Spinal Stenosis Surgery

Although non surgical care may help you relieve pain related to spinal stenosis, it likely will not alter the underlying cause of it, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, acronym: NIAMSD. (The underlying cause of stenosis pain is is a lack of space in holes - specifically, the intervertebral foramen and spinal canal, depending on which type you have - through which nerves need to pass unimpeded.)

Even when your symptom management is going well, and/or you are on a medication that is helpful in controlling pain, should a nerve and/or the spinal cord contact nearby bone, they may become irritated, which can cause spinal stenosis symptoms.

Related: Central Canal Stenosis

Related: Neuroforaminal Stenosis

This means that while non-surgical medical care for spinal stenosis may help you feel better and do more, the effects could be short-lived. What do you do then?

Determining the Need for Surgery

While it's true that to better manage your spinal stenosis pain/symptoms, your doctor may prescribe medication, physical therapy, injections or in some cases, alternative therapies, she may have a surgery related reason for this course of action as well.

Giving some or all of these conservative approaches a try for 6 weeks to 6 months may provide her with information about the potential effectiveness of surgery relative to your specific case.

The degree to which conservative treatments help relieve symptoms, along with how much pain you have, and your comfort level/preferences around having an invasive procedure will likely factor into your decision regarding surgery for spinal stenosis.

When lumbar stenosis causes significant weakness, numbness or problems with bowel or bladder function, surgery is generally recommended, often emergently.

A review of studies done in 2011 by Kovacs, et. al., and published in the journal Spine compared the effectiveness of surgery with the effectiveness conservative treatment. The researchers evaluated outcomes of each approach in terms of pain, disability, and quality of life loss caused by lumbar spinal stenosis symptoms. They found that when conservative treatment underwent for 3 to 6 months failed to control symptoms, decompressive surgery (for example, laminectomy) with or without spinal fusion - or the implantation of a device (for example the X-Stop) were each more effective than the continuance of the conservative care.

Related: What is a Laminectomy?

The most common type of surgery performed for spinal stenosis is a decompressive laminectomy. In this surgery, a portion of the ring of bone in the back part of the vertebra is removed in order to make room for the nerve as it passes through the area. Sometimes, spinal fusions are given while the laminectomy is done. This is called a complex fusion.

A 2010 review by Deyo, et. al, published in JAMA looked at the records of Medicare patients who had spinal fusions for lumbar stenosis between the years of 2002 and 2007.  The researchers found while the number of complex fusions increased in during this time frame, the number of simple decompressions and simple fusions decreased.

Further, the study found that in 2007, both simple and complex fusions carried an increased risk for major complications, 30 day mortality and resource use, when compared to simple decompression surgeries.

Potential complications of spinal stenosis surgery include dural tears, infections, and blood clots. There may be other risks, as well; if you are considering this surgery and you also have other health issues to consider, the possibility of complications may be even higher. Be sure to talk to your doctor about your risks.

Related: Dural Tears during Back Surgery


Deyo, R., MD., et. al. Trends, Major Medical Complications, and Charges Associated with Surgery for Lumbar Spinal Stenosis in Older Adults. JAMA April 2010. Accessed May 13 2015.

Francisco M. Kovacs, MD, PhD, Gerard Urrútia, MD, José Domingo Alarcón, MDDisclosures. Surgery Versus Conservative Treatment for Symptomatic Lumbar Spinal Stenosis. A Systematic Review of Randomized Controlled Trials Spine. 2011;36(20):E1335-E1351.

Marcia Vital O of C and PL. Questions and Answers about Spinal Stenosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Accessed May 13 2015 http://www.niams.nih.gov/health_info/spinal_stenosis/#spine_j

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