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Spinal Stenosis Treatments
This is an abbreviated version of the complete article.*
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| Basic Facts |
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Spinal stenosis occurs when the spinal canal narrows. This can put pressure on the spinal cord or nearby nerve roots. |
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This condition does not always cause symptoms, but it can trigger back, neck, or shoulder pain or numbness and tingling in the arms or legs, depending on where it occurs. |
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Spinal stenosis is typically treated first with pain relieving medications and physical therapy. Surgery may be recommended if spinal stenosis worsens or if symptoms are severe. |
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In spinal stenosis, the spinal canal narrows, putting pressure on the spinal cord or nearby nerve roots and often triggering back, neck, or shoulder pain, or numbness and tingling in the arms or legs, depending on where it occurs. Most cases of spinal stenosis are caused by age-related degenerative conditions such as osteoarthritis.
If nonsurgical measures have failed to relieve symptoms of spinal stenosis, a physician may recommend a series of epidural steroid injections (ESIs) into the back or neck to ease pain and inflammation or a surgical procedure called a laminectomy to widen the narrowed spinal canal.
WHEN IS IT INDICATED?
Epidural steroid injections. ESIs may be particularly helpful for treating acute, lumbar stenosis-related pain that radiates to the hip or down the leg.
Laminectomy. When nonsurgical treatments are no longer effective or if symptoms interfere with walking or bladder or bowel function, the physician may recommend laminectomy.
PRE-TREATMENT GUIDELINES
Epidural steroid injections. People who take warfarin (Coumadin) or other anticoagulant medications should discuss this with their physician in advance.
Laminectomy. People who smoke should stop smoking approximately 2 weeks before surgery. Smoking can cause postoperative complications and interferes with recovery, especially nerve healing.
WHAT TO EXPECT
Epidural steroid injections. The patient's back is numbed and a needle is inserted into the neck or lower back, depending on where stenosis is located. The physician then injects another numbing medication and a steroid drug into the space surrounding the membrane that covers the spine.
Laminectomy. For this procedure, the surgeon makes an incision into the patient's back and removes part or all of the back portion of one or more of a patient's vertebrae.
POST-PROCEDURE GUIDELINES AND CARE
Epidural steroid injections. Once the local anesthesia wears off, spinal stenosis pain usually returns. It may take a few days to feel the effects of the steroid injection, although it can provide significant pain relief that may last for weeks to months.
Laminectomy. Following the procedure, the patient will be taken to a recovery room. He or she will be given medication to relieve pain and will later meet with a physical therapist, who will give the patient instructions on the best positions for sitting, standing, and sleeping.
POSSIBLE COMPLICATIONS
Epidural steroid injections. The risks of ESIs are small when a skilled physician administers them. Complications from ESIs are rare but can include bleeding, infection, and paralysis.
Laminectomy. Possible complications from laminectomy include bleeding, infection, and blood clots.
Medical Review Date: May 24, 2006
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