Spinal stenosis is a fancy term for narrowing. Imagine a tunnel or canal that should be wide and spacious allowing plenty of room for the spinal cord and nerves which exit into your arms or legs. However, when stenosis is occurring this tunnel or canal is smaller or more narrow. This results in less room for the very important spinal cord and exiting nerves. This can be very painful and is one of the most common causes of low back and leg pain. Spinal stenosis is graded from mild to severe. Symptoms can include pain, numbness, tingling, and muscular weakness. In severe cases, this can result in loss of bowel and bladder function.
We recently had a patient with a history of a prior lumbar fusion. She felt great relief after her previous surgery. However, she returned to our clinic years later with severe low back and leg pain. The area above her fusion had worn out and she had spinal stenosis of her central canal where the spinal cord is. In order for her to get any relief, she had to use many high-dose pain meds as well as lean forward on her kitchen countertop or on a shopping cart while at the store. This position, where she flexed slightly forward, would remove some of the pressure of the stenosis by opening up the canal a bit wider. She required surgery to remove the stenosis, or open up the canal, to stop the compression of her spinal cord. The patient was in so much pain that she could not bear the thought of stopping her ibuprofen the week prior to surgery and required steroids to help manage her pain. Thankfully, her second surgery did not require a fusion, but simply a decompression. Dr. Mesiwala removed the lamina and the medial portion of the facet joints. These bony elements can be thought of as the “roof” of the canal. These are removed allowing for the spinal cord to be decompressed and have all the spacious room it needs to function and not cause pain.
The patient noted significant relief after her surgery. She was able to stop all high-dose pain medications almost immediately. She came to her first post-op appointment bearing gifts and was smiling ear to ear. She was so happy to be no longer in pain.
In general, spinal stenosis in its early stages can be treated with anti-inflammatory medications or cortisone injections with a pain management specialist. However, should it reach a point where neurosurgical intervention is needed, we highly recommend Dr. Mesiwala. Do you have spinal stenosis that may require surgery? Contact us to set up an appointment today.