Treatments - Spinal Stenosis (Page 3)
- First and foremost, a correct and very detailed anatomical diagnosis is required - knowing exactly where to go while considering the possibility of a double or triple location for choking of a nerve in it passages, on one or both sides.
- Secondly, the surgery should not create a new problem, such as nerve injury or a structural instability that might require additional surgeries.
- Thirdly, the approach to correcting spinal stenosis should be minimally destructive of normal structures. The surgeon should strive to leave as much as possible of the normal or slightly abnormal tissues alone. This again points to the importance of exactly identifying the offending stenosis.
- Fourthly, the metabolic and physical status of the patient is important. Even in the hands of an experienced surgeon a decompressive procedure - especially if more than one level and if bilateral procedures are needed - may require a few hours of anesthesia, and this is not well tolerated by some patients. Some surgeons will perform the spinal stenosis surgery under an epidural anesthetic instead of a general anesthetic.
Fortunately, a decompression surgery for spinal stenosis can be among the most rewarding surgical methods used on the spine (second only to removal of some herniated discs), because generally patients do well and are able to increase their activity and have a better walking tolerance postoperatively.
