Spinal Stenosis
Spinal stenosis is an arthritic narrowing of the spinal canal that can put pressure on the nerves that supply the arms and legs. This nerve compression can result in pain, numbness, or weakness in the back, neck, and/or one of the limbs, which can interfere with a patient’s daily life and require treatment.
Dr. Alex Ching is a fellowship trained and board certified spine surgeon with over a decade of experience in treating spinal stenosis. He has also published numerous articles in medical journals about spine conditions. Whenever possible, he recommends nonsurgical treatments initially, and only recommends surgery when more conservative treatments are ineffective in relieving symptoms.
Causes & Symptoms of Spinal Stenosis
Spinal stenosis is typically caused by arthritis and degenerative changes to the spine over time. The discs in the spine can lose water content over time, causing the disc space to collapse or lose height. This, in turn, can narrow the tunnels through which the nerves exit the spinal canal. It can also put more weight on the facet joints in the spine, causing them to eventually develop arthritis. If facet joint arthritis progresses to the point that the bones rub against each other, bone spurs may also develop, further narrowing the exit tunnels for the spinal nerves.
Symptoms of spinal stenosis can include:
- Back or neck pain
- Sciatica – numbness, tingling, or burning pain that radiates from the buttucks down through one of the legs
- Numbness, tingling, or burning pain that radiates down one of the arms
- Weakness in the affected arm or leg
In some cases, patients find relief from symptoms when leaning forward or sitting, especially when spinal stenosis is present in the lower back. Conversely, symptoms may get worse when standing or walking. Some studies show that leaning forward may increase space for the nerves to pass through, relieving some of the pressure.
Treatments for Spinal Stenosis
Initial treatment for spinal stenosis is typically nonsurgical. However, spinal stenosis tends to get progressively worse over time, and patients may reach a point where more conservative treatments are no longer effective. If symptoms progress to the point where they affect a patient’s daily life, Dr. Ching may recommend surgery.
Nonsurgical Treatment
Nonsurgical treatment for spinal stenosis typically involves physical therapy to strengthen and condition the back. Physical therapy can also help with strengthening the abdominal muscles, which provides additional support to the spine.
Cortisone steroid injections may also provide relief from spinal stenosis symptoms. Cortisone can be injected in the space surrounding the compressed nerve to decrease swelling, which can provide pain relief.
Over time, nonsurgical treatments tend to become less effective as arthritis progresses in the spine. If symptoms are severe and interfere with everyday activities, Dr. Ching typically recommends surgery.
Surgical Treatment
When patients need surgery for spinal stenosis, Dr. Ching typically recommends a laminectomy if the spine is stable. During this procedure, he makes an incision in the back above the affected area. He then removes the bone over the compressed nerve, essentially removing the “roof” from the tunnel through which the nerve passes, along with any bone spurs if they are present. This creates more space for the nerve and relieves compression. For this reason, a laminectomy is sometimes called a “decompression” procedure.
In more severe cases, arthritis can progress to the point of spinal instability. For these patients, Dr. Ching may recommend a spinal fusion in addition to a laminectomy. The unstable levels of the spine are fused together with screws and rods to provide stability of the spine. Sometimes the disc is removed and replaced with a cage filled with bone graft to further assist in getting the bones to grow together.
Recovering from Spinal Stenosis Surgery
Following surgery, patients may return home the day of surgery or stay in the hospital for 1-2 nights, depending on the extent of the procedure. Surgery typically relieves nerve-related pain almost immediately, but patients often experience surgical pain for the first couple of weeks after surgery.
Patients are advised to gradually build up activity after surgery, and it takes most patients about 4 to 6 weeks to begin to see progress in recovery. Patients typically start with light walking and progress to more strenuous activities as they build up strength. The majority of patients do not need physical therapy, but Dr. Ching may refer to a physical therapist if a patient wants or needs assistance with making progress in recovery.
Full recovery and return to activity varies from patient to patient and depends on the procedure done. It may take up to 5 months for complete recovery and return to activity. Dr. Ching will advise when it is safe to return to all normal activities.
Spinal Stenosis Treatment in Tualatin, OR
Dr. Alex Ching is a board certified and fellowship trained spine surgeon with over a decade of experience in treating spinal stenosis. He has been published in numerous medical journals on the treatment of spinal conditions. Dr. Ching only recommends surgery when spinal stenosis symptoms are affecting a patient’s daily life, and utilizes more conservative treatments whenever possible. If you would like to schedule an appointment with Dr. Ching, please call our office at (503) 828-1150 or use our Appointment Request form.