1. Open Spinal Stenosis Surgery is no Small Task
Traditionally, open spinal stenosis surgery of the lumbar spine has been a formidable procedure to undergo, with high risk potentials, lengthy hospitalizations and long, arduous and frequently uncomfortable recovery. Lumbar spinal stenosis surgery typically involves the removal of bone, ligamentous tissue, and occasionally, disc material, in an effort to relieve pressure. It can also require removal of bony structures to the extent that the spinal column can become unstable, requiring the insertion of plates and screws to stabilize those segments.
2. Have Realistic Goals After Surgery
This type of surgery, because of its invasive nature, involves cutting into deep muscular and ligamentous tissues, which naturally causes pain after surgery. Function and mobility return very slowly. Post operative pain will linger. If an area of the spine requires stabilization and/or bone grafting, this process can take months to solidify and heal entirely.
It is imperative to set realistic goals in regards to mobility within the allowable amounts during recovery. Pain control should be diligent because pain breeds inflammation, which breeds more pain. Many people expect to be pain free after surgery, and fail to comprehend how unrealistic that notion is, given the nature of the procedure.
3. The Spine Will Never be Normal
What brings a patient to the surgeon is, in essence, abnormal pathology. And it is unrealistic to expect the spine will be "normal" after surgery. While the problems may have been "solved" by removing bone and other pressure-inducing tissue, the spine is still not normal, especially if some type of instrumentation has been inserted.
Many people have expectations of being returned to a pre-disease state with surgery, only to find that things just aren't the same. This is not to say the surgery was anything less than successful; rather, expectations and understanding were flawed.
4. Be Aware of Potential Complications
All surgical procedures carry the potential for complications. Many are specific to the procedure itself. In lumbar spinal stenosis surgery, nerves that exit the spinal canal are manipulated and can be injured. Because of close proximity to the spinal sac, loss of spinal fluid and bleeding are possible. Nerve injury or damage is an ever-present risk and should not be taken lightly. Nerves that control the bowel and bladder are at risk of injury or damage. Healing can be incomplete, and the possibility of further surgery is a risk.
5. Research Your Options and Alternatives
Many patients with a diagnosis of lumbar spinal stenosis can have significant relief of symptoms without major surgery. Treatments such as steroid injections into the spine, physical therapy, pain management and medication can achieve tolerable comfort levels.
If conservative management is not an option, take time to research less invasive surgical options to see if they are right for you. An example of newer, less invasive stenosis surgical procedures is the endoscopic foraminotomy and laminotomy, which relieve pressure from bony encroachment into the openings for the spinal nerves to exit.
