Back pain is as common as it is frustrating. Almost everyone experiences back pain at some point and while most episodes will resolve with self-care within a few weeks, back pain can become chronic and disabling for many. “The back is a complex structure and there are many causes of back pain,” says Dr. Kaixuan Liu, chief surgeon at the Atlantic Spine Center. “Muscles, ligaments, nerves and the bony architecture of the spine can all be the source of pain and the wear and tear of simply using our backs over many years causes troublesome changes in spinal anatomy.” By the age of fifty, almost everyone will have degenerative changes that show up on an MRI. As these changes progress, there is a narrowing of the spinal canal and pressure on the nerves that exit the spine causing the symptoms of spinal stenosis, one of the most common age-related back conditions.
Spinal stenosis develops over years. Most cases occur in the lower (lumbar) spine and affect the nerves that go to the legs. Lumbar stenosis is generally preceded by one or more common degenerative conditions affecting the discs that act as shock-absorbing cushions between the vertebrae in the spine. Each disc has a strong, fibrous outer ring and a soft, gel-like center. With age, the discs weaken and the soft material inside the disc may bulge out of place or rupture. Over time, disc problems and other degenerative conditions like osteoarthritis and bone spurs cause a gradual narrowing of the spinal canals through which the nerves pass, putting pressure on the nerves and causing the characteristic symptoms of stenosis: numbness, tingling, or pain that radiates from the lower back to the buttocks, legs, and feet.
“Initial treatment for stenosis may include rest, ice, physical therapy, non-steroidal anti-inflammatory drugs, and steroidal epidural injections that act as a local anesthetic and may bring fast-acting, temporary relief,” says Dr. Liu. “But if these conservative treatments don't bring lasting relief or if the condition worsens, surgery is an option. For many patients, a minimally invasive endoscopic lumbar laminotomy is the most effective treatment for stenosis.”
Endoscopic lumbar laminotomy is a decompression procedure that relieves pressure on the nerves of the spinal cord. The laminae, which are small bones at the back of each vertebra, come together to form the bony back wall of the spinal canal. Laminotomy removes a small portion of the lamina and ligaments on one or more vertebrae that are pressing on the nerves, making more room for the nerves and allowing for the removal of bone spurs. By relieving pressure on the nerves, laminotomy relieves the symptoms of stenosis.
“Endoscopic lumbar laminotomy is an advanced alternative to traditional or open laminotomy,” says Dr. Liu. “It uses a smaller, less invasive incision and is usually performed with local anesthesia as a same-day outpatient procedure. Spinal mobility is preserved, the patient experiences less blood loss, and recovery time is much shorter. Deciding on a treatment plan for lumbar stenosis should take into account the severity of your symptoms and their effect on your daily activities. If you and your doctor decide that surgery is your best option, endoscopic lumbar laminotomy is a minimally invasive procedure that can help you reclaim your life.”
Learn more about this procedure or watch a video animation on our Laminectomy page: http://www.atlanticspinecenter.com/treatments/endoscopic-lumbar-laminotomy/
Learn more about Spinal Stenosis: http://www.atlanticspinecenter.com/conditions/spinal-stenosis/