You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
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Lumbar spinal stenosis is the narrowing of the spinal canal in the low back. It usually occurs when bone and other tissues grow inside the openings in the spinal bones. This can squeeze the nerves that branch out from the spinal cord. The squeezing can cause pain, numbness, or weakness, most often in the back, buttocks, legs, or feet.
Symptoms may be very bad at times and not so bad at other times.
Arthritis is the most common cause of spinal stenosis. There are a lot things that can help relieve your symptoms, but they won't make your arthritis go away. Over time, your arthritis may get worse, and symptoms of spinal stenosis may come back.
There are several treatments that don't involve surgery that can help you feel better, be more active, and avoid surgery. These include:
Decompressive laminectomy is the most common type of surgery to treat lumbar spinal stenosis. This surgery is done to relieve pressure on the spinal nerve roots. It removes bone (parts of the vertebrae), thickened tissue, or both to keep them from narrowing the spinal canal and squeezing or irritating the spinal nerves.
In some cases, spinal fusion may be done at the same time to help keep the spine stable. This surgery joins, or fuses, two or more bones so that the joints can no longer move. This surgery is more complicated and has more risks. And it's usually not needed unless you have other back problems along with spinal stenosis.
Some surgeons are doing newer, less invasive procedures. They are inserting small metal devices—called interspinous process devices—between the bones of the spine, near where the nerve roots leave the spinal cord. The idea is to create more space between the bones to take pressure off the nerve roots. This may be an option for some people. But not all surgeons do the procedure. And studies haven't yet shown how well the devices work over the long term.
Many people who have surgery for spinal stenosis get pain relief and have less disability by 3 months after surgery. Many people have good results that last for at least 8 years. Others don't have relief that lasts as long. And it doesn't work for everyone. Some people even get worse.
Surgery may not be an option if you have other serious health problems that make surgery too risky.
All surgery has risks. These risks may be more serious for an older adult.
About 10 out of 100 people have problems during or after this kind of surgery.
In one study, about 18 out of 100 people had another surgery within 8 years.
For most people, it's safe to try nonsurgical treatments for several months before thinking about surgery. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy.
But if these other treatments don't work, not having surgery means that you may still have pain or other symptoms that make it hard for you to do your daily activities.
There is little or no risk in not having surgery unless you have serious symptoms. These symptoms include having trouble controlling your bladder or bowels, numbness or weakness, and sudden changes in the way you walk or move. These symptoms aren't likely to get better on their own, and they could get worse.
Your doctor might recommend surgery if:
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These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
The pain and numbness in my legs got to the point where I could hardly walk. After my MRI showed I had spinal stenosis, my doctor said that the final decision for treatment was up to me. I should consider how bad the pain is and whether I can do my normal daily activities. Since I could hardly do my simple everyday routines without pain, I figured that it was time for surgery.
Ed, age 62
I have been working with a physical therapist for several months now to relieve my leg pain that is caused by spinal stenosis. My doctor says surgery may be an option if my leg pain gets worse. But I want to wait and see if other steps help relieve the pain first. The physical therapy seems to be working, so I will stick with it for now.
Tom, age 52
I noticed the numbness and pain in my legs for a while. It came on gradually, and I could manage it with pain relievers. Over time, though, the symptoms got worse and worse, even though I tried physical therapy and changing the way I do certain activities. Eventually, the pain got so bad that walking was quite uncomfortable. Since I don't have any other major health problems, I decided to have surgery so I wouldn't have to deal with the leg pain and could start walking again!
Clare, age 70
The pain, numbness, and tingling in my legs started about 5 years ago. Luckily, I did not feel pain all of the time when I was walking. When I was diagnosed with spinal stenosis, my doctor said that there were several things I could do to keep my pain at a minimum, such as using pain relievers and exercising. That's what I'm doing, and now I hardly ever get leg pain. I'm relieved that I avoided surgery.
Susan, age 64
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery for lumbar spinal stenosis
Reasons not to have surgery
I want surgery if there is a chance it will help me.
I want to avoid surgery at all costs.
My work and home life are flexible enough that I can take the time I need to recover after surgery.
I can't afford to take time off.
Nonsurgical treatments have not worked well enough for me.
I want to keep trying nonsurgical treatments and see if they help me feel better and move around easier.
Getting relief from my pain and weakness will be worth it, even if I need to have the surgery again in a few years.
I'm not sure it's worth it to have surgery that might need to be repeated in a few years.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
NOT having surgery
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Author | |
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Clinical Review Board | All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
Lumbar spinal stenosis is the narrowing of the spinal canal in the low back. It usually occurs when bone and other tissues grow inside the openings in the spinal bones. This can squeeze the nerves that branch out from the spinal cord. The squeezing can cause pain, numbness, or weakness, most often in the back, buttocks, legs, or feet.
Symptoms may be very bad at times and not so bad at other times.
Arthritis is the most common cause of spinal stenosis. There are a lot things that can help relieve your symptoms, but they won't make your arthritis go away. Over time, your arthritis may get worse, and symptoms of spinal stenosis may come back.
There are several treatments that don't involve surgery that can help you feel better, be more active, and avoid surgery. These include:
Decompressive laminectomy is the most common type of surgery to treat lumbar spinal stenosis. This surgery is done to relieve pressure on the spinal nerve roots. It removes bone (parts of the vertebrae), thickened tissue, or both to keep them from narrowing the spinal canal and squeezing or irritating the spinal nerves.
In some cases, spinal fusion may be done at the same time to help keep the spine stable. This surgery joins, or fuses, two or more bones so that the joints can no longer move. This surgery is more complicated and has more risks. And it's usually not needed unless you have other back problems along with spinal stenosis.
Some surgeons are doing newer, less invasive procedures. They are inserting small metal devices—called interspinous process devices—between the bones of the spine, near where the nerve roots leave the spinal cord. The idea is to create more space between the bones to take pressure off the nerve roots. This may be an option for some people. But not all surgeons do the procedure. And studies haven't yet shown how well the devices work over the long term.
Many people who have surgery for spinal stenosis get pain relief and have less disability by 3 months after surgery. Many people have good results that last for at least 8 years. Others don't have relief that lasts as long. And it doesn't work for everyone. Some people even get worse.
Surgery may not be an option if you have other serious health problems that make surgery too risky.
All surgery has risks. These risks may be more serious for an older adult.
About 10 out of 100 people have problems during or after this kind of surgery.
In one study, about 18 out of 100 people had another surgery within 8 years.
For most people, it's safe to try nonsurgical treatments for several months before thinking about surgery. Many people are able to manage their symptoms with things like changing the way they do their activities, taking medicines to manage pain, doing exercise, or getting physical therapy.
But if these other treatments don't work, not having surgery means that you may still have pain or other symptoms that make it hard for you to do your daily activities.
There is little or no risk in not having surgery unless you have serious symptoms. These symptoms include having trouble controlling your bladder or bowels, numbness or weakness, and sudden changes in the way you walk or move. These symptoms aren't likely to get better on their own, and they could get worse.
Your doctor might recommend surgery if:
Have surgery | Don't have surgery | |
---|---|---|
What is usually involved? |
|
|
What are the benefits? |
|
|
What are the risks and side effects? |
|
|
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"The pain and numbness in my legs got to the point where I could hardly walk. After my MRI showed I had spinal stenosis, my doctor said that the final decision for treatment was up to me. I should consider how bad the pain is and whether I can do my normal daily activities. Since I could hardly do my simple everyday routines without pain, I figured that it was time for surgery."
— Ed, age 62
"I have been working with a physical therapist for several months now to relieve my leg pain that is caused by spinal stenosis. My doctor says surgery may be an option if my leg pain gets worse. But I want to wait and see if other steps help relieve the pain first. The physical therapy seems to be working, so I will stick with it for now."
— Tom, age 52
"I noticed the numbness and pain in my legs for a while. It came on gradually, and I could manage it with pain relievers. Over time, though, the symptoms got worse and worse, even though I tried physical therapy and changing the way I do certain activities. Eventually, the pain got so bad that walking was quite uncomfortable. Since I don't have any other major health problems, I decided to have surgery so I wouldn't have to deal with the leg pain and could start walking again!"
— Clare, age 70
"The pain, numbness, and tingling in my legs started about 5 years ago. Luckily, I did not feel pain all of the time when I was walking. When I was diagnosed with spinal stenosis, my doctor said that there were several things I could do to keep my pain at a minimum, such as using pain relievers and exercising. That's what I'm doing, and now I hardly ever get leg pain. I'm relieved that I avoided surgery."
— Susan, age 64
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery for lumbar spinal stenosis
Reasons not to have surgery
I want surgery if there is a chance it will help me.
I want to avoid surgery at all costs.
My work and home life are flexible enough that I can take the time I need to recover after surgery.
I can't afford to take time off.
Nonsurgical treatments have not worked well enough for me.
I want to keep trying nonsurgical treatments and see if they help me feel better and move around easier.
Getting relief from my pain and weakness will be worth it, even if I need to have the surgery again in a few years.
I'm not sure it's worth it to have surgery that might need to be repeated in a few years.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
NOT having surgery
1. Is surgery the only thing you can try to make your symptoms better?
2. Will surgery help your leg pain?
3. If you have surgery, is there a good chance that the results will last for a long time?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
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Clinical Review Board | All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
Current as of: July 17, 2023
Author:
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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