When is surgery needed for spinal stenosis?

I have had spinal stenosis for 12 years. In the past 6 months, my leg pain has gotten worse and I have difficulty walking. How to treat this disease? Do I need surgery? (Huynh Hoai, Tien Giang )

Reply:

Spinal stenosis is a condition in which the space inside the spinal canal is narrowed, causing pressure on the nerve roots and spinal cord passing through the spine. In mild cases, the disease often has no obvious symptoms, but if not detected and treated promptly, spinal stenosis can cause numbness, weakness in the limbs, loss of balance, sphincter disorders causing incontinence and paralysis.

Treatment for spinal stenosis depends on the location of the stenosis, the cause, and the severity of the symptoms. Initially, the disease is often treated with conservative methods, lifestyle changes such as weight loss to reduce stress on the back, heat to increase blood flow, relax muscles and reduce pain... Patients may be prescribed physical therapy exercises to maintain flexibility and stability of the spine, increase strength, endurance and improve balance.

If necessary, your doctor may prescribe short-term pain medications and muscle relaxants to temporarily relieve the discomfort caused by spinal stenosis. If this does not provide the expected results, corticosteroid injections into the spinal canal may be recommended. Corticosteroids reduce inflammation, thereby relieving the nerve roots from swelling and irritation caused by compression.

Surgery is only used when other treatments have not been effective. The goal of surgery is to create more space for the spinal cord. During the surgery, the doctor numbs the lumbar region and performs decompression through a small incision in the skin. The advantage of this procedure is that it preserves the integrity of the bony structure and causes less mechanical disruption of the spine, allowing for a quick recovery. Patients can go home within a few hours of the procedure, walking and/or physical therapy immediately after. After surgery, symptoms of numbness, tingling, and muscle weakness are improved positively.

To have the appropriate treatment regimen, you should see a doctor for a direct examination and perform the necessary tests and imaging diagnostics.

MD.CKI Kim Thanh Tri
Spine Department, Tam Anh General Hospital, Ho Chi Minh City

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