Surgical Options For Spinal Stenosis

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Spinal stenosis occurs when the vertebra narrow, creating pressure on the spinal cord. In severe cases, the pain and potential damage to the spinal cord require surgical treatments to reduce pain and prevent permanent damage to the spinal cord. Fortunately, there are various surgical options, depending on the extent of stenosis.

Enlarge The Foramen

The process of enlarging the foramen, which is the canal containing the spinal cord, is one option to manage spinal stenosis. This is the least invasive form of spinal surgery and can work well for people without extensive stenosis. Surgery involves carefully removing obstructions within the foramen that are pressing on the spinal cord. In most instances, there are bone spurs inside the foramen that are pressing on the spinal cord. Bone spurs occur when there is friction between bone and your body forms new bone to protect itself, much like a callus on pressure points of the feet. In some situations, removing the bone spurs may not be enough to sufficiently enlarge the foramen. Additional soft tissue and some of the disc may need to be removed to provide adequate relief.

Removing The Lamina

The lamina are a bony protrusion on the backside of each vertebra. In severe cases of stenosis, it may be better to remove this area from the affected vertebrae to give the spinal cord and other nerves more space to prevent compression or damage. The procedure is similar to enlarging the foramen because removal of the lamina allows the spinal cord to have more space as it passes through the vertebrae. Much like enlarging the foramen, additional tissue might need to be removed for the procedure to be successful. This procedure is not an option for people with widespread stenosis. Since removal of the lamina leaves the spinal cord exposed in that area, it is potentially dangerous to have too many vertebrae with their lamina removed. A partial disc removal may also be done with this procedure.

Disc Removal And Fusion

Other procedures may involve a partial disc removal, but removal of the entire disc may be necessary. Since removal of the disc leaves space between the vertebrae without any way to maintain the space, a fusion is often necessary. Fusing two vertebrae involves performing a bone graft. Bone grafts generally involve either the use of real bone or a material used to trick the body into thinking the material is bone.

If your surgeon uses a bone graft, the bone may either come from elsewhere in your body or donor bone from a cadaver. Your own bone is preferred because there are fewer risks, such as rejection of tissue that is not your own. When you use your own bone, the bone may be taken from the ribs but may come from elsewhere in the body, such as bone that was removed from the vertebrae or bone spurs. The bone is placed in the space between the two vertebrae and is held in place with screws, plates, wires, or whatever hardware is needed to maintain the integrity of the bone graft. Over time, the donated bone triggers the body to create new bone allowing the vertebrae to fuse together. Although fusions can be quite effective for extensive stenosis, it comes at a cost of lack of spine movement.

Spinal stenosis is not only a painful condition because of compression of the spinal cord and surrounding nerves, it can also cause permanent damage. Surgical procedures to reduce pressure on the spinal cord are the most effective way of minimizing pain and the potential for permanent spinal cord injuries. For more information regarding spine surgery, contact a clinic.