CNY Orthopedic Sports Medicine, PC: TreatmentPrint: Spinal Stenosis
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Injuries and Conditions: Spinal Stenosis : Spinal Stenosis : Treatment Options
 

Treatment options:

Spinal Stenosis Overview

Evaluation of Patient for Surgery

  • Patients undergo a complete history and physical examination.
  • Specific diagnostic imaging studies to determine the extent and level of the disc herniation are also obtained.

    Post Operative Recovery

  • Immediately after surgery, as anesthesia wears off, patients will usually feel tired and slightly disoriented, although the after-effects of anesthesia can vary greatly from patient to patient.
  • Post-operative pain will be present and may require over-the-counter or prescription medication to control the pain.
  • The patient is normally released from the hospital two to five days after surgery and can resume physical activities such as walking almost immediately.
  • Total recovery may take anywhere from six weeks to six months depending on how advanced the spinal stenosis and associated nerve involvement was at the time of surgery.

    Surgical Procedure

    Possible Complications and Risks

  • Nerve root injury that could result in partial or complete loss of function.
  • Risks during and after surgery include problems that may develop in relation to bleeding, the possibility of infection, and reactions to anesthesia.
  • Injury to blood vessels, or the development of blood clots.
  • Anesthesia and medical (heart, lung) complications.
  • The possibility of unforeseen complications.

    Conservative Treatment of Spinal Stenosis Overview

  • Medications specifically designed to treat nerve pain and irritation can be prescribed.
  • NSAID's (non-steroidal anti-inflammatory drugs) are administered to treat the pain and inflammation associated with both the degenerative changes in the spine and the compression of the nerves and spinal cord.
  • Since steriods have very strong anti-inflamatory effects, epidural steriod injections may be useful in relieving the pain associated with nerve compression.
  • Postural changes may relieve symptoms. These include leaning forward while walking or lying down with the knees drawn up to the chest. Both enlarge the space available for the nerve root in the lumbar spine.
  • Physical therapy can strengthen and help maintain flexibility within the spine.
  • Weight loss, if over weight, to lessen the load supported by the spine.

    Medication and Medical Products
    NSAIDs NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
  • Pain resulting from inflammation or swelling.
  • Pain after injury.
  • Joint pain and arthritis.


  • Long-Term Expectations for Recovery

  • Recovery is dependent on the cause and the extent of the narrowing within the spinal canal, the amount of nerve root or spinal cord compression, and the length of time of the compression.
  • Patient's goals and lifestyle may need to be altered, with modification of symptom producing activities.
  • Generally, good results are expected with increased walking capacity and decreased leg pain.

    Possible Complications and Risks

  • Permanent nerve root injury that could result in paralysis or loss of feeling and function of an extremity are uncommon.
  • Loss of bowel and bladder control if specific nerves in the lumbar region are involved
  • The possibility of unforeseen complications
  • Anesthesia and medical (Heart, lung, and blood clots) complications