Your spine is the central framework of your body. It holds you upright, connects the rest of your skeleton together, and allows your body to flex and move freely. When the spine functions correctly, it provides support and balance. But if you’re dealing with a spinal condition, it can significantly affect your mobility and ability to carry out everyday activities. One of those conditions is called spinal stenosis, which refers to the narrowing of the spaces between your vertebrae. Symptoms of spinal stenosis and their impacts can vary greatly from patient to patient, as can treatment options. But if you’ve recently been diagnosed with this condition, you’re likely wondering, “Do I need surgery for spinal stenosis?”
At Spine Medicine & Surgery of Long Island, we always take a conservative approach to spine treatment. So depending on your symptoms and the cause of spinal stenosis, you may not require surgery to get back to living your life to the fullest. In this post, Dr. Daniel Choi will share:
- The function of the spine
- What is spinal stenosis?
- Treatment options for spinal stenosis
- Surgery for spinal stenosis
How the Spine Works
To help us understand how spinal conditions like spinal stenosis affect mobility and quality of life, let’s first take a look at how the spine is meant to function. The spine is made up of 33 vertebrae — disc-shaped, interlocking bones — that stack up to form the spinal canal. Your cervical spine, which is the section of spine that makes up your neck, comprises seven vertebrae. Your upper back is known as the thoracic spine and has 12 vertebrae. Your lower back is your lumbar spine and has five vertebrae. And lastly, you have five vertebrae in the sacrum and four fused vertebrae in the coccyx (which form the tailbone).
The spine naturally has four slight curves. At the neck (cervical spine) and at the lower back (lumbar spine), the spine curves inward. At the upper back (thoracic) and the bottom of the spine (sacrum), the spine curves outward. These S-curves give your spine stability and mobility, act as a shock absorber during movements like running and walking, and provide protection to the vertebrae.
Your spinal cord, which is a bundle of nerves, runs through the spinal canal. This is where spinal stenosis shows up. Keep reading to learn more about what causes spinal stenosis and how to know if you have this condition.
What is Spinal Stenosis?
So we know that the vertebrae create a tunnel known as the spinal canal. If the spinal canal narrows, it reduces the space available for your spinal cord and its bundle of nerves. This tightening of space is referred to as spinal stenosis, and it can irritate or put pressure on the spinal cord and nerve roots, leading to back pain, sciatica or neck pain.
Some of our Long Island spinal stenosis patients have no symptoms at all. For those with symptoms, they vary depending on the area of the spine affected and can include:
- Back pain and/or neck pain, ranging from mild to severe
- Tingling or numbness in an arm, leg, foot or hand
- Weakness in an arm, leg, foot or hand
- Difficulty walking or standing for long periods
- Problems with balance
Spinal stenosis typically happens gradually over time and is most common in people over the age of 50. The condition is often caused by:
- Bone spurs due to osteoarthritis
- The thickening of ligaments that can occur with age
- Injury to the spine
- Spondylolisthesis (slipped disc/vertebrae)
- Herniated discs
How is Spinal Stenosis Diagnosed?
Since the symptoms of spinal stenosis are often similar to other spine conditions, getting a proper diagnosis is key to treatment. Early diagnosis and treatment can slow or even stop the progression of spinal stenosis, so if you think you might have spinal stenosis, come see us for a consultation. When you visit our Long Island spine specialist, here’s what you can expect:
- Discussion with Dr. Choi: Dr. Choi will start your consultation at Spine Medicine & Surgery of Long Island by talking with you about your symptoms, the triggers for your pain and your medical history.
- Exam: Next, Dr Choi will perform a comprehensive physical examination. He’ll assess your spine and may ask you to bend in different directions to see if certain positions cause discomfort.
- Imaging Tests: Depending on your symptoms, Dr. Choi will likely order one or more imaging tests, such as:
- An X-Ray: This will allow Dr. Choi to determine if bone spurs and/or spinal instability (spondylolisthesis) are causing your spinal stenosis.
- An MRI: An MRI can identify specific areas where disc herniations or ligament and joint overgrowth are causing spinal stenosis.
If Dr. Choi determines that you do, in fact, have spinal stenosis, he will then begin to formulate a comprehensive, minimally invasive treatment plan to help you regain a pain-free life.
Non-invasive Treatment for Spinal Stenosis
When you visit us for spinal stenosis treatment in Long Island, Dr. Choi will create a personalized plan tailored to your needs. Your options will depend on how severe your symptoms are and the extent of your condition. Treatment may involve a combination of any of the following:
- Medications: Medications including non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants can reduce the symptoms of spinal stenosis.
- Physical Therapy: A physical therapist will guide you through exercises and stretches to help you regain your strength, balance and flexibility. They may also use techniques like massage to loosen up stiff muscles if they’re contributing to your symptoms.
- Steroid Injections: Steroid injections are a minimally invasive way to temporarily reduce inflammation and pain.
- Surgery: Surgery for spinal stenosis is typically only recommended after the more conservative treatment options fail.
Surgery for Spinal Stenosis
Worst case scenario, if non-invasive treatment options are ineffective for spinal stenosis, surgery may be your only option. However, as a minimally invasive spine surgeon, Dr Choi uses the latest technology and techniques for a safer procedure and shorter recovery period.
There are a few types of spine surgeries that can relieve spinal stenosis. At our Long Island spine clinic, we offer:
The laminectomy procedure is one of the most common types of back surgery. It’s highly effective for treating pain when conservative treatments have failed. When performing a laminectomy, Dr. Choi makes an incision in the treatment area. He then gently moves the muscle and soft tissue aside so he can access the spine. Finally, Dr. Choi removes any structures that are compressing the nerves, such as bone, bone spurs and ligaments.
Cervical Laminectomy and Fusion
This type of laminectomy procedure is performed to widen the spinal canal. By creating more room, the pressure on the spinal nerve or spinal cord is relieved. A cervical laminectomy and fusion is a common treatment option for cervical spinal stenosis.
During the procedure, which is performed under general anesthesia, Dr. Choi makes an incision at the center of the back of the neck in order to reach the cervical spine. He then removes a small portion of the lamina (the bony area that forms the roof of the spine).
In addition to a laminectomy or as a standalone surgery, Dr. Choi may also perform a spinal fusion. In this procedure, Dr. Choi places bone graft to fuse together two or more vertebrae. If necessary, he also inserts titanium screws to keep the bones secure until you have healed. A fusion stabilizes the spine, reduces the chance of the symptoms recurring and prevents development of spinal instability.
Have questions about spinal stenosis, getting a diagnosis or your treatment options? Contact Spine Medicine & Surgery of Long Island to talk to our Harvard-trained spine specialist today.