Spinal Stenosis and Walking Problems

Spinal stenosis is a condition that develops when the spinal canal narrows. It typically develops in older age and may affect your mobility. But, does spinal stenosis affect basic movements, like walking?

In this article, we’ll discuss how lumbar spinal stenosis can influence your ability to walk, as well as treatments that can restore your mobility. Rest assured, spinal stenosis and walking problems from the lumbar spine can be resolved with modern therapies. 

Does Spinal Stenosis Get Worse With Walking?

First off, let’s go over how spinal stenosis can affect your legs. 

With lumbar spinal stenosis, the spinal canal in the lower spine becomes narrower. This can lead to compression of the nerves that extend from the lumbar spine through the hips, buttocks, and down the legs. 

When the lumbar spinal nerves become compressed, it can lead to neurological symptoms in the legs, including numbness, tingling, weakness, burning, and/or cramping. Essentially, spinal stenosis suffocates the nerves supplying the legs. 

These neurological symptoms can make it difficult to move the legs and walk normally. Additionally, these symptoms are likely to worsen the longer you walk. 

Along with neurological symptoms, spinal stenosis can cause the following walking issues:

• Persistent back pain while walking
• A sensation of pressure in the lower back while walking
• Difficulty lifting the top portion of the foot (known as drop foot)

Can Spinal Stenosis Stop You From Walking?

Spinal stenosis is unlikely to stop you from walking if you seek out prompt treatment. However, symptoms of this spinal condition worsen with time, particularly if you don’t receive treatments aimed at preventing further degeneration. 

If spinal stenosis reaches a severe stage, it may lead to excruciating pain and neurological symptoms while walking or sitting. In these cases of late-stage spinal stenosis, physicians often recommend surgery to restore the patient’s ability to walk and carry out other day-to-day tasks. 

Does Walking Ever Help Spinal Stenosis?

Although long periods of walking can be painful for spinal stenosis patients, it may also benefit this condition. Walking is a gentle, low-impact activity that can help you stay active with this condition. 

The potential benefits of walking with spinal stenosis include:

• Increasing circulation, which promotes healing and nerve health
• Maintaining strength in the muscles that support the spine and preventing muscle atrophy
• Preventing stiffness and tension in the back
• Promoting mood regulation, which can help you maintain a positive attitude throughout your recovery

Of course, you should follow all of your doctor’s instructions for physical activity with spinal stenosis. If you’re not sure whether or not it’s safe to walk, ask your doctor specifically. Your doctor can likely also advise you on how long to walk in a single outing, ensuring that you don’t walk for too long at once.  

Is Climbing Stairs Good For Spinal Stenosis?

Climbing stairs is similar to walking in the realm of physical activity. However, walking on a flat surface and walking at an incline present a few key differences for your spine.

In particular, when people climb upstairs, they tend to lean forward at the waist. This brings the lower back out of its usual alignment and tends to make it bend or flex. This position alters how the spine bears impact with each step. 

As a result, climbing stairs reduces the amount of space in the spinal canal. This temporarily exacerbates the effects of spinal stenosis, potentially leading to worsened pain and other symptoms.

If you’ve been diagnosed with spinal stenosis, it’s wise to keep climbing stairs to a minimum.  

What is The Best Treatment For Spinal Stenosis?

We’ve established that spinal stenosis may diminish your ability to walk and partake in other physical activities. Thankfully, several treatments have proven to be effective for restoring mobility and alleviating symptoms in spinal stenosis patients.

Trusted treatments for lumbar spinal stenosis include:

• Lifestyle adjustments

Physicians often recommend lifestyle adjustments as an early treatment for spinal stenosis. Losing weight may be suggested for overweight and obese patients, as extra pounds place pressure on the spine with each step. Reaching and maintaining a healthy weight will lighten the load on your spine to encourage healing.  

• Physical therapy

Physical therapy is a tried-and-true treatment method for spinal stenosis. It’s used both as a non-surgical treatment approach and to support the recovery process after spinal stenosis surgery. 

Your physical therapist may implement both a targeted exercise program and a passive treatment program. Targeted exercises for spinal stenosis typically involve strengthening the core and back muscles, which support the spine. Passive PT treatments may include hot and cold therapy, massage, acupuncture, and electrical stimulation. 

• Medications

Physicians often recommend pain relief and anti-inflammatory medications to help patients manage spinal stenosis symptoms. These medications may be available over-the-counter or, for more persistent symptoms, require a prescription. 

• Epidural steroid injections

Epidural steroid injections can offer fast relief from pain and inflammation in spinal stenosis patients. These injections are generally only implemented in moderate to severe spinal stenosis cases. Additionally, physicians generally only recommend three to four steroid injections per year, as using this treatment excessively can lead to tissue damage. 

• Spinal stenosis surgery

If patients don’t experience any improvement after six to 12 months of non-surgical treatment, surgery may be considered. Spinal stenosis surgery typically involves spinal decompression surgery to create more space in the spinal canal and alleviate nerve compression. 

To prevent spinal instability, spine surgeons often perform spinal fusion after decompression surgery. Spinal fusion involves permanently fusing the affected vertebrae with bone graft material. Unfortunately, this process limits all motion in the fused segment. 

Non-fusion spinal devices can stabilize the spine after spinal decompression without fusion. Also known as motion preservation surgery, this emerging option for severe spinal stenosis can help patients regain mobility. 

Lumbar spinal stenosis and walking problems are closely linked. However, with an appropriate treatment plan, patients can attain pain relief and return to their normal activities. Contact a spine specialist in your area to learn about available treatment options. 

What Are The Final Stages of Spinal Stenosis?

Spinal stenosis is a condition that impacts the structures of the spine, often due to age-related spinal degeneration or genetic factors. In either case, with this condition, the patient’s spinal canal narrows, leading to less open space surrounding the spinal cord and nerves. 

Table of Contents

What is Considered Severe Spinal Stenosis?

What Happens When You Have Severe Spinal Stenosis?

Can You Live With Severe Spinal Stenosis?

Severe Spinal Stenosis Surgery

Typically, spinal stenosis progresses at a slow pace if it’s not treated properly. As the condition advances, the open space in the spinal canal continues to decrease. Eventually, spinal stenosis can lead to nerve impingement as the spinal canal presses on nearby nerves. 

Understanding how spinal stenosis progresses and what to expect in the final stages of this condition can be helpful for patients. Continue reading for more information about this prevalent topic. 

What is Considered Severe Spinal Stenosis?

Spine specialists generally take an MRI scan to determine the severity of a spinal stenosis case. An MRI can give the physician a detailed image of the spinal structures, which makes it possible to view how far the condition has progressed. 

Once the physician has obtained the MRI scan, they may use the following spinal stenosis grading system: 

• Grade 0: No lumbar spinal stenosis, no obliteration of the anterior cerebrospinal fluid (CSF) space
• Grade 1: Mild lumbar stenosis with visible separation of the cauda equina
• Grade 2: Moderate lumbar stenosis with some aggregation of the cauda equina so that they can’t be visibly separated
• Grade 3: Severe lumbar stenosis with no separation of the cauda equina

The cauda equina is a clump of spinal nerves and nerve rootlets found at the lower end of the spinal cord. These nerve roots’ function is to supply sensation to the legs, as well as support bladder and bowel function. 

What Happens When You Have Severe Spinal Stenosis?

With severe spinal stenosis, the spinal canal has narrowed to a considerable degree. As a result, patients with the severe form of this condition may experience a significant loss of function, potentially including bladder and/or bowel function.  

Additionally, lumbar spinal stenosis may be considered severe if conservative treatment options have repeatedly failed to improve the patient’s symptoms. 

Cauda Equina Syndrome

Severe spinal stenosis can cause cauda equina syndrome. This syndrome occurs when the cauda equina nerves, which are located at the lower end of the spine, are compressed. 

Cauda equina syndrome can cause permanent nerve damage and disability if it’s not treated immediately. Patients with spinal stenosis who experience symptoms of this syndrome should seek out emergency medical care. 

Symptoms of cauda equina syndrome include: 

• Loss of bladder or bowel control

A new loss of bladder or bowel control is a key symptom of cauda equina syndrome to be aware of. If you experience this symptom, make sure to contact your doctor immediately. 

• Saddle anesthesia

Saddle anesthesia affects the saddle region, which includes the buttocks, groin, genitals, and upper inner thighs. With this symptom, patients experience weakness, tingling, and/or numbness in all or part of the saddle area. 

• Sciatic nerve pain on the right and left sides of the body

Cauda equina syndrome can cause a stabbing, sharp, and/or hot pain that radiates from the bottom of the spine down the backs of the legs. In some patients, this pain may also travel into the calves and feet. 

• Neurological symptoms in the lower extremities

Patients with cauda equina syndrome may experience weakness, tingling, or numbness in the feet or legs. These sensations may occur on one or both sides of the body and may inhibit the patient’s ability to stand or walk.

Neurological symptoms in the lower extremities are also a symptom of spinal stenosis itself. This can make it difficult to identify this symptom as a sign of cauda equina syndrome. However, if you experience new or worsening neurological symptoms, or if they’re accompanied by other symptoms listed here, contact your doctor immediately. 

Can You Live With Severe Spinal Stenosis?

Unfortunately, spinal stenosis isn’t a curable condition – it can only be corrected with surgery. However, most patients can live normally with the condition if it’s treated in its early stages. 

Once patients have reached the final stages of spinal stenosis, they’re likely to experience a notable degree of disability. This may hold them back from partaking in normal activities. Additionally, patients with severe spinal stenosis are likely to experience back pain and neurological symptoms with day-to-day motions, including standing and walking. 

Surgery for severe spinal stenosis is typically required to restore patients’ quality of life. 

Severe Spinal Stenosis Surgery

Surgery is a spinal stenosis treatment option that specialists may recommend in severe cases. Generally, physicians don’t recommend spinal stenosis surgery unless patients have undergone six to 12 months of non-surgical treatment without symptom improvement. 

As a treatment for severe spinal stenosis, surgery typically involves spinal decompression. While there are multiple methods of surgical spinal decompression, laminectomy is the most common approach for spinal stenosis. 

Laminectomy and Spinal Fusion

Laminectomy involves surgically removing some or all of the lamina to create more space in the spinal canal. The lamina is a small piece of bone that covers the back of the spinal canal, acting like a roof. By removing a portion of the bone, spinal surgeons can alleviate nerve compression and resolve patients’ symptoms. 

Along with laminectomy, severe spinal stenosis surgery often involves spinal fusion. Fusion is performed to prevent spinal instability by fusing the affected vertebrae into one bone. This is achieved with bone graft material. 

Unfortunately, spinal fusion can greatly limit patients’ mobility. After fusion, you can’t bend, twist, or flex the spine at the fused spinal segment. 

Now, with motion preservation surgery and non-fusion implants, patients can undergo severe spinal stenosis treatment without the need for fusion. These procedures preserve patients’ mobility while alleviating the symptoms of severe spinal stenosis. 

TOPS System Testimonial

If severe spinal stenosis is diminishing your quality of life, talk to a spine specialist about the complete range of treatment options available today.  

What Activities Should Be Avoided With Spinal Stenosis?

As a prevalent spinal condition, spinal stenosis impacts hundreds of thousands of people across the United States. This condition involves the narrowing of the spinal canal and triggers symptoms including persistent back pain. 

Table of Contents

Spinal Stenosis Exercises to Avoid

What Activities Should Be Avoided With Spinal Stenosis?

How Can You Prevent Your Spinal Stenosis From Getting Worse?

When Can I Return To Sports After My Spinal Stenosis Diagnosis?

What is The Newest Treatment For Lumbar Spinal Stenosis?

Unfortunately, spinal stenosis affects the activities and exercises that patients can safely partake in. But, that doesn’t mean that a spinal stenosis diagnosis will completely derail your physical activity. 

Understanding which lumbar spinal stenosis activities to avoid can help patients recover from the condition while safely remaining active. 

Spinal Stenosis Exercises to Avoid

Physicians often recommend certain forms of exercise for patients with spinal stenosis. Although it may seem counterintuitive while you’re struggling with spinal stenosis pain, low-impact exercise, stretching, and gentle motions can help alleviate symptoms. 

In spinal stenosis patients, excessive bed rest can lead to worsened back pain. Patients’ posture while resting in bed tends to place added pressure on the spine, while long periods of rest can lead to muscle atrophy. 

With that said, spinal stenosis patients should avoid certain forms of exercise. High-impact activities can worsen pain, inflammation, and neurological symptoms.  

What Activities Should Be Avoided With Spinal Stenosis?

Specific activities that spinal stenosis patients should avoid include:

• Running

Running is a high-impact activity that causes repeated impacts on the spine. This can worsen back pain and neurological symptoms from spinal stenosis. 

• Extended walks

While short walks are considered a good option for exercise with spinal stenosis, it’s wise to avoid prolonged walks. Due to muscle fatigue, long walks can increase the strain on your lumbar spine. This can lead to increased compression and pain. 

• Contact sports

Contact sports like basketball, football, soccer, and martial arts are exercises to avoid with spinal stenosis. These activities can involve sudden trauma to the spine, which may lead to further injury. 

• Jumping

Activities that involve jumping, such as jumping rope, should be avoided with spinal stenosis. When you jump, the spine quickly compresses and decompresses, potentially leading to added pain.

Additionally, your back muscles tighten when you jump to protect the spine. While this can help avoid additional damage to the spine, it can also lead to worsened back pain. 

• Climbing

Rock climbing and related activities aren’t advisable for patients with spinal stenosis. Climbing can force your spine out of its proper alignment, and place excessive pressure on it. 

• Deep back stretches

Back stretches that involve deep spinal extension or flexion aren’t beneficial for spinal stenosis patients. These stretches strain the spinal structures and can increase your pain levels. 

• Cycling

Cycling in hilly areas or on the uneven ground should be avoided with spinal stenosis. Doing so may cause trauma to the spine, leading to exacerbated symptoms. 

How Can You Prevent Your Spinal Stenosis From Getting Worse?

We’ve already mentioned that gentle, low-impact activity can help patients keep spinal stenosis symptoms in check. This, along with avoiding the activities above, is an important component of most spinal stenosis treatment plans. 

Other ways to prevent the progression of spinal stenosis include:

• Practicing good posture

With good posture, the head is above the shoulders and the shoulders are aligned over the hips. This limits stress and compression on the spine. 

• Maintaining a healthy weight

Excess weight places added pressure on the spine with every step that you take. 

• Quitting smoking

The nicotine in cigarettes limits blood flow throughout your body. As a result, your spine will receive less of the oxygen and nutrients that it needs to heal.

• Following your physician’s recommendations

Making sure to abide by your physician’s recommendations, including what exercises to avoid with spinal stenosis, will help ensure that you make a full recovery.  

When Can I Return To Sports After My Spinal Stenosis Diagnosis?

If you’re very active or an athlete, a spinal stenosis diagnosis can derail your day-to-day activities. Among active spinal stenosis patients, one of the most common questions is when they’ll get to return to their sports or exercise routines. 

In truth, the amount of time that it takes to return to sports after a spinal stenosis diagnosis can vary from patient to patient. In mild to moderate cases of spinal stenosis that are diagnosed and treated promptly, patients may be able to return to sports after three to six months of treatment, including physical therapy.

Unfortunately, spinal stenosis isn’t a curable condition. So, patients will need to continue to care for their spines and check in with their physicians to keep spinal stenosis pain at bay. Patients should also remain mindful of spinal stenosis exercises to avoid. 

For patients with more severe forms of spinal stenosis, conventional treatments may not be sufficient for pain relief. In these cases, surgery may be the only remaining option to restore spinal function and alleviate symptoms.

What is The Newest Treatment For Lumbar Spinal Stenosis?

In the past, spinal decompression surgery with spinal fusion was the only way to surgically resolve spinal stenosis. Now, medical advancements have led to new treatment options that can help patients avoid the downsides of spinal fusion, including limited mobility and an extensive recovery process. 

Innovative non-fusion spinal implants are now being used more for cases of lumbar spinal stenosis that don’t respond to conventional treatments. This type of implant is used to replace the spinal structures that are removed during decompression surgery. The implant stabilizes the spine without fusing the affected vertebrae. 

For spinal stenosis patients with active lifestyles, alternatives to spinal fusion are particularly beneficial. After all, by permanently fusing two or more vertebrae, spinal fusion can reduce or eliminate patients’ ability to partake in certain activities. By creating a controlled range of motion, non-fusion implants like the TOPS System can allow patients to return to various sports and activities.  

A spine specialist can help you learn more about the complete scope of spinal stenosis treatments available today. 

Grades and Treatment Options For Spinal Stenosis Severity

Table of Contents

• What Are The Grades of Spinal Stenosis?
• How Fast Does Spinal Stenosis Progress?
• Can You Slow The Progression of Spinal Stenosis?
• Can You Live With Spinal Stenosis Without Surgery?
• When Does Spinal Stenosis Require Surgery?
• What Is The Best Surgical Treatment For Spinal Stenosis?
• What Is The Latest Treatment For Severe Lumbar Spinal Stenosis?

Being diagnosed with any spinal condition, including spinal stenosis, can be stressful and confusing. However, knowledge is power. Understanding the grading system used in the diagnosis of spinal stenosis, as well as the available treatment options, can help you get on the path to relief. 

What Are The Grades of Spinal Stenosis?

There are two popular, universal grading systems to evaluate the severity of spinal stenosis cases. These systems include the Lee grading system and the Schizas grading system. Both systems are implemented by visually assessing MRI results and have been deemed reliable. 

The Lee grading system includes four grades. It’s based on the obliteration of the CSF (cerebrospinal fluid) space in front of the cauda equina, which are the roots of the spinal nerves in the lumbar and sacral spine in the dural sac. The dural sac is the sac that encloses the spinal cord.  

• Grade 0, or no stenosis

A case given a grade 0 has an anterior CSF space that’s not obliterated. 

• Grade 1, or mild stenosis

A case given a grade 1 has an anterior CSF space that’s mildly obliterated, but all of the cauda equina can be distinctly visually separated. 

• Grade 2, or moderate stenosis

A case given a grade 2 has an anterior CSF space that’s moderately obliterated and some of the cauda equina can’t be visually separated. 

• Grade 3, or severe stenosis

A case given a grade 3 has an anterior CSF space that’s severely obliterated with apparent dural sac compression. None of the cauda equina can be visually separated. 

The Schizas grading system includes seven grades. It’s based on the form of the dural sac and the ratio of nerve roots to CFS. 

• Grade A: no/minor stenosis

Grade A indicates that CSF is apparent in the dural sac with a heterogenous distribution.

• Grade B: moderate stenosis

With grade B spinal stenosis, spinal roots populate the entire dural sac, but can still be distinguished, and some CSF is visible. 

• Grade C: severe stenosis

Grade C spinal stenosis has no recognizable spinal roots and no visible CSF. 

• Grade D: extreme stenosis

Grade D spinal stenosis involves no recognizable spinal roots and no epidural fat posteriorly. 

How Fast Does Spinal Stenosis Progress?

Many cases of spinal stenosis aren’t progressive. In these cases, the condition causes episodes of pain and dysfunction. However, spinal stenosis can slowly progress over time from day-to-day wear and tear.

Patients who don’t seek out immediate treatment for spinal stenosis are more likely to experience worsening symptoms over time. 

One clinical study showed that among 32 patients with lumbar spinal stenosis, after 49 months without surgery, 70% of patients had unchanged symptoms, 15% of patients’ symptoms improved, and 15% of patients worsened. 

Can I Slow The Progression of Spinal Stenosis?

You may not be able to entirely prevent the spinal stenosis from progressing. However, there are a few tactics that you can use to slow down the narrowing of the spinal canal, including:

• A low-impact exercise routine

This may be counter-intuitive, as many people assume that they should rest and avoid physical activity with spinal conditions. However, while you should follow your doctor’s instructions for physical activity, low-impact exercise is typically beneficial for spinal stenosis patients. 

Exercise can help improve muscle strength, mobility, and balance in people with spinal stenosis pain. It also boosts circulation throughout the body, which may help deliver healing oxygen and nutrients to the irritated tissue. 

Keep in mind that certain forms of exercise, like running and weightlifting, can put excess strain on the spine. These activities may worsen spinal stenosis symptoms. So, we recommend sticking to low-impact activities, such as walking, swimming, and water aerobics.

• Proper posture

Your posture while sitting, standing, and exercising makes a large impact on the long-term health of your spine. With this in mind, it’s particularly important for spinal stenosis patients to maintain proper posture throughout the day. 

• While sitting, make sure that your back is straight with your shoulders back. You shouldn’t be leaning forward, and your buttocks should be touching the back of the chair. Selecting an office chair with lumbar support may help you maintain good posture throughout the work day. 
• While standing, keep your weight on the balls of the feet with your feet shoulder-width apart. Keep your head right above the neck (not tipped forward) and don’t lock your knees. 
• While lifting objects, bend at the hips and knees – not the waist. This means that your back should remain straight while you’re lifting. 

• Prioritize sleep

While you sleep, your body undergoes various processes that are essential for healing.

• For one, while you sleep, the brain stimulates the release of human growth hormone or HGH. This hormone helps to build, sustain, and repair tissue throughout the body. 
• The body is also able to produce a higher volume of white blood cells while you sleep. This strengthens the immune system’s ability to fight foreign invaders that could sabotage your healing process. 
• While you’re asleep, your body takes a well-deserved break. Your blood pressure falls, which allows your heart to rest throughout the night. Additionally, the hormones released during sleep relax your muscles and slow down your breathing, which can facilitate healing and decrease inflammation. 
• Sleep is also known to benefit mental health, which can have a positive overall effect on your recovery process. This is in part due to sleep’s stress-relieving effects, as well as its ability to improve energy levels, memory, and focus. 

Can You Live With Spinal Stenosis Without Surgery?

In short, yes. Less than 5% of patients with a spinal disorder need spine surgery. There are several non-surgical treatment options available, which often are sufficient to alleviate patients’ symptoms. Additionally, especially with an early diagnosis, many patients can take measures to stop the condition from causing severe disability. 

Physical therapy, lifestyle modifications, and pain medications are often key components of non-surgical treatment plans for spinal stenosis. 

• Physical therapy

Physical therapy can help spinal stenosis patients overcome pain, stiffness, and poor mobility. Physical therapists provide exercises to strengthen the muscles that support the spine, as well as stretches to promote flexibility. Additionally, many physical therapists offer alternative therapies, like electrical stimulation, acupuncture, and massage, to support your recovery process.

• Lifestyle modifications

Adjusting your diet, activities, and habits may help you overcome spinal stenosis symptoms without surgery. As general guidelines, many physicians recommend focusing on hydration, quitting smoking, eating a high volume of nutrient-dense fruits and vegetables, and reducing your intake of alcohol, caffeine, red meat, processed foods, and sugars. 

• Pain medications

Over-the-counter pain medications are often helpful for spinal stenosis patients struggling with pain management. More severe cases may require prescription medications from a physician. 

When Does Spinal Stenosis Require Surgery?

There are a few reasons why spinal stenosis may require surgery:

• If non-surgical treatment methods fail to provide any improvement after several months, it may be an indication that the patient needs surgery. 
• If the patient experienced neurological symptoms that point to severe or progressive spinal nerve compression, surgery may be required to avert serious complications. 
• If spinal instability contributes to a case of spinal stenosis, specialists may recommend surgery to stabilize the spine and prevent future injury. 

What Is The Best Surgical Treatment For Spinal Stenosis?

When conservative treatment options like physical therapy, medication, and lifestyle adjustments fail to improve spinal stenosis, surgery may be considered. Decompressive laminectomy is widely considered to be the best surgical treatment for lumbar spinal stenosis. 

During a decompressive laminectomy, the surgeon removes a small portion of the lamina at the affected spinal segment. The lamina is a piece of bone covering the back of each vertebra. By removing some (or all) of the lamina, your surgeon will create more room for the spinal nerves and tissues, leading to relief from nerve compression symptoms. 

Since decompression surgery involves removing spinal structures, it can lead to instability. To avert this issue, surgeons often pair decompression with spinal fusion. 

Spinal fusion is a surgical procedure during which a bone graft is secured between the affected vertebrae. Over time, the graft will cause the vertebrae to fuse into a single bone.

While spinal fusion prevents spinal instability, it also prevents all motion at the fused segment. This can severely limit patients’ mobility.  

What Is The Latest Treatment For Severe Lumbar Spinal Stenosis?

Recent innovations in medical technology have created a path to spinal stenosis surgery without fusion. Non-fusion implants, like the TOPS System from Premia Spine, allow patients to avoid the extensive recovery process and diminished range of motion associated with fusion.  

The TOPS procedure stabilizes the lumbar spine to reestablish a stable range of motion. It allows spinal stenosis patients to get back the ability to twist, bend, and flex the spine. For many, the TOPS System facilitates a return to day-to-day activities, as well as long-term pain relief. 

If you’ve been diagnosed with spinal stenosis, don’t hesitate to talk to your doctor about every treatment option available to you. 

What is Spinal Stenosis?

Table of Contents

Understanding Spinal Stenosis

What Causes Spinal Stenosis?

Spinal Stenosis Symptoms

Severe Spinal Stenosis Symptoms

Spinal Stenosis and Walking Problems

What is Considered Severe Spinal Stenosis?

Can Spinal Stenosis Be Treated At Home?

What Is The Best Treatment For Spinal Stenosis?

What Is The Latest Treatment For Spinal Stenosis?

“What is spinal stenosis?” is one of the most frequently asked questions in any spinal specialist’s office. Given that up to 95% of people develop degenerative spinal changes by age 50, it’s no surprise that spinal stenosis is a prevalent medical concern today. 

Although spinal stenosis is a common back problem, many affected patients have never heard of it at the time of their diagnosis. With this in mind, we’ll provide a detailed explanation of spinal stenosis below, including the causes, symptoms, and treatments available for this prevalent condition. 

Understanding Spinal Stenosis

“Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal. The spinal canal is the space at the center of the vertebrae that houses the spinal nerves. 

This restriction of the spinal canal places pressure on the spinal nerves. It can also impact nerves that emanate from the affected vertebrae to other parts of the body. The area that’s the most commonly affected by stenosis is the lower, or lumbar, region of the spine. 

What Causes Spinal Stenosis?

Spinal stenosis can be caused by a variety of factors, including:

• Chronic inflammatory, arthritic, and spinal conditions conditions

Osteoarthritis, rheumatoid arthritis, scoliosis, and herniated disc are among the medical conditions that may lead to spinal stenosis.  

• The normal aging process

The spine naturally changes with age. For one, the intervertebral discs dry out, become thinner, and may begin to bulge. An injured intervertebral disc takes up additional space in the spinal canal, potentially leading to spinal stenosis. 

Additionally, the aging process can cause the ligaments and/or bone in the spine to thicken or expand. When this occurs, the open space in the spinal canal becomes more limited.

Spinal stenosis is most often seen in adults above the age of 40 years, and women are affected by spinal stenosis more frequently than men.

• Heredity factors

Clinical studies have confirmed that lumbar spinal stenosis is highly genetic. This is despite the fact that spinal degeneration is widely considered to be the key contributing factor to the development of stenosis. In a 2014 study, lumbar spinal stenosis cases yielded heritability estimates of 66.9%. 

Spinal Stenosis Symptoms

Symptoms of spinal stenosis can include intense back and leg pain, as well as numbness or cramping in various regions of the body. In spinal stenosis patients, loss of sensation can be extreme. 

Severe Spinal Stenosis Symptoms

Lumbar spinal stenosis symptoms in severe cases may include difficulty controlling urine or bowel movements and difficulty balancing while walking. While these symptoms can sound alarming, especially if you were just diagnosed with spinal stenosis, they only occur in a small portion of spinal stenosis patients.

To illustrate this fact, let’s consider a survey conducted in 564 U.S. hospitals and general practice clinics. Out of 3,647 patients diagnosed with lumbar spinal stenosis in this survey, only 135 patients experienced bowel and bladder dysfunction. 

Bowel and bladder dysfunction mainly occur in spinal stenosis patients with cauda equina lesions. The cauda equina is the collection of nerve roots located in the lower spinal cord. It facilitates movement and sensation in the legs and bladder. 

Spinal stenosis can trigger cauda equina syndrome, which requires immediate diagnosis and treatment to prevent severe neurological complications. 

Spinal Stenosis and Walking Problems

As we mentioned above, severe spinal stenosis can lead to walking and balance problems. However, even in its earlier stages, spinal stenosis can cause difficulty walking for extended distances.

Walking problems with lumbar spinal stenosis may include:

• Cramping, tingling, and/or numbness in the legs while walking
• Pressure in the lower back while standing upright
• Muscle weakness in the legs
• Pain in the buttocks, legs, and/or back while walking
• A foot that slaps the ground when you take a step due to weakness

Leaning forward alleviates pressure on the spinal nerves. So, spinal stenosis patients experiencing walking problems often experience relief when they sit down, crouch, lean forward, or even push a grocery cart.

If you’ve been diagnosed with spinal stenosis and are experiencing severe pain and weakness while standing or walking, reach out to your doctor immediately. You may be experiencing cauda equina syndrome.   

What is Considered Severe Spinal Stenosis?

Patients may have what’s considered a severe case of lumbar spinal stenosis if they experience a loss of physical function or are disabled as a result of the stenosis. Additionally, physicians may classify a case of spinal stenosis as severe if the patient doesn’t respond to several months of non-surgical treatment. 

Severe spinal stenosis typically requires surgery for symptom relief. After spinal stenosis surgery, patients generally experience restored function and improved quality of life. 

Can Spinal Stenosis Be Treated At Home?

Patients experiencing symptoms of spinal stenosis need to receive a medical evaluation and diagnosis. This ensures that any troubling symptoms are promptly addressed before causing lasting complications.

With that said, after receiving a diagnosis, many patients with early spinal stenosis can manage their symptoms with at-home care. Paired with physical therapy and physician-recommended lifestyle changes, at-home treatment can significantly improve spinal stenosis symptoms. 

Along with heat/cold therapy, exercises for spinal stenosis are among the most widely-recommended at-home treatment for this condition. Spinal stenosis exercises can be done at home to strengthen the spine’s stabilizing muscles and improve range of motion. Your physical therapist may give you a specific exercise regimen to complete at home based on your personal needs. 

What Is The Best Treatment For Spinal Stenosis?

Many treatments for spinal stenosis are available, including medications, physical therapy, and, as we mentioned above, exercises for stretching the spine. 

Physical therapy is often highly successful in treating spinal stenosis. Your physical therapist may implement a combination of therapies including massage, stabilization methods, heat/cold therapy, exercises, and acupuncture to help you overcome your symptoms. 

Spinal Stenosis Surgery

For patients with moderate to severe spinal stenosis who don’t respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option.

In spinal decompression surgery, the back surgeon reestablishes the proper diameter of the spinal canal at the affected area. To accomplish this, the surgeon will remove bony elements that have grown towards the spinal canal and are impinging on the nerves.

There are a few different spinal decompression procedures. The most common of these procedures for spinal stenosis is laminectomy, which involves removing some or all of the lamina. The lamina is the section of bone that covers the back of the spinal canal.

Am I a Candidate For Spinal Decompression?

You may not be a candidate for spinal decompression surgery as a treatment for spinal stenosis if:

• You’re currently pregnant
• You have already had spinal fusion
• You have vertebral fractures
• You’re experiencing pain from a previous failed spinal surgery
• You’ve already had an artificial disc or spinal implant placed
• You’ve already undergone more than one spinal surgery and haven’t recovered properly 

Spinal Fusion

Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves turning two or more adjacent vertebrae into one bone. This is done by placing bone graft material in between the vertebrae, then securing them with screws and rigid rods.

Fusion restores stability but eliminates the natural mobility between the vertebrae. The fusion of the vertebrae is permanent and typically diminishes patients’ ability to move, stretch, and rotate the torso. 

The Risk of Reoperation After Spinal Fusion

Clinical research has shown that spinal fusion has a higher reoperation rate than spinal decompression alone. With this in mind, patients must carefully consider the risk of reoperation before undergoing decompression with fusion. 

One reason why spinal fusion may lead to reoperation is the risk of adjacent segment disease. This complication of spinal fusion occurs when the vertebrae above and below the fused segment undergo added pressure. This leads to a faster rate of degeneration in these vertebrae. 

Patients with adjacent segment disease may start to experience back pain, reduced range of motion, and neurological symptoms. These uncomfortable and potentially debilitating symptoms can create the need for corrective spinal surgery. 

What Is The Latest Treatment For Spinal Stenosis?

Many modern spinal stenosis patients are concerned over the risks of decompression surgery with spinal fusion. This has led to an increased interest in alternative treatments that alleviate spinal stenosis symptoms without the risks associated with fusion. 

Patients who haven’t responded to conservative treatments can now consider non-fusion spinal implants as a spinal stenosis treatment option. These implants are designed to alleviate nerve compression while stabilizing the spine. As a result, patients can experience relief from spinal stenosis without reduced mobility from fusion. 

The TOPS™ System For Spinal Stenosis

Today, a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine.

How Does TOPS™ Work For Spinal Stenosis?

The TOPS™ System works for spinal stenosis by replacing the tissues removed during spinal decompression. The implant is designed to be placed at a single level between L2 and L5 in the lower spine. These segments are the most commonly affected by spinal stenosis. 

Once positioned, the TOPS™ System allows movement in all directions. It simultaneously blocks sheer forces on the lower spine, which helps prevent injury after spinal stenosis surgery. 

TOPS™ System Results

Clinical studies show the TOPS™ System provides better outcomes than spinal fusion. In a seven-year study for TOPS™ in the management of lumbar spinal stenosis, the device maintained clinical improvement and radiologic stability, preserved spinal motion, and prevented degeneration. 

Physician and patient testimonials demonstrate that the TOPS™ System provides excellent outcomes for spinal stenosis patients and allows patients to retain mobility at the operative segment. Additionally, patients experience symptom relief long after the TOPS™ System procedure. 

We encourage patients with persistent back pain to consult with a spinal specialist and learn more about all of the available treatment options.

“What is spinal stenosis?” is one of the most frequently asked questions in any spinal physician’s office. Spinal stenosis is a common back problem, but many affected patients have never heard of it before they are given the diagnosis. Symptoms of spinal stenosis can include intense pain inside the back of the legs and numbing or cramping in various regions of the body. The loss of sensation that spinal stenosis patients experience can be extreme.

Here at Premia Spine we focus on advanced surgical treatments for spinal stenosis and related spinal disorders, including bone spurs, or facet arthrosis, and slipped disc, or spondylolisthesis. We’re excited to share information about these conditions – conditions that affect up to 70 percent of all people at some point in their lives – through our blog. An explanation of spinal stenosis is a good place to start.

“Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal, the space at the center of the vertebrae that houses the spinal nerves. This narrowing puts pressure on the nerves, and on nerves that emanate from the affected vertebrae to other parts of the body. The most commonly affected area is the lower, or lumbar, region of the spine. The neck, or cervical region of the spine, can also exhibit a narrowing; these conditions are called lumbar spinal stenosis and cervical spinal stenosis respectively.

Spinal stenosis can be caused by a variety of factors, including heredity, chronic inflammatory and arthritic conditions, and the normal aging process. In fact, it is most often seen in adults above the ages of 45 years; women are affected by spinal stenosis more frequently than men. The severity is related to the extent of the narrowing and of any attendant spinal problems, such as bone spurs, slipped discs, pinched nerves, spondylolisthesis, or sciatica. A neurosurgeon, orthopedic surgeon or any physician specializing in spinal disorders can diagnose spinal stenosis based on radiographs and X-rays.

Many treatments for spinal stenosis are available, including medications and physical therapy, including exercises for stretching the spine. For patients with moderate to severe spinal stenosis who do not respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option. In spinal decompression procedures, the back surgeon reestablishes the proper diameter of the spinal canal at the affected area by removing bony elements that have grown towards the spinal canal and are impinging on the nerves. Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves connecting two or more adjacent vertebrae with screws and rigid rods. Fusion restores stability but eliminates the natural mobility between the vertebrae.

Today a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine. Clinical studies show the TOPS System provides better outcomes than spinal fusion. We encourage patients to consult with a physician who specializes in spinal medicine and to educate themselves about treatment options.

How to Reverse Lumbar Spinal Stenosis?

Table of Contents

What is Lumbar Spinal Stenosis?

What Activities Should be Avoided With Spinal Stenosis?

Does Spinal Stenosis Hurt All The Time?

What is Considered Severe Spinal Stenosis?

Can Lumbar Stenosis Be Reversed?

What Is The Best Treatment For Spinal Stenosis?

How Long Does Lumbar Stenosis Take to Heal?

Surgery For Lumbar Spinal Stenosis

Fusion Alternatives For Spinal Stenosis Patients

If you’re suffering from lumbar spinal stenosis, you may experience back pain, stiffness, and neurological symptoms on a daily basis. While these symptoms can diminish your quality of life, there is a path to recovery from lumbar spinal stenosis. 

In this article, we’ll discuss lumbar spinal stenosis and the range of treatment options available to help you recover from this condition. 

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis, a common medical problem, occurs when the lower portion of the spinal canal becomes narrower. The spinal canal is the center of the spinal column and houses the spinal nerves, which relay sensory information to the brain and control muscular movements.

The term stenosis comes from Latin and means “a narrowing”. When a portion of the spinal canal narrows unnaturally, it can place pressure on the spinal nerves. These pinched nerves can, in turn, cause pain and limited mobility.

Many people may be wondering what causes spinal stenosis. While this condition can stem from a variety of factors, it’s most commonly caused by osteoarthritis. 

What Activities Should be Avoided With Spinal Stenosis?

Certain activities can exacerbate spinal stenosis, leading to worsened pain and stiffness. So, while spinal stenosis patients need to remain physically active to promote circulation and strengthen the back muscles, the following activities should be avoided:

• Running

Running is considered a high-impact exercise. This means that it places considerable stress on the joints and the spine. 

• Long walks

Walking is a low-impact exercise that you can do anywhere, without a gym membership. So, it’s an excellent option for many spinal stenosis patients. However, patients should be sure to limit their walking sessions to avoid pain flare-ups. 

• Stretches and yoga poses that require hyperextension of the spine

To hyperextend the spine means to arch the spine beyond its natural anatomical position. Any exercise that involves hyperextending the spine can worsen spinal stenosis pain, as this movement involves compressing the spinal structures. 

• Contact sports

Contact sports involve a higher risk of injury than other physical activities. These sports may involve a sudden impact or trauma, which may exacerbate spinal stenosis or even cause additional injuries. 

Additionally, spinal stenosis patients need to practice good posture while exercising. Poor posture while lifting weights, for example, can place extra stress on the spine and aggravate back pain. 

All of the factors listed above are also things to avoid with cervical spinal stenosis. 

Does Spinal Stenosis Hurt All The Time?

In most cases, spinal stenosis pain comes and goes. Pain from spinal stenosis may flare up whenever the spinal nerves are compressed or irritated, such as when you stand or walk for long periods. 

Generally, spinal stenosis isn’t progressive, meaning that it doesn’t gradually worsen over time. However, certain factors can worsen spinal stenosis or lead to more frequent pain flare-ups, including poor posture, smoking, being overweight, and being physically inactive. 

What is Considered Severe Spinal Stenosis?

Spinal stenosis ranges in severity. Some cases are asymptomatic because the spinal canal hasn’t narrowed enough to impart pressure on nearby nerves. However, severe spinal stenosis can cause debilitating pain and neurological symptoms. 

Patients may have what’s considered to be severe spinal stenosis if:

• Excruciating flare-ups of back pain
• Extreme weakness in both legs
• Loss of bowel and/or bladder control
• Severe numbness in the legs

If you experience any of the symptoms listed above, visit a physician immediately for medical treatment. These symptoms can result from serious medical complications, including cauda equina syndrome, that may trigger loss of leg function.  

Can Lumbar Stenosis Be Reversed?

Technically speaking, the only way to reverse spinal stenosis is through surgical intervention. However, the good news is that a variety of treatment options, including non-surgical methods, are available and have been proven effective in helping individuals recover from spinal stenosis symptoms.

What Is The Best Treatment For Spinal Stenosis?

Conservative, non-invasive spinal stenosis treatments include: 

• Lifestyle changes

Lifestyle changes are often an effective way to manage lumbar spinal stenosis. A low-impact exercise regimen, shedding extra pounds, quitting smoking, maintaining proper posture, and eating a nutrient-dense diet can all positively contribute to your lumbar stenosis recovery. 

• Medications

Over-the-counter anti-inflammatory medications can help patients manage pain from spinal stenosis. In some cases, physicians prescribe stronger medications to help treat lumbar stenosis, although it’s not considered a long-term solution. 

• Physical therapy

Physical therapy is an essential component of a conservative treatment plan for lumbar spinal stenosis. PT for spinal stenosis typically involves exercises to strengthen and stabilize the muscles that support the spine and stretches to alleviate tension. Your physical therapist will also likely work with you to improve the alignment of the spine through proper posture. 

• Anti-inflammatory injections

Anti-inflammatory injections are rarely the first treatment recommendation for lumbar stenosis pain. However, patients experiencing persistent pain may benefit from the effects of epidural steroid injections, which alleviate inflammation throughout the body. To prevent tissue damage, however, patients should receive no more than three to four injections per year. 

For patients with spinal stenosis, there’s no way of knowing which of these approaches will be most successful. So, physicians often prescribe one of these treatments as a first step and monitor the results. If the first method doesn’t help the patient recover from spinal stenosis, the next option may be tried, and so on.

Is stretching good for spinal stenosis?

We’ve already mentioned that low-impact exercise is beneficial for spinal stenosis. However, many patients wonder whether or not to include stretching in their regimen of spinal stenosis exercises. 

Stretching is, in fact, good for spinal stenosis. Gentle stretches can help release muscle tension, improve mobility, and promote circulation. 

Is heat good for spinal stenosis?

Many patients with spinal stenosis experience tension in the back muscles, which may limit mobility and exacerbate back pain. The heat helps relax the muscles while increasing blood flow to the affected area. This can enhance the body’s healing process. 

How Long Does Lumbar Stenosis Take to Heal?

The amount of time needed to fully recover from lumbar stenosis will differ depending on the patient and the treatment plan. However, generally speaking, most patients recover from spinal stenosis within six months to a year of beginning treatment. 

Surgery For Lumbar Spinal Stenosis

For patients with moderate to severe spinal stenosis who don’t respond to conservative treatments, surgery may be recommended. Spinal stenosis surgery typically involves spinal decompression surgery, during which the surgeon trims away excess bone in the narrowed center of the affected vertebra. This relieves pressure on the compressed nerve(s). 

The Recovery Process For Lumbar Spinal Stenosis Surgery

Lumbar laminectomy is the most common surgical procedure for spinal stenosis. Typically, patients can return to their regular activities four to six weeks after this procedure. It may take up to six months for patients to experience complete pain relief after a lumbar laminectomy. 

Fusion With Lumbar Stenosis Surgery

Historically, a spinal fusion back surgery operation has been performed in conjunction with decompression surgery to relieve spinal stenosis. Spinal fusion stabilizes the region of the spine that’s treated during the operation. 

Unfortunately, spinal fusion involves a variety of risks. For one, patients lose a great deal of mobility in the back after fusion and can no longer twist, bend, and flex the spine. This permanently limits their activities after the surgery. 

Additionally, spinal fusion requires a significant recovery process. Patients may not fully heal until a year after the procedure. 

Fusion Alternatives For Spinal Stenosis Patients

Considering these risks, patients are interested in emerging alternatives to spinal fusion. 

One such alternative is the TOPS System procedure, which provides better clinical outcomes than spinal fusion surgery.

The TOPS System from Premia Spine preserves the spine’s full range of motion. This is unlike spinal fusion, which permanently fuses adjacent vertebrae. TOPS also offers a much quicker surgical recovery for spinal stenosis patients than spinal fusion.

If you’re a candidate for spinal stenosis surgery, consider all of the advanced surgical solutions available today, as well as the impact that each will have on your healing process.

What is Lumbar Spinal Decompression?

Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.

There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve. 

This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure. 

Why is Lower Back Pain So Common?

Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.

This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.  

The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.

Lumbar Spine Disorders

The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.

• Bulging disc

A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal. 

• Herniated disc

A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior. 

• Spinal stenosis

Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.

Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress. 

• Spondylolisthesis

Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it. 

These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.

What is a Lumbar Decompression Surgery?

Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.

The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.

How is Lumbar Decompression Surgery Performed?

There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:

Laminectomy and Laminotomy

Laminectomy and laminotomy are two surgical methods of lumbar decompression that involve the lamina. The lamina acts like the roof of the spinal canal and protects the spinal cord. 

• In a laminectomy, the surgeon removes the majority of the lamina at the affected spinal segment. 
• In laminotomy, the surgeon only removes a small portion of the lamina. 

Laminoplasty

Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina. 

Foraminotomy

In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery. 

By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves. 

Discectomy

Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.

Lumbar Decompression Surgery With Spinal Fusion

Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. 

In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.  

Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:

• Reduced range of motion

The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery. 

• Damage to adjacent vertebrae

The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms. 

Are Alternatives To Spinal Fusion Available?

Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world. 

The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.

How Long Does It Take to Recover From Lumbar Decompression Surgery?

The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work. 

Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.

Is Lumbar Decompression Surgery Serious?

Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.

With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications. 

If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you. 

What is Lumbar Spinal Stenosis?

Spinal stenosis is a prevalent spinal disorder in the U.S. and across the globe. In fact, the condition affects an estimated 250,000 to 500,000 U.S. residents. 

This spinal disorder can occur in the lower, or lumbar, region of the spine, which is known as lumbar spinal stenosis. Or, it may occur in the neck, or cervical, region of the spine, which is known as cervical spinal stenosis. Lumbar spinal stenosis is the most common form of this condition, and it’s the topic of our article. 

What is Lumbar Spinal Stenosis?

Spinal stenosis is a common condition, especially among patients who are aged 50 and over. It occurs when the spinal canal abnormally becomes narrower. The word “stenosis” can be traced back to ancient Greek and refers to narrowing, or constriction.

As the spinal canal progressively narrows over time, it strains the nerves that extend outward from the spine and travel into the extremities. This can cause a range of symptoms.

What Are Lumbar Spinal Stenosis Symptoms?

The symptoms of lumbar spinal stenosis can differ from patient to patient. However, pain, tingling, and numbness in the extremities are among the most common signs of this spinal disorder. 

Other symptoms of lumbar spinal stenosis may include:

• Numbness or tingling in a foot or leg
• Weakness in a foot or leg
• Pain or cramping in one or both legs
• Lower back pain

There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.

What Causes Lumbar Spinal Stenosis?

Most cases of spinal stenosis occur for unknown reasons. However, the causes of lumbar spinal stenosis are rooted in specific parts of the spine’s anatomy, such as: 

• The intervertebral discs

An intervertebral disc is located between each of the bones in the spine. It provides cushioning for the bone and prevents damage by absorbing impact. These discs break down with age and may even become herniated, meaning that the disc interior protrudes from a crack in the disc interior. 

A damaged intervertebral disc can take up extra space in the spinal canal, potentially leading to spinal stenosis. 

• The facet joints

The facet joints connect the vertebrae of the spine to one another. These joints support a large amount of weight and undergo a significant amount of stress. As a result, they’re vulnerable to wear and tear, as well as various injuries. Damage to the facet joints (and the cartilage within these joints) can trigger spinal stenosis.  

• The spinal cord

When the spinal cord and/or the nerve roots become compressed, it may trigger pain and neurological symptoms. When the spinal cord and nerve roots are involved in spinal stenosis, the patient is rarely asymptomatic. 

What is Inherited Spinal Stenosis?

The narrowing, or tightening, of the spinal canal, may result from abnormal bone and/or tissue growth. or due to a hereditary disorder. This is referred to as inherited spinal stenosis. 

Some people are born with a spinal canal that’s narrower than average. This can cause the patient to experience spinal stenosis symptoms much earlier in life than the average patient. Additionally, patients who are born with scoliosis may experience spinal stenosis.

Scoliosis is an atypical, sideways curve of the spine. It’s commonly recognized and diagnosed in children and adolescents. In patients with scoliosis, the curved spine may place stress on the spinal cord, potentially leading to spinal stenosis. 

What is Degenerative Spinal Stenosis?

Degenerative spinal stenosis refers to cases of this condition that are caused by wear and tear on the spine. This is the most common type of spinal stenosis. 

Spinal degeneration is a normal effect of aging. It occurs as the intervertebral discs and facet joints weaken from repeated strain over time. Factors including a sedentary lifestyle, poor posture, obesity, injuries, smoking, and other spinal disorders (such as scoliosis) can speed up the process of spinal degeneration.  

Effects of aging that can contribute to the development of degenerative spinal stenosis include:

• The cartilage in the facet joints gradually wears down, which increases friction in the spine and may cause bone spurs to form. 
• The intervertebral discs become drier, flatter, and weaker. The discs may become damaged, leading to a slipped or herniated disc. 
• As the cushioning in the spine from intervertebral discs decreases, the spinal cord and/or nerve roots can become strained. 

Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.

What Are The Best Treatments For Lumbar Spinal Stenosis?

Options for spinal stenosis treatment include:

• Spinal stenosis exercises

Various exercises can help with spinal stenosis by improving strength and mobility in the affected areas. You can perform these exercises at home to support your lumbar spinal stenosis recovery. 

Examples of spinal stenosis exercises include:

• Bridges

This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine. 

• Pelvic tilts

This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine. 

• Knee-to-chest exercise

This exercise stretches and helps relieve tension in the lower back muscles. It also flexes the spine, which relieves pain from spinal stenosis by temporarily creating more space in the spinal canal. 

• Physical therapy

Physical therapy may improve symptoms of lumbar spinal stenosis by relieving pressure on the spinal cord. For lumbar spinal stenosis, physical therapy typically involves stretches for the lower back, legs, and hips, as well as strengthening exercises for the abdominal muscles, which support the lower spine. Your physical therapist may work with you on mobility exercises to improve your range of motion in the lower back. 

Additionally, physical therapy may involve treatments that can help with pain, tension, and inflammation. These treatments include heat/cold therapy, electrostimulation, massage, etc. 

• Medication

Both over-the-counter and prescription medications may be used to reduce pain and inflammation from lumbar spinal stenosis. Talk to your doctor before starting a new medication for spinal stenosis symptoms in the lumbar spine.

Surgery For Lumbar Spinal Stenosis

In extreme cases, surgery for lumbar spinal stenosis may be recommended. Typically, doctors don’t recommend lumbar spinal stenosis surgery unless the patient has first undergone at least 6 months of conservative treatment. 

For lumbar spinal stenosis, spinal decompression surgery is often performed. This type of surgical procedure involves removing portions of the vertebrae that are impinging on the roots of nerves emanating from the spine. By relieving this pressure, the procedure gives patients symptom relief and provides the spinal nerves with enough space to heal. 

Laminectomy is the most common form of spinal decompression surgery for spinal stenosis of the lumbar region. In this procedure, the surgeon removes all or part of the lamina, which forms the ceiling of the spinal canal. Other types of spinal decompression surgery include foraminotomy and discectomy.   

Spinal Fusion in Lumbar Spinal Stenosis Surgery

Following the spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. Over time, the bone graft will cause the vertebrae to permanently fuse.

Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Patients can lose a significant amount of motion in the lower back after spinal fusion.

Alternatives to Spinal Fusion 

Spinal fusion alternatives, such as non-fusion implants, can offer stability without limiting the patient’s mobility after spinal stenosis surgery. The TOPS™ System, for example, provides an alternative to spinal fusion that maintains the spine’s full range of motion. It’s been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery. 

Patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever. Talk to your doctor about the best course of treatment for your needs. 

Can Spinal Stenosis Surgery Be Minimally-Invasive?

Especially in people over the age of 50, spinal stenosis is a prominent cause of chronic back pain and neurological symptoms. When this condition isn’t improved with several months of non-invasive treatment, your doctor may recommend spine surgery. 

Patients who are concerned about the complications associated with traditional spine procedures may be interested in minimally-invasive spinal surgery. Also called MIS, minimally-invasive surgery can reduce your risk of complications, shorten your recovery, and cause less pain after the procedure. 

With the benefits of MIS in mind, can spinal stenosis surgery be minimally-invasive? Here, we’ll discuss this question and discover spinal fusion alternatives for spinal stenosis patients. 

What is Spinal Stenosis?

Spinal stenosis is a common condition that develops when the spaces in the spinal canal become narrower. With less space in the spinal canal, the nerve roots and spinal cord may become compressed. This can result in a variety of symptoms, including:

• Back pain and stiffness
• Sciatica, which is nerve pain that extends from the lower back to the buttocks and down the legs
• Cramping and/or numbness in the legs
• Lost sensation and/or a sensation of weakness in the feet
• In severe cases, lost bladder or bowel control

What Causes Spinal Stenosis?

Most often, spinal stenosis is triggered by osteoarthritis-related spinal degeneration. Osteoarthritis is a condition that occurs when the cartilage that cushions the joints (including the joints in the spine) breaks down over time. This results in pain, stiffness, and inflammation. 

Other spinal conditions including herniated discs, spinal fractures, and bone spurs can also lead to spinal stenosis. Less commonly, patients are born with a narrow spinal canal or scoliosis (an irregular curve of the spine), leading to congenital spinal stenosis

Surgery For Spinal Stenosis

Surgery for spinal stenosis typically entails spinal decompression. The goal of spinal decompression surgery is to alleviate pressure on the spinal cord and/or spinal nerves to relieve back pain, stiffness, and neurological symptoms. 

There are multiple possible approaches to decompressive spinal stenosis surgery. These include:

• Laminectomy

Laminectomy is the most frequently performed procedure for spinal stenosis. It involves removing some or all of the lamina, which covers the back of the vertebra. By getting rid of some or all of the bony arch at the back of the affected vertebra, your surgeon creates more room in the spinal canal. 

• Laminotomy

Laminotomy is similar to laminectomy. However, while laminectomy involves the total removal of the lamina, laminotomy involves only partial removal of the lamina. Laminectomy and laminotomy are both performed to alleviate nerve compression. 

To determine which procedure you need, your surgeon will consider the specifics of your case. However, both types of spine surgery are conventionally performed with a posterior method. 

• Foraminotomy 

Foraminotomy is another type of spine procedure. It’s done to expand the path where the spinal nerve roots leave the spinal canal. The name of this procedure is taken from the word “foramen”, which is defined as a passage in medical terminology. The end of the word, “otomy”, is a term meaning “to open”. 

While performing a foraminotomy, your surgeon will cut out any bone and soft tissue that’s blocking the passageway. By removing these tissues, your surgeon will effectively relieve pressure on the spinal nerve roots. 

• Facetectomy

The facet joints are small joints that connect the vertebrae from the back of the spine. Each vertebra has two facet joints. 

In facetectomy, the surgeon fully or partially removes the facet joints of the affected vertebrae. The goal of this procedure is to assuage nerve compression on the nerve roots that run near the facet joints of the lower spine. 

• Discectomy

Patients who experience spinal stenosis caused by a herniated (bulging) disc may need a discectomy. In this spinal procedure, the surgeon removes damaged disc tissue to eliminate strain on the spinal nerves. 

In a discectomy, your surgeon will aim to leave as much of the intervertebral disc untouched as possible. 

The Benefits of Minimally-Invasive Spinal Treatment

Minimally invasive spinal stenosis surgery presents several benefits over conventional spinal surgery. These include:

Less Postoperative Pain

During surgery, the body goes through a degree of trauma. But, minimally-invasive spine surgery limits or entirely avoids cutting through the muscles.

By reducing the trauma to your muscles and soft tissues, MIS leads to less pain after spinal procedures. This can also lessen the need for pain medication after surgery. 

Less Time in The Hospital

After undergoing spinal surgery, patients are eager to return home as fast as possible. After all, you’re bound to feel more comfortable in your own home than in a hospital bed. So, one of the most attractive benefits of minimally-invasive surgery is that it can reduce the length of your hospital stay. 

Faster Recovery

After struggling with chronic back pain, a lengthy recovery period from spine surgery can be daunting. Additionally, a lengthy recovery period can require patients to take time away from work and their favorite activities.  

Local Anesthesia

Many minimally-invasive procedures can be done with local anesthesia, rather than general anesthesia. This makes MIS safer, as the risk of severe complications is much lower with local anesthesia when compared to general anesthesia. 

Less Scarring

Though arguably a less crucial benefit than reduced pain and a faster recovery, less scarring is a perk of minimally-invasive surgery. Due to a smaller incision, MIS limits scarring after surgery. 

Lower Risk of Complications

Medical complications are a major concern among surgery patients. Minimally-invasive surgery can limit the risk of medical complications, including the risk of infection and an adverse reaction to general anesthesia. Additionally, MIS avoids excess blood loss and the problems that it can cause. 

Minimally-Invasive Spinal Stenosis Surgery

Minimally invasive surgery (MIS) is available for spinal stenosis. Methods that can be used to achieve minimally invasive spine surgery include:

• Using small incisions to limit bleeding and scarring
• Using specialized instruments and/or a microscopic camera to guide the surgeon
• Moving the muscles away from the spine with a tubular retractor
• Accessing the spine from the patient’s side, rather than the back, to avoid the large back muscles
• Using a percutaneous placement of rods, screws, and other spinal implants for implant placement without disturbing the spinal muscle
  • A percutaneous placement involves using x-ray imaging to position guidewires into the vertebrae on the same path as the screws will take. The screws can then take the route of the guidewires and help guide the rod placement. The rods can be connected to the screws and the screws can be secured into place using screw extenders that reach outside of the skin.  

Spinal Fusion and Minimally-Invasive Spinal Stenosis Surgery 

Spinal fusion is commonly performed for spinal stenosis surgery. By fusing two or more of the injured vertebrae together, fusion provides stability and pain relief. However, spinal fusion isn’t conventionally a minimally-invasive procedure. 

The Downsides of Spinal Fusion Surgery

Along with the risks of a non-MIS procedure, traditional fusion also presents risks of its own. For one, fusion significantly lengthens the amount of time that the patient must remain in the hospital after spine surgery. Additionally, the complete recovery period after spinal fusion can last as long as a year. 

One of the most prominent downsides of spinal fusion is the fact that it can limit patients’ mobility. In the area of the fused vertebrae, patients often lose the ability to bend, rotate, and flex the back. This can prevent patients from taking part in their favorite activities after fusion surgery.

Thankfully, minimally-invasive spinal fusion surgery is possible with the help of innovative spinal implant systems. 

Spinal Implants For Minimally-Invasive Spinal Stenosis Surgery

Some implant systems can facilitate minimally-invasive spinal stenosis surgery and serve as spinal fusion alternatives. By stabilizing the spine without preventing motion, an implant can help resolve spinal stenosis without the need for fusion. 

The TOPS spinal implant is one of the available alternatives to spinal fusion that can allow for a minimally-invasive procedure. It’s a mechanical device that replaces the tissues removed in spinal decompression surgery. The implant works by instituting a controlled range of motion in the spine.  

Minimally-Invasive Spinal Fusion Surgery Recovery Time

The minimally-invasive spinal stenosis surgery recovery time is much shorter than that of conventional spine surgery. With the TOPS System, patients can regain a complete range of motion immediately after the procedure. Additionally, in comparison to fusion, TOPS patients are subject to far fewer restrictions during the recovery period. 

Non-Surgical Alternatives to Spinal Stenosis Surgery

Patients looking to entirely avoid spinal surgery may achieve symptom improvement from ongoing non-surgical treatment. Treatment options include:

• Physical therapy
• Chiropractic care
• Massage therapy
• Acupuncture
• Anti-inflammatory medication
• Epidural steroid injections
• Lifestyle and activity modifications

Your doctor can advise you on the best approach for surgical or non-surgical treatment to resolve symptoms of spinal stenosis, including proven and less invasive solutions like the TOPS spinal implant. 

What Is XLIF?

Thanks to breakthroughs in spinal medicine, patients today can benefit from treatment regimens and procedures tailored to their individual needs and specific conditions. Among these recent advances on the surgical front is eXtreme Lateral Interbody Fusion, or XLIF.

What is XLIF Spine Surgery?

XLIF refers to a type of spine fusion surgery. In this procedure, the surgeon reaches the spinal disc from the side of the body, which is known as a lateral approach. This is unlike other methods, which access the spine anteriorly (from the front of the body) or posteriorly (from the back of the spine)

For patients suffering from symptoms of spinal conditions, XLIF spine surgery is to assuage nerve root compression in the spine, correct spinal deformities, and resolve spinal instability. 

XLIF Procedure Process

XLIF is among the endoscopic spine surgery procedures performed with microsurgery tools and techniques. It’s generally performed with general anesthesia, so the patient is asleep through the procedure. Additionally, XLIF takes about an hour to complete. 

Electromyography in XLIF

Nerves extending from the backbone are positioned near the psoas, which can be compromised during surgery. To avert nerve damage, the XLIF procedure utilizes electromyography (EMG), a type of neuromonitoring. This enables the surgeon to examine the nerves that emerge out of the spine throughout the procedure, making sure that they’re not inflamed or damaged.

Fusion

XLIF falls into the category of back surgery involving the removal of the disc in the front of the spine. Then, an implant that holds a bone graft is used to replace the disc. The graft enables the two vertebrae to fuse between the disc area in a process known as spinal fusion.

For patients with chronic back pain, XLIF provides a method of spinal fusion for the treatment of several different lower back disorders.

Steps of XLIF

1. The first step of XLIF surgery is to put the patient under general anesthesia. 
2. Next, with the patient positioned on one side of the body, the surgeon will take x-rays. Using the information gathered from these x-rays, the surgeon can define the exact position of the intervertebral disc that will be extracted. 
3. With the position of the disc marked on the patient’s skin, the surgeon will create an incision in the patient’s flank. The flank is located in between the hips and lower ribs. 
4. Next, the surgeon will adjust the peritoneum aside from the abdominal wall. The peritoneum protects and encompasses the organs of the abdomen. 
5. The surgeon will then make a second incision in the side of the body. A dilator will be placed into the incision, and the position of the dilator is checked with an x-ray. The dilator should be positioned precisely above the intervertebral disc. 
6. To gain access to the spine, the surgeon will use a probe to separate the psoas. Then, a retractor can be used to allow spinal access. 
7. With a path to the spine, the surgeon will remove the nucleus (interior) of the affected intervertebral disc. This step, which is referred to as discectomy, preps the area for fusion. 
8. A spacer containing bone graft material will then be placed into the disc area. The spacer maintains the position of the vertebrae and helps with the fusion process. 
9. In some cases, the surgeon may opt to complete posterior fixation with rods and facet/pedicle screws. This step can provide spinal stability after XLIF surgery. 

How Does XLIF Differ From Conventional Spine Procedures?

XLIF differs from the traditional posterior approach for spine surgery, which is called posterior interbody fusion (PLIF). Since PLIF involves reaching the spine from the back, the procedure requires the surgeon to disturb the large back muscles. Doing so triggers a lengthy recovery process, along with significant pain in the post-op period. 

Additionally, XLIF is a minimally-invasive form of spine surgery, unlike PLIF. Along with a shorter recovery period and less postoperative discomfort, minimally-invasive procedures offer the benefit of a lower risk for medical conditions.  

What Are The Benefits of XLIF?

• Requiring only small incisions, XLIF surgery minimizes tissue damage, blood loss. and scarring. 
• XLIF has a relatively quick recovery time, especially when compared to conventional spine surgery.
• Taking as little as an hour to complete, XLIF minimizes the amount of time that the patient spends under anesthesia. 
• Since the back muscles, ligaments, and bones are left undisturbed with the lateral approach of XLIF, patients experience less pain. 
• After XLIF, patients can return to their regular activities faster than through conventional spine surgery. 
• Patients can often walk on the day of the XLIF procedure. 
• Although some XLIF cases may require the patient to stay for one night at the hospital, it typically results in a quicker hospital stay than other spinal procedures. After conventional spinal fusion, patients must remain in the hospital for multiple days after the procedure. 
• XLIF surgery reviews are positive and indicate that the procedure can successfully reconstruct spinal deformities. 

What Are The Drawbacks of XLIF?

A drawback of the XLIF procedure is that it involves fusing vertebrae. Spinal fusion eliminates independent movement between adjacent levels.

Spinal fusion significantly lengthens the recovery period of any spinal fusion procedure. Unfortunately, even after making a full recovery, patients won’t regain a full range of motion in the spine. With each vertebra that’s fused, patients lose a degree of spinal flexibility. 

After XLIF with spinal fusion, patients may no longer be able to bend, flex, stretch, and twist the back like they once could. This can diminish patients’ ability to partake in various physical activities. 

Additionally, when two or more vertebrae are fused, they force the rest of the spine to compensate for their lack of motion. Specifically, the vertebrae on top of and below the fused spinal bone undergo increased impact. This can result in adjacent segment disease, or ADA.

With ADA, the vertebrae that are adjacent to the fused portion of the spine degenerate more rapidly. This can result in chronic back pain and neurological symptoms in the legs and feet. 

Fusion Alternatives

Non-Surgical Treatment Methods

Spinal fusion typically isn’t recommended until patients have undergone several months of conservative treatments. Nonetheless, patients looking to avoid the complications of fusion may consider continuing with non-surgical therapies, such as:

• Physical therapy

Physical therapy can help patients improve their posture, strengthen the spine’s supporting muscles, and alleviate muscle tension. 

• Chiropractic care

Chiropractic care can help relieve tension in the spine by enhancing spinal alignment. 

• Lifestyle modifications and rest

Rest and lifestyle modifications can reduce the strain on the spine. Lifestyle factors including smoking, having a sedentary lifestyle, and having a high body weight can exacerbate spinal conditions.  

• Anti-inflammatory medications

Anti-inflammatory medications can help patients manage chronic pain from spine conditions. NSAIDs, muscle relaxants, and acetaminophen are examples of medications that may benefit patients with chronic spinal pain. 

• Epidural steroid injections

Epidural steroid injections can only be used a few times per year. However, this condition can help alleviate pain and swelling from spinal disorders. 

Spinal Implants

Today, thanks to another advance in spinal medicine – the TOPS™ System –  some patients may be able to avoid the risks and complications associated with spinal fusion. In select cases, a TOPS implant can be used in place of traditional spine fusion surgery to resolve conditions such as spinal stenosis, spondylolisthesis, and herniated discs. 

Unlike fusion, the TOPS System preserves the full range of motion of individual vertebrae. Additionally, the TOPS System has been proven to provide better outcomes than spinal fusion in clinical studies conducted around the world. This adds up to two breakthroughs in the treatment of spinal conditions, promising effective relief for many patients with back problems that require a surgical solution.

With the TOPS System, patients can avoid:

• The lengthy recovery period associated with fusion
• The post-operative pain that patients experience with fusion
• The prolonged hospital stay required after fusion
• The reduced spinal mobility caused by fusion
• The risk of adjacent segment disease and related conditions

If you’re struggling with symptoms of a spinal disorder, talk to your doctor about the available treatment options, such as XLIF surgery and the TOPS System.