Veteran orthopedic surgeon Dr. Richard Obedian knows that no matter the severity, from annoying to debilitating, spinal problems can seriously get in the way of an individual’s daily life. If not treated properly, many of these problems can go on to have even more severe consequences.
One such issue that orthopedic doctors like Obedian deal with fairly regularly is that of lumbar spinal stenosis. Thankfully, this issue can be resolved with a relatively straightforward procedure called a lumbar laminectomy. First, though, it pays to give the problem itself a bit of professional attention.
What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis, also called LSS, is a potentially serious spinal health problem that occurs in the lower area, or lumbar region, of a person’s spine. According to Dr. Richard Obedian, the main issue is that the bones in the spinal canal grow too narrow. This means that the space available for nerves to pass through the spinal canal is significantly reduced, which can lead to the nerves being pinched.
When this happens, a variety of negative symptoms such as the following may occur:
- Constant lower back and leg pain, especially when walking or standing
- Relief from this pain whenever the patient sits down, leans forward, or walks with support from a walker, cane, shopping cart, etc.
- Enhanced difficulty with maintaining proper balance
- A dull and cramping pain, weakness, stiffness, or numbness in the legs and lower back
- A tingling sensation like pins and needles shooting down the back of the legs
- The sudden onset of fatigue or weakness whenever performing activities like exercise
What Causes Lumbar Spinal Stenosis?
As Dr. Richard Obedian explains, lumbar spinal stenosis comes in two main types, either congenital or degenerative
- Congenital LSS is present in an individual at birth.
- Degenerative LSS occurs in individuals due to wear and tear as an individual advances in age.
Of the two, degenerative LSS is the most common, especially in patients age 50 or older. “With degenerative LSS,” says Dr. Obedian, “symptoms generally tend to come on gradually as time progresses, worsening with the years. The longer it is allowed to go untreated, the more severe these symptoms may become. The symptoms that manifest and how badly they do so will depend largely on the individual patient and vary from case to case.”
There are several ways to treat and deal with lumbar spinal stenosis, says Dr. Obedian. For particularly bad cases, a surgical procedure called a lumbar laminectomy, also known as open decompression, presents the best chance of long-term relief from the discomfort and pain caused by lumbar neural impingement.
What Happens During a Lumbar Laminectomy?
The goal of a lumbar laminectomy, says Dr. Richard Obedian, is to provide a more advantageous environment for the lumbar nerve root by giving it more space in the spinal canal. To do so, surgeons remove a small section of disc material around the nerve root with the following procedure:
- Step 1 – An incision of two to five inches long is cut into the patient’s back at the midline.
- Step 2 – The erector spinae, or left and right back muscles, are dissected on multiple levels off of the lamina on either side, granting surgeons better access to the patient’s spine.
- Step 3 – With the spine revealed, the lamina is removed to allow surgeons visualization of the nerve roots.
- Step 4 – Surgeons undercut or trim the facet joints that are positioned directly above the nerve roots. This is how the nerves are given more room in the canal, thus alleviating the pain of nerve pinching.
- Step 5 – With the nerve roots freed, the patient is closed back up and the surgery is complete.
What Can Patients Expect After a Lumbar Laminectomy?
“Patients typically have to stay in the hospital for the next few days once a lumbar laminectomy surgery is finished,” says Dr. Richard Obedian. “Afterward, the patient can return to his or her normal activities with increased mobility and reduced pain. The extent to which this recovery takes place, and the speed at which it happens, depends largely on the physical condition and age of the individual before the procedure.”
After the procedure, doctors typically encourage most patients to walk around. This helps with the process of physical therapy by utilizing and strengthening the muscles in the lumbar back. “For the next six weeks, though, don’t bent, lift, or twist excessively,” Dr. Obedian advises. “Doing so might cause you to accidentally pull on the suture line before it has healed fully. Readjust to your daily routine slowly, but don’t be afraid to put your back to moderate use.”
Once the period of convalescence is over, says Dr. Richard Obedian, then patients should find that the pain and discomfort of their lumbar spinal stenosis have been fully alleviated.