Surgery for Spinal Stenosis
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| Illustration: ADAM |
A recent study completed at 13 spine clinics around the US, and published in the Feb. 21 issue of the New England Journal of Medicine shows that surgery yields more dramatic pain relief than non-operative care of spinal stenosis. The study also revealed that 2 years after surgery, the positive effect - in terms of pain relief and return to function - is less, and the benefits gap between invasive treatment and conservative care for this condition is narrowed.
The goal of surgery is to relieve pressure on nerve roots and the spinal cord. A laminectomy is the type of surgery usually done for stenosis.
Spinal stenosis can be a real bear, and surgery, as the study indicates, will likely relieve a lot of pain, fast. But the New England Journal of Medicine also points out that there have been no high quality research studies addressing pain relief when non-operative, aka, conservative care is tried. In other words, we still don’t have all the information.
But there are some things we do know. As far as pain medication goes, Tylenol is usually tried first. If that doesn’t work, NSAIDs are next. Sometimes doctors will recommend an injection for scar tissue they believe to be in the epidural space. But there is only sparse and conflicting data on the value of this injection for patients. If your doctor wants to try the epidural, ask her or him to explain how it will relieve your back pain.
Also, extension movements (bending backwards) of the spine bring on symptoms of spinal stenosis. Therefore, a slight bit of spinal flexion (forward bending) tends to relieve symptoms. The NEJM recommends that a physical therapist show you how to incorporate flexion into your daily life. It also says that strengthening core abdominals can help you to live with a little spinal flexion all the time, thus relieving some of the pain.
Comments
As a physical therapist, I have worked with many patients following spinal surgeries who don’t see a huge change in their pain or function. Conservative care should always be tried prior to surgical intervention, with a focus on stretching the back, hip, and leg muscles, strengthening core muscles, and learning how to move and position the body in order to create the least amount of pressure on the spine.
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Thank you for your input! I am with you on that. As an exercise instructor for people with back and neck (and other problems), I know that most people give up too easily on activities like stretching the hip muscles (VERY important) and strengthening muscles of the core, spine and pelvis. Ditto for learning how to move and position one’s self. Why turn to surgery unless you absolutely need it?
How Much Should Spinal Stenosis Surgery Cost? I’ve heard that Israel is one of the cheapest medical tourism countries for Spinal Stenosis Surgery. Can anyone name a better place to go?
I had spinal stenosis so bad that my legs and feet were numb, I couldn’t walk without pain and couldn’t stand for more than five minutes. I tried everything and finally had surgery. I seem to be completely heeled. The recovery is slow, but all the symptoms are gone and I have no pain. I’m confident that I had a wonderful surgeon. My brother had the same operation ten years ago and is an active outdoors man, hiking and fishing in Montana.
Turkey is a great place for having spinal surgery with JCI acredited hospitals ,reasonable prices and experienced surgeons.