The Cleveland Clinic describes spinal stenosis as a condition in which the spinal canal narrows over time. As a result, the spinal cord and nerves have less space. As the narrowing continues, the nerves that travel through the spinal column to the legs become squeezed, leading to back and leg pain, according to the Cleveland Clinic. Patients with severe spinal stenosis commonly undergo physical therapy and pain-blocking injections. Surgical options include laminectomy, foraminotomy and spinal fusion.
Physical Therapy
Physical therapy helps to relieve symptoms of spinal stenosis by restoring flexibility and strengthening the back and abdominal muscles, according to the Mayo Clinic. Physical therapy involves an extensive treatment plan consisting of heat and cold therapy, water therapy, acupuncture, traction, dynamic lumbar stabilization, electrical stimulation, assessment of musculoskeletal imbalances, stretching exercises and training in posture and body mechanics.
Pain-Blocking Injections
Periodic steroid or cortisone injections can often reduce inflammation of the spinal nerves and nerve roots, according to the Mayo Clinic. The patient receives these injections next to the spine, at the site of back pain, which offers temporary relief. The number of injections patients receive depends on their needs and the severity of their condition.
Laminectomy
The Cleveland Clinic describes the most common type of surgery for this condition: laminectomy. The surgeon removes the lamina, which is a portion of the vertebra, to make room for the nerves. She makes an incision into the patient's back, allowing her to view the spinal canal. The spinal canal is O-shaped and is formed by the vertebrae in front and tissue in the rear. The Mayo Clinic states that when surgeons remove the lamina, they transform the canal from an O-shape to an open-ended U shape. The newly formed U-shape creates room in the canal and restores normal blood flow to the nerves. The patient's back muscles then cover and protect the open area of the canal.
Foraminotomy
A surgery, known as foraminotomy, widens the opening in the back where nerve roots leave the spinal cord, according to Medline Plus. The procedure involves expanding this area to provide more space for the nerve roots. Medline Plus states foraminotomy takes pressure off nerves in the spinal column and allows it to move more easily.
Spinal Fusion
In the procedure know as spinal fusion, surgeons join bone together with screws or bone grafts to provide spinal stability, according to the Cleveland Clinic. Spinal fusion surgery typically lasts several hours and has two different procedure methods.
The first method involves bone removal from elsewhere in the body, according to the Cleveland Clinic. The bone then creates a bridge between the vertebrae to stimulate the growth of new bone. The second method uses metal implants, such as rods, hooks, wires or screws. These metal implants secure the vertebrae to hold them together until new bone grows between them.
