What is Spinal Stenosis?
Spinal stenosis is the abnormal narrowing of the spinal canal, which causes pressure on the spinal cord and nerves. It can occur anywhere along the spinal canal and can be caused by
- The wear and tear that comes with aging
- Bone spurs
- Certain medical conditions including Paget’s disease when bones can grow improperly
- Herniated (bulging) discs
- Slipped vertebrae (spondylolisthesis)
- A spinal canal that is naturally narrow (from birth)
- Degenerative disc disease
- Enlarged facet joints
- Previous surgery
There are two main types of stenosis: lumbar and cervical, and both can cause significant “quality of life” issues.
Spinal Stenosis of the Lumbar Spine (Lower Back)
This type of stenosis is the most common and occurs in the lower section of the back. It is often caused by degenerative arthritis, and the symptoms may impact the lower back and legs. Symptoms might include:
- Lower back pain
- numbness, weakness, heaviness or decreased sensation in one or both legs
- sciatica (pain that radiates down the buttock and leg)
- loss of mobility
- difficulty sleeping or finding a comfortable sleeping position
- incontinence if the nerves that control bowel and bladder functions are affected.
Stenosis of the Cervical Spine (Neck)
Cervical stenosis, (cervical myelopathy) is similar to lumbar stenosis, except that it occurs in the neck instead of the lower back. There are seven vertebrae located between the chest and head, and this area is known as the cervical spine. When stenosis narrows the spinal canal in the neck, it can impact the neck, arms, or legs. Symptoms may include
- limited mobility and a reduced quality of life
Diagnosing Spinal Stenosis
To diagnose Spinal Stenosis, Dr. Brisson will talk to you about your symptoms and your medical history. He will conduct a physical exam including neurology, arms, and legs. He may order lab tests including spinal imaging such as X-rays, CT scans or other tests.
Non-Surgical Treatment for Back Pain
The main type of surgery is decompressive laminectomy, which involves removing part of the vertebra and thickened ligaments to reduce pressure on the nerves. Sometimes, a spinal fusion is also needed to stabilize the spine and relieve pain. This allows the patient to move around more easily and helps keep the bones in place, preventing them from further squeezing the spinal canal and restricting the nerves.
If you have severe symptoms stemming from spinal stenosis and you are in good health otherwise, Dr. Brisson will likely recommend spinal stenosis surgery. Though he is a skilled spinal stenosis surgeon, Dr. Brisson always explores non-invasive treatment options first, before determining that a laminectomy surgery is needed. With spinal stenosis, as with other back conditions, the goal is to find the most appropriate solution to help the patient achieve a high-quality and pain-free life.
If surgery is needed, options might include various types of spinal laminectomy,++LINK++ including a lumbar laminectomy ++LINK++ or cervical laminectomy,++LINK++ depending on where the pain is occurring.
Whether your pain is in your neck or back, Dr. Brisson always begins with the most conservative approach to treat spinal stenosis. Most of the time, no medical intervention is necessary. Treatments may include pain management, physical therapy, and exercise or steroidal injections.
Spinal Stenosis (Back or Neck) Surgery
If none of the less invasive treatments give you relief, Dr. Brisson may recommend Spinal Stenosis Surgery. ++LINK TO THAT PAGE++ After carefully assessing your condition and prior treatment, Dr. Brisson will discuss whether surgery is indicated and what your best options are.
The surgery to treat spinal stenosis is called Decompression Surgery. The goal is to remove arthritic or bony material and relieve pressure on the spinal cord, thus removing the cause of the pain you are having.
Decompression Surgery Types We Perform
Laminectomy is one of the most common back surgeries. Dr. Brisson will remove a small portion of the back part of the vertebrae to create space and reduce “impingement” – the compression of the nerve which causes pain and other symptoms. All decompression surgeries enlarge the spinal canal to relieve pressure on the spinal cord or nerves. There are a number of variations in laminectomy which might apply to your case. You can read about them here. (link to laminectomy list)
- Spinal stenosis decompression surgery (microsurgery, laminectomy, laminotomy, laminoplasty) involves the removal of bony spurs or any increased arthritic material in the spinal canal. This can free up space for the nerves and the spinal cord, relieve the pressure, thereby alleviating symptoms.
Be assured that at NY Spine Care we understand considering back surgery can be stressful. Dr. Brisson and his staff will handle your case with compassion and professionalism.
Call us today to schedule your consultation and experience our exceptional care for yourself.