of surgical treatment of spinal stenosis.

Pros of Surgical Treatment of Spinal Stenosis

1. Relieve pain

One of the main purposes of the surgery is to remove the thing that is causing compression of the nerves in the spine, giving more space for the spinal canal and the nerves within (this is called lumbar decompression surgery, or laminectomy). As a result, this will relieve leg pain and in many cases will relieve back pain, too.

2. Minimally invasive surgery

The surgery can be done via a minimally invasive spine surgery (MISS ) approach with more localized lesions for less severe stenosis and open approaches for more involved cases. The presence of instability, due to the removal of more than 50% of the facet joints or the underlying spondylolisthesis, usually requires stabilization with a fusion procedure (XLIF, TLIF, PLFI). Surgery for spinal stenosis is one of the most successful orthopedic procedures, with good to excellent results in the majority (>90%) of patients. Outcome studies demonstrate similar quality of life (QOL) scores following spinal decompression compared to total hip and knee arthroplasty as well as superior cost utility (QALY).

3. Relatively quick recovery

The post-operative recovery will of course depend on the patient, but usually, it takes about 4 to 6 weeks to fully recover. In general, patients who undergo laminectomy can go back to their office job a few days after the surgery. Meanwhile, those who undergo spinal fusion are likely to be able to go back to work after a few weeks.

Cons of Surgical Treatment of Spinal Stenosis

As in any surgery, there are some risks. In some cases, the surgery may cause instability to the spine (as a result of removing the material that is causing the compression). When that occurs, the doctor may recommend the patient undergo spinal fusion. Other risks include, but are not limited to, the following:

• Infection
• Dural tear
• Nerve injury
• Chronic pain
• Bone not healing after surgery
• Failure of the metal fasteners, screws, and plates
• Return of symptoms

It is important to note that not all patients will experience the side effects listed above. The best spine surgeons in South Florida will ensure that the procedure will provide the best results and pain relief.

Spine Surgeon in Palm Beach County – About Dr. Matthew Hepler

Each patient is unique and only a comprehensive evaluation with a fellowship-trained spine surgeon, such as our spine surgeon in Delray Beach, FL, can give you the best appreciation of the risks and benefits of undergoing surgery for your condition.

If you live in Broward County or Palm Beach County and are looking for an orthopedic doctor, Dr. Matthew Hepler is your best option. He is a Board Certified physician with years of experience in his specialty. He is also an expert in back surgery and spinal stenosis treatment in Fort Lauderdale and Delray Beach. 

To learn more about the conditions that we treat, as well as the treatment options and surgeries we provide, visit southfloridabackspineandscoliosis.com. Give us a call or  schedule an appointment. We are more than happy to answer any questions you may have. 

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment.  Always seek the advice of your physician or other qualified healthcare provider with any questions or concerns you may have regarding your health.