Treatment of Lumbar Spinal Stenosis
During your conversation with your doctor, he will ask about treatments you’ve already tried to help relieve and manage your low back pain and spinal stenosis symptoms. Previous therapies may have been provided by another doctor or practitioner (eg, pain management specialist, physiatrist). Insight into treatments that helped and those that were ineffective is important to developing your treatment plan.

It’s important to know that lumbar spinal stenosis is rarely an urgent surgical situation; in fact, many patients do not need spine surgery. Rather, non-surgical treatments often effectively manage pain and symptoms related to spinal disorders that cause spinal canal and/or nerve compression. Some therapies are combined and may include a treatment that was previously ineffective.

1. Non-operative therapies may include:
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs)
Massage
Heat
Acupuncture
Prescription anti-inflammatory, analgesic, topical drugs
Spinal injections
Physical therapy

Spine surgery may be considered or recommended if non-operative therapies are ineffective, your symptoms progressively or worsen, you have significant weakness or pain or the inability to walk becomes intractable or difficult to manage.

2. Surgery to treat lumbar spinal stenosis:
The primary goals of surgery for lumbar spinal stenosis are to:

Decompress the nerves that are compressed (ie, make more room for the nerves). This can be achieved either by opening up the back of the spinal canal, also known as a laminectomy or by restoring the height of a collapsed disc by placing a device into the disc to lift it up. In some cases both techniques are used.

Restore stability to the spine. This is commonly the case when the patient has a spondylolisthesis or when the surgeon needs to remove substantial bone from the spine to decompress the nerves. The most common way that stability is restored is by performing a fusion where bone and implants are inserted into the spine.

A number of traditional or open techniques exist to achieve these goals of decompression and stabilization. More recently, minimally invasive options have been developed that can achieve these same aims with reduced blood loss, risk of infection and recovery time.