Orthopedic & Neurosurgery for Spinal Stenosis

Spinal stenosis is a condition in which the space where the spinal cord passes through the vertebrae becomes narrow and presses on the spinal cord or spinal nerves. Conservative treatments, such as medication and physical therapy, can relieve the symptoms of most spinal stenosis. However, if surgery becomes necessary, both neurosurgeons and orthopedic surgeons who specialize in spine surgery can perform surgery to relieve spinal stenosis, according to Spine Universe.

Background

• The purpose of spinal stenosis surgery is to widen the spinal canal, thus relieving pressure on the spinal cord or spinal nerves. The surgeon removes, trims or realigns parts contributing to the pressure. Different types of surgery are available for spinal stenosis. The choice of surgery depends on where in the spine the stenosis is occurring, the alignment of the spine and what is causing the stenosis.

Decompressive Laminectomy

• According to Spine Universe, the most common spinal stenosis surgery in the lumbar spine is decompressive laminectomy. The surgeon removes the roof of the vertebrae to create more space for the nerves. The surgeon may or may not fuse the vertebrae, remove part of an intervertebral disc or use devices (such as screws or rods) to support unstable areas of the spine.

Surgery for Cervical Stenosis

• Surgery to relieve stenosis in the cervical spine may include anterior cervical discectomy and fusion, cervical corpectomy or laminoplasty. In anterior cervical discectomy and fusion, the surgeon makes a small incision in the front of the neck, removes an intervertebral disc and replaces the disc with a small plug of bone, which over time will fuse the vertebrae.

  In cervical corpectomy, the surgeon removes part of the vertebra and adjacent intervertebral discs. The surgeon then uses a bone graft and sometimes a metal plate and screws to stabilize the spine.

  In laminoplasty, the surgeon goes in through the back of the neck to reconstruct parts on the back of the cervical spine to make more room for the spinal canal.

Other Surgeries

• Other surgeries, which may be done in any part of the spine, include laminotomy, which removes only part of the lamina, instead of the whole thing. In a foraminotomy, the surgeon widens the foramen (the area where the nerve roots exit the spinal canal). Sometimes, foraminotomy and laminotomy are done together.

  Medial facetectomy removes part of a facet (a bony structure in the spinal canal) to increase the space.

Considerations

• When considering surgery, review your options, get a second or third opinion, understand the risks and understand what surgery can and cannot do for you.