1. Low Back Pain: One of the Most Common Ailments
Disabling low back pain that requires surgical intervention is a very common aliment, and the surgery is one of the more commonly performed spinal surgeries in the United States. The most common culprits causing pain and disability are the degenerated, protruding disc, with bony degeneration and spur formation. Lumbar spinal stenosis can occur at more than one level, and has an incidence of 5 in every 1,000 persons over the age of 50.
2. Same Cause, Different Treatments
Historically, surgical procedures for lumbar spinal stenosis required long incisions, together with wide exposure so that significant bone could be removed to decompress the spinal cord structures. Additionally, significant disc material was also removed to decompress the nerves from the anterior side of the spinal canal. Consequently, as a result of this wide, aggressive bone and disc removal, spinal segments became unstable, requiring various types of additional fusion/stabilization procedures.
Over the years, a trend in lumbar spinal surgery has shifted to the minimally invasive techniques. Procedures are now being performed with the assistance of a microscope, stealth technology and micro instrumentation. This results in less tissue trauma, less blood loss, less postoperative pain and faster recovery
3. Know Your Limitations During Recovery
Even with the advent of the minimally invasive/microscopic lumbar spinal surgery, patients should exercise caution and patience during the recovery phase. On the advice of your physician, activities should resume slowly and cautiously, beginning with the most basics, such as walking. Follow your physical therapy protocols, as they are designed to help strengthen the body in a manner that parallels the recovery process.
Avoid bending, stooping, and lifting activities until given the go-ahead by your doctor. Understand that the low area will remain sore for several weeks, and that it can take up to 12 to 18 months before being considered fully recuperated.
4. Feeling Better Doesn't Mean Doing More
It is quite common for patients to feel considerably better within a few days after minimally invasive lumbar surgery. While there can be a major reduction in symptoms from this procedure, care must be taken to avoid overdoing activities. Be respectful of the procedure and your body by taking it easy and progressing in a deliberate fashion.
For patients who had experienced severe leg pain before surgery, this often is the first symptom that a patient reports being absent post-operatively. Overexertion in the early postoperative period can easily cause a recurrence of symptoms.
5. Have Realistic Expectations of the Surgical Outcome
Even minimally invasive surgery is still surgery, and the degeneration in the lumbar spine is still degeneration. It is important to maintain a realistic outlook and have realistic expectations of the level and quality of recovery based on the magnitude of surgery performed.
Surgery can be curative. However, for the most part, surgery for lumbar spinal stenosis for reasons other than an isolated disc rupture may carry with it some level of prolonged discomfort and debilitation. Most patients go on to full recovery, but must maintain proper perspectives about it.
