Treatment Options For Spinal Stenosis: Posterior Lumbar Interbody Fusion
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.
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.
No. Because anesthesia is required for surgeries, we cannot let anyone drive themselves home following a procedure. We ask that you arrange for a family member or close friend to drive you to and from the facility on the day of your appointment. You also need a responsible adult to stay with you for 24 hours after receiving anesthesia.
Our fees cover the use of the facility only. Facility fees do not include laboratory, pathology, surgeon, anesthesiologist or certified nurse anesthetist fees, nor does it include the cost of any implants used for your surgery. You will be billed separately for these fees.
Yes. Before surgery, you and your anesthesia provider will sit down to discuss your medical history and review the anesthesia plan; this is when you’ll be able to voice all of your questions and concerns. Feel free to call our admissions nurse if you have concerns that should be addressed prior to the day of surgery.
No. Your physician, along with the other medical service providers, including anesthesia, radiology or pathology specialists, who use this facility are independent contractors. Because these individuals are not employed by our facility, we are not responsible or liable for their acts or omissions.