What to Know About Spinal Stenosis Surgery

Spinal stenosis surgery involves making more room in the vertebrae of the spine to relieve compression on the spinal cord and nerve roots. Spinal stenosis occurs when vertebral openings narrow due to degenerative changes.

This can result in the pinching of the spinal cord or the spinal nerve roots that exit the spinal cord. It most commonly occurs in the lumbar spine, or low back, but it can also occur in the cervical spine or neck.

Low back pain, especially when extending the lumbar spine, standing, or walking, as well as tingling, numbness, weakness, and radiating pain into the legs, are common symptoms of spinal stenosis. Spinal stenosis usually develops gradually, with symptoms that worsen over time.

Adults typically undergo spinal stenosis surgery after conservative measures fail to produce long-term improvements in symptoms such as pain, numbness, weakness, and tingling that interfere with daily life. Medication, spinal injections, and physical therapy are all conservative treatments for spinal stenosis.

If you haven't seen any improvement after several weeks of trying these methods and your symptoms are interfering with your daily functioning, your healthcare provider may want to schedule a surgical consult to discuss your options and prepare you for surgery.

Your healthcare provider will schedule spinal stenosis surgery ahead of time. Based on the availability of the surgeon and the operating room, you may have to wait several weeks or months to schedule your surgery.

The surgical team will give you more detailed instructions on what you need to do in the days and hours leading up to surgery. To promote optimal healing and a smooth recovery, it is recommended that you stay active, eat a healthy diet, and stop smoking prior to any operation.

Certain medications may need to be discontinued in the days leading up to surgery to avoid excessive bleeding or anesthesia interaction during the procedure. For your safety, always consult with your healthcare provider about all prescriptions, over-the-counter medications, and supplements you are taking.

Spinal stenosis surgery will take place in a hospital, and you should plan on staying for at least a day. The length of your stay will vary depending on the procedure, but it will include at least another day in the hospital and up to a five-day stay.

Arrive early on the day of your surgery to allow extra time to find your way around the hospital, check-in, and fill out all necessary paperwork. Once all paperwork is completed, you will change into a hospital gown and undergo a brief physical examination to ensure you are fit for surgery.

You will be wheeled into the operating room on a hospital bed and given an IV in your arm or hand to administer fluids and medication. The surgical team will help you into the operating room and administer anesthesia to put you to sleep for the surgery.

Most spinal stenosis surgeries will have you lying on your stomach so that the surgical team can access your back. To access the vertebrae, an incision is made vertically along the spine of the low back.

Tissue such as disc portions, vertebral portions, or bone spurs will be surgically removed during discectomies, laminectomies, and foraminotomies to relieve compression on the nerve roots or spinal cord and create more space.

If there are fractures and slippage of the vertebrae, significantly herniated discs, or laminectomies to multiple vertebrae, spinal fusion surgery may be required because the spine will become unstable.

By removing the disc between the vertebrae and surgically fusing two or more vertebrae together, spinal fusion will help stabilize the affected segments of the spine. To help the vertebrae heal and fuse together, a bone graft is used to fill in the space where the disc was removed.

An anterior approach, in which the spine is accessed from the front of the body, is occasionally used during spinal fusion surgery. In order to access the spine from the front, an incision is made along the side of the abdomen.

Following your surgery, you will be transferred to a recovery room for several hours until you fully awaken from anesthesia. When it is determined that you are stable, you will be transferred to a hospital room until you are discharged.

Within 24 hours of the surgery, you will be encouraged to get up and walk. When you are discharged from the hospital, your healthcare provider will schedule follow-up appointments for you.