Recovering From Spinal Stenosis Surgery

Recovery Time For Minimally Invasive Spinal Stenosis Decompression Surgery

We have two common minimally invasive decompression procedures that are used to treat spinal stenosis foraminotomy and laminotomy.

While the specific details of your recovery might change depending on the type of surgery you receive, all minimally invasive decompression surgeries allow for a 12-week recovery period. Prior to your minimally invasive decompression surgery for spinal stenosis, your surgeon or nurse will explain the postoperative guidelines to help you recover in a healthy and timely manner. You will also be given a postoperative guide to help you through the process.

Our patient care and superior surgical techniques allow our patients to experience successful surgical outcomes and return to their lives quicker than they imagined. Take a look at our most recent successful outcomes for minimally invasive decompression surgery:

• 81 percent of patients report returning to work within three months after surgery^
• 88 percent of patients report returning to daily activities within three months after surgery^

During your recovery period, you will have 24-hour access to our nurses and dedicated team. Please reach out to our team if you have questions or are experiencing unexpected discomfort during your recovery. Remember, you may be sore for the first few days following your surgery.

When Is Spinal Stenosis Surgery Considered

Because of the complexity of spinal stenosis and the delicate nature of the spine, surgery is usually considered when all other treatment options have failed. Fortunately, most people who have spinal stenosis dont need surgery. However, talk with your healthcare provider about surgical options when:

• Your symptoms are intolerable, you no longer have the quality of life you desire and you cant do or enjoy everyday life activities.
• Your pain is caused by pressure on the spinal cord.
• Walking and maintaining your balance has become difficult.
• You have lost bowel or bladder control or have sexual function problems.

Surgery For Lumbar Spinal Stenosis

For patients with moderate to severe spinal stenosis who dont 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.

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Is Stretching Good For Spinal Stenosis

Weve 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.

Keeping Patients Awake During Spine Surgery Is Cutting Recovery Time In Half

The spinal surgery David B. underwent in November wasnt his first but it was the first time he was awake for a procedure.

David is one of about 10 patients so far who have taken advantage of UC San Franciscos offering of awake spine surgery, which neurosurgeon Praveen Mummaneni, MD, began doing in spring of 2018.

At first I thought Do I really want to be awake for this? said David. But in reality, it was more like being pleasantly oblivious. I was not aware of anything that was going on. It was sleepy time.

After the procedure a transforaminal lumbar interbody fusion, or TLIF, which generally takes only two to three hours David was up and walking again, without pain, before the end of the day.

The procedure is relatively new, said Mummaneni, who is also co-director of the UCSF Spine Center. Its changing my practice in that I can get my patients through their surgery much more quickly.

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How Is Spinal Stenosis Surgery Performed

The goal of spinal stenosis surgery is to relieve the pressure on the spinal cord or nerve roots by creating more space within the spinal canal. Research shows that when performed by a highly experienced and qualified surgeon, spine surgeries are more successful and result in fewer complications.

The gold standard for surgical treatment of spinal stenosis is a laminectomy. The procedure involves removing the back part of the affected vertebra . Sometimes the vertebra may need to be joined to adjacent vertebrae with metal components and a bone graft to stabilize the spine, known as spinal fusion. Over time, the vertebrae will fuse and come together as one bone. Modern minimally-invasive techniques may use smaller incisions to access the narrowed spinal column, conserving healthy soft tissue.

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 thats 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.

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Recovery From Spinal Stenosis Surgery

If you are living with spinal stenosis and are considering surgery, researching the recovery process is essential. Depending on the severity and location of your spinal stenosis, there are different types of surgical options available. Each of these options will produce different recovery times and movement restrictions. Read below to get a general understanding of recovery from spinal stenosis surgery.

Recovery Time Following Spinal Stenosis Surgery

Coming to how long does it take for an individual to recover from surgery for spinal stenosis, the first and the most important thing is to know that the symptoms will not get better overnight or immediately after surgery.

The surgeon will allow the patient to get out of bed and walk with assistance about 24 hours after spinal stenosis surgery. Within a couple of days after spinal decompression surgery, if the surgeon feels that the patient is recovering well following surgery then he or she will be discharged from the hospital. The patient will be prescribed pain medications to be taken for about three weeks.

The patient will be given detailed instructions on how to sit, stand, walk, and rise from a seated position after spinal stenosis surgery . The patient will be advised to restrict activities which may aggravate the condition or stress the spine excessively. Sport is something which the patient will be asked to avoid, especially contact sports. These restrictions will be in place for up to three months after surgery.

On the whole, it will take about 3-6 months for an individual to completely recover from a spinal stenosis surgery and be able to perform all the activities of daily living without pain or discomfort from spinal stenosis.

What Medical Problems Can Be Confused With Spinal Stenosis

Medical problems that can sometimes mimic spinal stenosis include neuropathy, peripheral artery disease, diabetes-related neuropathy and inflammatory arthritis, such as ankylosing spondylitis. Rare, but still other possible medical conditions that might be mistaken for spinal stenosis include cancer and abdominal aortic aneurysms.

A note from Cleveland Clinic

• Spinal stenosis is the narrowing of the spaces within the spine, which eventually results in pressure on the spinal cord or nerve roots.
• Symptoms of spinal stenosis vary widely from person to person and range from no symptoms to pain in the back or neck and numbness, tingling and weakness in the arms and/or legs.
• Treatment depends on the severity and location of the stenosis and its effects on the quality of your life. Treatment usually starts with nonsurgical options and may move to surgical options if other methods no longer relieve your pain.
• Although there is no cure for spinal stenosis, exercise to keep your muscles strong, improve your flexibility and reduce pain. Always check with your provider before starting any exercise or movement program.
• If needed, use assistive devices such as a cane or walker to safely move about.
• Find positions that relieve your pain. A slight forward lean, for example, may relieve pain if you have lumbar spinal stenosis. Ask for a referral to a physical therapist who can develop an individualized exercise plan for you.

References

What To Expect After Spine Surgery

After surgery, you spend several hours in the recovery room. NYU Langones pain management specialists are available 24 hours a day to make sure youre comfortable during the initial stages of recovery.

Depending on the type of surgery performed, you may spend one or more days in the hospital for observation.

A physiatrist, a doctor who specializes in rehabilitation medicine, visits you after surgery to help you adjust to moving with the newly fused bones. He or she also shows you simple exercises to rebuild strength in the muscles in and around the affected area of your spine. If surgery was performed on the lumbar spine, you may receive a walker or a cane to help you get around.

Some people need to wear a back or neck brace after surgery to keep the spine stabilized while it heals. Your surgeon makes this decision. Typically, a brace is required if surgery was performed in the cervical spine or if a spinal fusion was performed to correct multiple vertebrae. An orthotics specialist can custom fit a brace for you.

Your doctor provides you with pain medication that is taken by mouth in the weeks after surgery. How long medication is required and how quickly your back heals depend on many factors, including your age, what type of procedure was performed, and whether spinal stenosis caused major nerve damage before treatment.

Making Surgery Accessible To More People

In addition, the awake surgery appeals to those who are deterred from the traditional operation by the recovery time of a week or more.

To determine whether a patient is a good candidate for awake surgery, Mummaneni reviews the MRI and clinic notes. Awake surgery is currently available for one- or two-level lumbar procedures for decompression and/or fusion to treat stenosis and spondylolisthesis. UCSF is one of the first major medical centers in the U.S. to offer awake spine surgery through an Enhanced Recovery After Surgery protocol.

David had seen his share of back problems when he contacted Mummaneni last summer. Ive had so many surgeries, he said. Im hardly a rookie with this.

Despite previous spinal procedures done at other hospitals, David experienced persistent back pain, and hed been referred to Mummaneni by another surgeon. When the UCSF doctor offered him the opportunity for spine surgery without general anesthesia, David opted for it.

I have zero pain now, he said. It was less time in the hospital, less impact on your body, recovery is accelerated, and theres less need to use pain meds.

Surgery For Spinal Stenosis

If nonsurgical treatment and therapeutic injections have not eased the pain caused by spinal stenosis, doctors at NYU Langone may recommend surgery to relieve pressure on nerves or the spinal cord.

Usually, our spine specialists consider surgery only if symptoms such as weakness, numbness, or pain in the arms or legs indicate severe or progressive nerve or spinal cord compression.

In addition, if instability in the spine has contributed to spinal stenosisfor example, a vertebra or disc that has slipped out of place is constricting nerves or the spinal cordsurgery may be required to stabilize the spine and prevent further damage.

Spinal neurosurgeons and spinal orthopedic surgeons at NYU Langone may perform one or more of the following procedures in either the lumbar or cervical spine. All types of spinal surgery require general anesthesia.

Limitations Of This Study

In the NASS-criteria for clinical symptoms it is stated that low back pain, gluteal pain and lower extremity pain are symptoms of lumbar spinal stenosis.

Patients may find it difficult to fit their symptoms into a standardized questionnaire used in a registry, so there may be errors in preoperative classification. It might be difficult to identify the exact location of their symptoms . In the registry forms, patients are asked to quantify their pain intensity during the previous week in the lower back or gluteal region, and in the lower extremity. But should they for instance note their pain in the buttock as back pain or leg pain? Furthermore, should buttock pain be registered as radiating pain to the extremity?

Recently it has been questioned if the Oswestry Disability Index is well enough validated for patients with spinal stenosis . However, a recent publication from the SWESPINE register show a high consistency between a five point Global Assessment-scale and the ODI questionnaire and NRS for low back pain/lower extremity pain in over 94,000 patients, including lumbar spinal stenosis patients . This shows that an improvement of ODI is consistent with the patients self-reported effect after surgery.

What Are The Symptoms Of Spinal Stenosis

You may or may not have symptoms when spinal stenosis first develops. The narrowing of the spinal canal is usually a slow process and worsens over time. Although spinal stenosis can happen anywhere along the spinal column, the lower back and neck are common areas. Symptoms vary from person to person and may come and go.

Symptoms of lower back spinal stenosis include:

• Pain in the lower back. Pain is sometimes described as dull ache or tenderness to electric-like or burning sensation. Pain can come and go.
• Sciatica. This is pain that begins in the buttocks and extends down the leg and may continue into your foot.
• A heavy feeling in the legs, which may lead to cramping in one or both legs.
• Numbness or tingling in the buttocks, leg or foot.
• Weakness in the leg or foot .
• Pain that worsens when standing for long periods of time, walking or walking downhill.
• Pain that lessens when leaning, bending slightly forward, walking uphill or sitting.
• Loss of bladder or bowel control .

Symptoms of neck spinal stenosis include:

• Neck pain.
• Numbness or tingling in the arm, hand, leg or foot.
• Weakness or clumsiness in the arm, hand, leg or foot.
• Problems with balance.
• Loss of function in hands, like having problems writing or buttoning shirts.
• Loss of bladder or bowel control .

Symptoms of abdomen spinal stenosis include:

• Pain, numbness, tingling and or weakness at or below the level of the abdomen.
• Problems with balance.

Low Back Pain Takes Physical Economic Toll

Theres no shortage of people in the U.S. in need of back surgery. Spinal disorders debilitate more Americans than any other medical condition. Nearly four in five Americans struggle with low back pain at some point in life. About one-quarter of those, or 20 percent of Americans, experience chronic low back pain with persistent symptoms, according to the National Institutes of Health.

Nearly four in five Americans struggle with low back pain at some point in life.

The incidence of low back pain has been steadily increasing since the 1990s, is now the leading cause of missed workdays and the most common cause of job-related disability, according to the National Institutes of Health.

Because back pain interferes with an individuals ability to exercise and be active, it often saps a person of their overall wellness. In fact, back pain now ranks third as a cause of poor health among Americans, following heart disease and chronic obstructive pulmonary disease .

In other words, getting people with spinal conditions back to work faster and with fewer complications has economic and social benefits as well as health advantages.

Causes Of Spinal Stenosis

Primarily, the cause of spinal stenosis is aging, which means it will affect more people who are older. As your body ages, it undergoes various degenerative processes. For instance, tissues in the spine will become thick and the bones will get bigger that will cause compression of the nerves.

Research studies have shown that spinal stenosis is also due to osteoarthritis and rheumatoid arthritis. The inflammation puts pressure on the spinal cord and complicates the problem further.

Some other health conditions that can cause spinal stenosis are spinal defects at birth, narrowing of the spinal cord, scoliosis or spinal curvature, and Pagets disease of the bone. Bone tumors and dwarfism can also cause this painful condition.

Can Spinal Stenosis Heal On Its Own

Generally no because the most common causes of spinal stenosis is normal age-related wear and tear on the bones and structures of the spine. However, if the cause of your spinal stenosis is a herniated disk, it can sometimes get better on its own with a short amount of rest or with treatments such as physical therapy, anti-inflammatory medications or spinal injections.

Recovery After Lumbar Laminectomy For Spinal Stenosis

Recovery after an open laminectomy surgery typically depends on the fitness and level of activity prior to surgery. A course of physical therapy may be advised to improve pre-surgical activity level in order to encourage better recovery after surgery. It typically takes 4 to 6 weeks until normal function is established.1–2 When fusion is also done, it may take longer to recover.

Several precautions and procedures are necessary to ensure safe and complete recovery.

Strengths Of This Trial

A register trial has a high external validity. This is a cohort from most of the hospitals performing spinal surgery in Norway in the given period. The high numbers of patients in the study strengthens the validity of the results.

The surgical techniques used in this study are similar, and have been documented not to influence the clinical outcome. All patients in the present study had surgery for lumbar spinal stenosis with spinal decompression with a midline retaining method , without additional fusion. A previous study from the same register showed similar clinical results after using these three posterior decompression techniques .

Is Spinal Surgery Safe What Are The Risks Of Surgery For Spinal Stenosis

All surgeries have the risks of infection, bleeding, blood clots and reaction to anesthesia. Additional risks from surgery for spinal stenosis include:

• Nerve injury.
• Tear in the membrane that covers the nerve or spinal cord.
• Failure of the bone to heal after surgery.
• Failure of the metal plates, screws and other fasteners.
• Need for additional surgery.
• No relief of symptoms/return of symptoms.