Surgery for
Spinal Stenosis
C o n ta c t
D e ta i l s
Spinal Team
Nuffield Orthopaedic Centre
Windmill Road
Headington
Oxford
OX3 7LD
Phone:
Fax:
01865 738051
01865 738027
Web Site
www.noc.nhs.uk
Surgery for stenosis version 2
© 2008 Nuffield Orthopaedic Centre
Normal Spinal Canal
Narrow Spinal Canal
Hospital treatment
This leaflet aims to give you some information about what spinal
The time in hospital is somewhat variable but is usually 2 - 4 days.
stenosis is and why surgery may be helpful to you. It will help you
It could be longer or shorter. Once your wound is healing well and
make your mind up whether surgery is what you want.
you are reasonably independent you will be allowed home.
What is Spinal Stenosis?
After discharge from hospital
Your spine is made up of many bony blocks with discs
between
Your physiotherapist will tell you how to exercise before you go
them. Behind these bony blocks there is hollow canal, which runs
home. You should gradually increase your activities over time.
from your head down to your pelvis. Inside this canal is your
Your spine is quite stable. You are unlikely to require formal
spinal cord. There are some holes along the length of the canal
physiotherapy initially. You will be reassessed at 6 – 8 weeks in the
where the nerves to your arms and legs come out. Stenosis means
clinic by the medical team, and the need for any further treatment
narrowing of this canal or of the holes where the nerves exit.
will be decided then.
Why have I got spinal stenosis?
Driving earlier than 2 weeks is probably not a good idea (as much
•
There are some people who are born with narrow canals.
for other peoples benefit as your own). The time you will require
•
In some people part of the canal gets narrower as they get older.
This is because the joints in the spine get larger due to aging
change; this then reduces the space in the spinal canal, leaving
less room for the nerves.
off work is very variable depending on your occupation, but it might
be as little as 1 week or as much as 6 weeks.
In this leaflet we have tried to give you an idea of the aim of
surgical decompression and some of the risks and benefits. It is
important to stress that there are many differences between one
person and another, in how they get symptoms and where the
stenosis is. We hope that this information will help you to decide
what particular questions you would like to ask when you meet with
your surgeon.
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What are the risks of surgery?
What symptoms does spinal stenosis cause?
About 5 out of 100 people can be made worse by surgery by a
Most people with spinal stenosis have difficulty with
variety of means:
walking and standing for any length of time. This is because when
•
We can only do the operation where the narrowing is at the
we stand straight the canal is narrower. This then affects the nerves
moment. It is quite possible for people to come back at a later
and causes pain in the bottom or legs.
stage with narrowing elsewhere in the spine.
Commonly people find that if they sit or bend forwards the symp-
Surgery can be complicated by tears to the lining of the nerves,
toms ease off again. Many people tell us that they can walk better
leading to leakage of fluid. If this occurs during the surgery we
and further, if they lean on a shopping trolley. Others tell us that
can repair it but sometimes we are not aware this has happened
they can cycle without any pain, yet can hardly walk the length of
until after the operation. This sometimes means that a repeat
the garden. This is because when you bend the spinal canal gets
operation would be necessary to try and seal off the leak.
wider thereby giving the nerves more space.
The nerves that control the bladder, bowel and sexual functions
Many people with stenosis report bladder disturbance: slow to pass,
may be damaged, which could mean that you are incontinent or
urine, incontinence, urgency or frequency. These symptoms are
are unable to have sex.
common in older adults generally and not likely to be related to
•
•
spinal stenosis. In rare cases severe canal stenosis may cause
The surgeon should be able to show you on your scan where the
numbness around the back passage in combination with bladder
narrowing is and whether there are any particular problems with
and/or bowel disturbance.
surgery in your case.
What can I do to help the pain?
Take mild painkillers such a paracetamol. Many people find that
using a walking aid helps them walk for longer. The best ones are
walking aids, which you lean on such as a walking frame with
wheels. These are called ‘All-Terrain Rollators’.
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Why would an operation help my stenosis?
When am I best to have an operation?
The spinal surgeons can help spinal stenosis by taking away some
There is no straightforward answer to this. You have to balance up
bone thereby widening the canal. The operation is called a spinal
the amount of pain and trouble you are getting against the risks and
decompression. The decompression gives the nerves more room
benefits of the operation.
and therefore will remove or reduce the pain in your legs, which
limits your walking. Your surgeon will explain which type of
decompression will be best for you.
What are the benefits of surgery?
In most people we can expect about a 70% chance of improving the
symptoms. In particular this means that you will be able to walk
What will happen if I do not have an operation?
further and stand for longer.
• Fortunately spinal stenosis is not damaging or dangerous. Your
spine is still strong and it is all right to continue to use your
However good the surgery is, it does not cure everything. We have
spine.
found that although people can walk double or triple the distance,
the pain has not completely gone away.
• In most people the symptoms remain much the same over future
years.
present for several months before the operation:
• Around 10% of people find that their symptoms get worse. Over
time they find that the distance they can walk gets less and less.
• There are also a few people who tell us that their
Surgery is unlikely to change any of the following if they have been
•
Numbness in the legs or around the back passage
•
Weakness of the ankle or foot
•
Bladder or bowel dysfunction.
•
Back pain.
symptoms
improve with time and they are able to walk further.
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