What is Lumbar spinal stenosis?
Lumbar Spinal Stenosis is a condition where the central canal in the lumbar spine, which carries the nerves, narrows.
It leads to a compression of the nerves going to both legs and can cause sciatic pain, or you might have difficulty walking due to a sense of weakness or numbness in the legs.
What causes Lumbar spinal stenosis?
The cause of the narrowing is a gradual process of degenerative change that results in bony spurs and thickened ligaments.
These impinge on the spinal canal. It develops over a period of years.
Why have surgery?
Lumbar spinal stenosis surgery is one of the most common spinal surgeries.
Surgery for Lumbar Spinal Stenosis will enable you to walk more easily and relieve the pain in your legs.
The surgical process
The surgery takes place under a full anaesthetic, so it requires admission to the hospital for three to four days.
- We place you face down on the operating table and then anaesthetise you.
- Using X-rays, we find the correct level to operate and make a small incision in the middle of your back.
- We expose the back of the spine at that level and remove a small portion of bone to see the thickened ligaments overlying the nerves.
- We then carefully remove those ligaments. And if there are any bony spurs in the way, we will also remove those, so the nerve is safe and free.
- Then we close the incision.
The operation takes about an hour and a half. Though it is important to note that if we are operating on multiple levels of your spine, it can take up to three hours.
The immediate after-effects of surgery
There will be some pain in your back at the site of the surgery at the site though the experience varies. For some people, it can be quite sharp. For others it is just a dull, numbing pain.
It usually settles down after two to three weeks.
At the time of surgery we often place a drain, because the accumulation of blood is potentially dangerous. In this case this will be left in place for twenty-four hours after the surgery.
If we are operating at more than one level, we will use a urinary catheter, which again, will come out the next day.
Your recovery from Lumbar spinal stenosis surgery
We get you up and walking the day after surgery and you can go home as soon as you feel comfortable. For most people that is usually after three or four days.
In the first six weeks after surgery, my advice for everyone is that the best form of recovery is to go walking as much as you can. And only after that initial six week should you resume any of your normal exercise routines.
POST-OPERATIVE follow up
I will see you post-operatively, one or two weeks after the surgery and again after six week. To assess how you are going in your rehabilitation and discuss any side-effects you might be having.
An important note
For some patients who have been in pain for a long period, their muscles and joints are deconditioned. This means that after surgery these muscles and joints will be used again and may cause some aches and pains for a while until strength returns.
In this case their recovery will be longer. It will take an extended period of gentle rehabilitation. This can include hydrotherapy or physio, and we will discuss that at your check-up visits.
If you have any questions about Lumbar spinal stenosis and surgery, please don't hesitate to contact us.
Author:
Dr Ralph Stanford
Dr Stanford is a spinal surgeon with over 20 years’ experience. He is Head of Department of Orthopaedics at Prince of Wales Hospital and adept in all surgical approaches to successfully treat his patients.
Dedicated to lifelong learning, Ralph attends spinal conferences worldwide and regularly consults with colleagues about successful treatments.
He is also a current member of Spinal PFET and an active researcher in spine disorders.
If you have any questions he can be contacted on 02 9650 4893 or info@powspine.com.au.