What is spinal stenosis?

Spinal stenosis is where the space in the centre of your spine (spinal canal) narrows. The spinal canal contains the nerves that leave the lower end of your spinal cord (see figure 1).

A combination of arthritis in your spine, thickening of the ligaments, and bulging of the discs can cause this to happen. The nerves can get trapped in the spinal canal or where they leave your spine, causing weakness or pain in your legs.

What are the benefits of surgery?

You should get relief from any pain or weakness in your legs.

Are there any alternatives to surgery?

If you have only mild symptoms, you may not need any treatment. Your symptoms are unlikely to get worse quickly. A few people will even get better with time.

If you have pain down your leg that is caused by pressure on a nerve in your lower back (sciatica), you can have a steroid injection in your spine.

What does the operation involve?

You will usually have an MRI scan, to confirm the diagnosis and help your surgeon to plan the operation.

Various anaesthetic techniques are possible. The operation usually takes an hour to 90 minutes.

Your surgeon will make a cut on the centre of your lower back. They will remove enough bone and ligament tissue from the back of your spine to free the trapped nerves.

Your surgeon may need to join the bones using a bone graft. Sometimes they will need to use metal screws and rods.

What complications can happen?

1 General complications

  • Pain
  • Bleeding
  • Infection of the surgical site (wound)
  • Unsightly scarring
  • Blood clots
  • Difficulty passing urine
  • Chest infection
  • Heart attack
  • Stroke

2 Specific complications

  • Continued pain or numbness
  • Numbness between your legs, loss of normal bowel and bladder control and, for men, problems with having an erection
  • Tear of the thin membrane that covers the nerves in your spine
  • Infection in your spine

How soon will I recover?

You will usually be able to start walking the next day. You should be able to go home after three to five days.

Do not lift anything heavy.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery from surgery, but you may still get backache from time to time because of wear and tear in your spine.

Spinal stenosis can sometimes come back.

Summary

Spinal stenosis causes pain or weakness in your legs. If your symptoms are severe, a spinal decompression operation should relieve your symptoms and help you to return to normal activities.

Acknowledgements

Author: Mr Stephen Milner DM FRCS (Tr. & Orth.)

Illustrations: Copyright © [[SYMBOL:Neurodesign]]. All rights reserved. www.neurosurgeon.co.uk and Medical Illustration Copyright © Medical-Artist.com


This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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