Spinal Stenosis Surgery: Everything You Need To Know
Spinal stenosis is the narrowing of spaces within your spinal canal, which reduces the amount of space available for your spinal cord and the nerves that branch off from it. This causes the spinal cord or nerves to become irritated, compressed or pinched, which can result in a range of conditions such as:
- Back or neck pain
- Burning, numbness, tingling or weakness down the arms or legs
- Loss of sensation in the extremities (feet and hands)
- Problems with walking or balance
- In severe cases, bowel or bladder issues may occur (urinary urgency or incontinence)
The most common for spinal stenosis are in the lower back or neck. While some people may experience the symptoms noted above, others may be asymptomatic until something triggers or irritates their underlying condition.
Causes of Spinal Stenosis
A common cause of spinal stenosis is osteoarthritis (OA), a condition developed as a result of wear and tear, physical stress or repetitive injuries. People with poor posture, alignment or movement of their spine and surrounding tissues may be more prone to developing OA. Over time, osteoarthritis can lead to the development of bone spurs and irritation of the surrounding ligaments and tissues. Chronic tissue irritation can cause the ligaments to enlarge over time, thus narrowing the spinal canal. This narrowing process will lead to increasing pressure on the spinal cord and its surrounding nerves.
Another common factor for those with spinal stenosis are degenerative disc and slipped disc issues. The bulging part of the disc can further crowd the neural canal where the spinal cord resides. Thus, many older patients with slipped disc or degenerative disc may also exhibit signs and symptoms consistent with spinal stenosis.
When do I need Spinal Stenosis Surgery?
Most people with spinal stenosis do not need any surgery. However, there are certain situations which may require surgical intervention. These situations include:
- Exhausted non-surgical treatments such as medication, chiropractic and physical therapy, or injections have failed to bring relief to symptoms.
- Persistent and severe pain over long periods.
- Progressive muscle weakness or numbness that makes daily activities difficult (loss in sensation or motor strength in arms or legs).
- Loss of bowel or bladder control.
Surgical Treatment for Spinal Stenosis
The most common surgical treatment for spinal stenosis is a laminectomy. This may also be known as surgical decompression. This surgical procedure creates space for the spinal cord by removing the lamina, a back part of a vertebra that covers the spinal canal. It is known as decompression surgery because the surgery enlarges the effective space of your spinal canal to relieve pressure on the spinal cord and nerves. In many cases the adjacent vertebrae next to the one(s) with the lamina removed will be fastened with screws to prevent movement of those segments. This will of course change the natural mechanics (movement) of the spine and surrounding tissues. Thus, patients having had a laminectomy should still seek quality physical therapy and chiropractic care post-recovery to ensure they decrease their chances of future secondary problems.
Spinal Stenosis Surgery Costs: Laminectomy
Laminectomy procedures in Singapore typically cost from anywhere between SGD 16,600 to SGD 25,000 or more.
Laminectomy is a generally safe procedure; however, as do most forms of surgery, pose potential complications such as:
- Blood Clots
- Nerve Injury
- Spinal Fluid Leak
- Longer-term movement issues
Although laminectomy is a proven effective way to relieve stenosis symptoms, it opens up the spinal cord to direct impact risks as the lamina is no longer there to protect it.
Spinal Stenosis Surgery Recovery Time
Patients can typically return home within the same day of surgery or stay in the hospital for 1-2 days for larger procedures. The less invasive the surgical procedure, the faster the patient can return home and to their daily lives. Medication should be provided to the patient to relieve any post-surgical discomfort experienced.
While everyone recovers at a different pace, patients who have undergone surgery should avoid any bending or twisting motions immediately after surgery to prevent any further complications. The intensity of physical activity should be gradually increased as your body allows.
Spinal Stenosis Surgery Success Rate
70 to 80 percent of patients that experience significant back pain observed relief and symptom improvement after laminectomy surgery. However, as the surgery does not correct the underlying problem that causes the spinal tissues to wear down gradually (poor spinal mechanics and/or posture), symptoms can return down the road.
Chiropractic and Rehabilitation for Spinal Stenosis
Chiropractic takes a holistic approach to spinal stenosis by taking into account the patients symptoms, the current state of the spine, the patient’s lifestyle, and the body’s response to treatment. Your chiropractor can better assess your situation before beginning treatment with an X-Ray, MRI or CT scan to determine the level(s) of the spine in which stenosis is occurring, and which stage of degeneration you are currently at.
The objective of care is initially to widen the space available for the spinal cord and nerve roots, via conservative means, so as to reduce pressure on the nerves and ease the symptoms associated with spinal stenosis. Once the patient is experiencing a significant relief from their presenting condition, it is critical to begin them on home rehabilitation exercises to activate and strengthen supporting muscles, stretch overly tight muscles, improve posture, and more.
After you have been diagnosed, our chiropractors will apply a variety of techniques to restore proper mechanics, release tight muscles and other tissues, relieve nerve compression and inflammation, and begin to restore proper mobility.
- Non-surgical spinal decompression (NSSD). Our modern generation decompression machines use state-of-the-art algorithms to gently, safely, and effectively reduce crowding within the spinal canal caused by degenerative disc disease (bulging or “slipped disc”) and inflammation of surrounding tissues.
- Specific spinal manipulation. This gentle thrusting technique (often with associated “popping” or “clicking” sounds) has been known to restore joint movement and reduce pain effectively.
- Whole body vibration (WBV). High-frequency vertical vibration with the body in a flexed position can help tissues relax muscles and soft tissues, and decrease pressure on the nerves.
- Low-level laser therapy (LLLT). Also known as “cold laser” therapy, LLLT has been shown to reduce inflammation, help minimise pain, and accelerate the body’s natural healing process.
- Physiotherapy. Critical to restoring proper long-term movement patterns, posture and reducing the likelihood of relapse.
Is Chiropractic Treatment and Rehabilitation better for me?
Chiropractic care focuses on identifying and correcting dysfunction in the normal movement and alignment of joints and tissues of the spine and body as a whole. As a result, chiropractic care is naturally less invasive than other treatment options and doesn’t require any harmful medications or risks associated with injections or surgery.
At Elite Spine Centres, we will first assess each patient’s condition based on the amount of damage present, the patient’s age and the symptoms experienced before we determine whether conservative treatment is suitable. Chiropractic care is an excellent option to slow down the progression of the condition significantly should the patient not want or require surgery. Furthermore, beyond our unique FCM Chiropractic methods, we have a fully-equipped centre with various therapies that can enhance your healing process and get you back to your normal life faster.
Most importantly, regardless of the treatment you opt for, if you find yourself or a loved one experiencing these symptoms, seek a detailed consultation immediately to have it diagnosed and treated before symptoms worsen. We hope you found this information useful, and please do feel free to reach out to us should you have any questions.
Dr. Michael Bryant, doctor of chiropractic and member of the Alliance of Chiropractic (AOC) Singapore, graduated summa cum laude from Life University in Atlanta and received several distinctions, as well as completing additional coursework and NBCE certification in physiotherapy. Michael Bryant is the founder of Elite Spine Centers. Read more about Dr. Mike here.