by David Borenstein, MD
The goal of surgical treatment for lumbar spinal stenosis is to remove enough bone or disk to re-establish blood flow to the compressed nerve without causing instability to the spine. This is called decompression. The main difficulty for the surgeon performing this type of surgery is to identify which changes in the spinal anatomy correspond to significant narrowing and compression of the spinal nerves. Anyone considering spinal surgery should thoroughly discuss the procedure with the spinal surgeon, either an orthopedic surgeon or neurosurgeon. (To find an orthopedic surgeon, visit the Web site of the American Academy of Orthopaedic Surgeons; to find a neurosurgeon, visit the Web site of the American Association of Neurological Surgeons.) Some people who have instability in their spine may need a spinal fusion, which can include the insertion of metal parts designed to keep the spine stable.
Which form of therapy is best for improvement of the problems associated with lumbar spinal stenosis — surgical or nonsurgical? Very few studies are available to answer this question. Successful lumbar spine surgery for spinal stenosis offers better short-term results than drug therapy. People with fewer comorbidities are more likely to have a better result from surgery. However, the difference in benefits diminishes over time, and some people treated with medicines experience symptom relief for extended periods. If you are considering surgery to treat your lumbar spinal stenosis, you should first have a thoughtful discussion with your doctor about your condition and its potential for improvement.
Last Reviewed on July 27, 2011
David Borenstein is a rheumatologist and Clinical Professor of Medicine at The George Washington University Medical Center in Washington, DC. Over the course of his 32-year career, his major medical interest has been the evaluation and treatment of spinal disorders.
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