Treating A Constricted Spinal Space

When the spaces within the spine constrict, creating pressure on the spinal cord and nerve roots, a person is said to have spinal stenosis. With a narrowed space, a person often experiences aggravating symptoms such as pinched nerves and back pain. The symptoms of spinal stenosis can be managed with conservative approaches or surgical options.

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The conservative approach

When spinal stenosis is first diagnosed, orthopedic doctors will usually advise medications and physical therapy (PT) to relieve the symptoms. Medications can include nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, antidepressants, and anti-seizure drugs. If these fail to provide pain relief, the doctor may recommend stronger drugs such as opioids. Chiropractic care, massage, acupuncture, and yoga are other conservative treatments many people will try early on to get relief.

Injections for further relief

When medications and PT do not work well, a person with spinal stenosis may need to visit the doctor’s office for injections. The doctor will inject steroids into the affected area or perform a nerve block near the affected nerve. Every patient will experience a different level of symptomatic relief. Percutaneous image-guided lumbar decompression (PILD) is another non-invasive procedure that helps to create space and lessen symptoms.

When surgery is recommended

If symptoms persist after attempting conservative treatments or non-invasive procedures, the healthcare provider may recommend surgery. Surgery is also advised if there is a disturbance in gait or issues controlling the bladder. Multiple different kinds of surgeries exist to treat spinal stenosis. The most common type used is decompressive laminectomy, but foraminotomy, facetectomy, laminoplasty, discectomy, and spinal fusion are other options the doctor may consider.

Joining the vertebrae

Spinal fusion surgery involves combining the vertebrae to ease the symptoms of spinal stenosis. There are 5 kinds of spinal fusion surgical techniques, including posterolateral fusion, transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), and instrumented fusion. The doctor will decide which type of surgery is best for the patient.

Posterior lumbar interbody fusion

For patients pursuing a PLIF, the surgery involves making an incision in the back and removing the damaged disc. The doctor can also retract the nerve roots to lessen pain. Next, a replacement made of bone or synthetic material is inserted to fuse the 2 vertebrae.

Expect some downtime

The recovery period after a spinal stenosis surgery can take up to 3 months or more. Resuming normal activities and work can usually take place a few weeks after surgery. Returning to more strenuous physical activity may take longer. Regularly attending physical therapy (PT) can help with recovery.

No more back pain

After carefully examining the patient’s spine, the healthcare provider will decide on the right treatment choice. If surgery is recommended, ask about the best technique and expected recovery time. Back pain doesn’t have to be a chronic problem with the proper treatment.

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