For those diagnosed with spinal stenosis, the spinal canal space is smaller, making it crowded and difficult for nerve roots to exit freely through the foramen. As we age, the tissue in our spine that connects bones together (ligaments) may start to thicken and harden from arthritis, discs may start to collapse and bulge (or herniate), and bone spurs, known as osteophytes, may grow on bone in the spine. All of these things narrow the amount of space in the spinal canal, reducing the nerve’s ability to exit and extend to your lower extremities. Therefore, the nerves in the lumbar spine become compressed, causing pain in the lower back, buttocks and legs.
Healthy Spinal Canal
Narrowed Spinal Canal
In more severe cases, your doctor may recommend surgery to relieve your leg pain and back pain. The typical spinal stenosis surgery begins with a procedure called “decompression.” This is where the doctor surgically relieves the SOURCE of the pain – anything that may be impinging on those nerves that are trying to exit the spinal canal – which could be related to the disc, the ligaments or the bones in the lower spine.
Depending on the type and degree of decompression, the spine may become unstable afterward and need support. And for many years, the only way to achieve that support was through a spinal fusion. This is where the surgeon “fuses” two of your vertebrae together to ensure stability and limit any other movement that might cause more pain.
But before you consider fusion, you should know what that means. A typical spinal fusion surgery will relieve the pain caused by spinal stenosis, but it may also leave you with significantly less flexibility and less mobility than you had before. That’s because spinal fusion surgery affixes two of your vertebrae together – so neither of them move freely anymore – with a lot of hardware, like pedicle screws, metal rods and other fasteners to lock it into place.
As a result, the recovery from fusion surgery can be long and difficult. Some patients may wear a body brace for up to six weeks before starting physical therapy. And even when recovery is “complete,” patients will typically have less flexibility and mobility than they did before the surgery.