Treating Spinal Stenosis

In this month’s first blog, we detailed the spinal nerve compression that is a part of spinal stenosis, whether it happens in the neck (cervical stenosis) or the lower back (lumbar stenosis). Dr. Tinley’s first course of treatment is always conservative. This would involve options such as corticosteroid injections into the area of the compression and inflammation, medications, and physical therapy.

But if the patient has problems such as bone spurs due to degenerative disc disease, the situation often cannot improve without surgical intervention. In this second blog of November, let’s get into the surgical options Dr. Tinley uses to help patients overcome their pain from stenosis.

Cervical laminectomy

In this procedure, Dr. Tinley removes both the spinous process and lamina where the compression is occurring. This helps decrease pressure on the spinal cord. Rods may be used to ensure future stability. This is because without the lamina, the vertebra loses some stability on the back side.

Lumbar decompression

In these lower spine procedures. Dr. Tinley removes all or part of the lamina, removing bone spurs and/or enlarging the foramen to relieve pressure or compression on the nerve roots or spinal cord.

Decompression and posterolateral fusion

In many cases, decompression isn’t enough on its own. Fusion is necessary to keep the area of the spine stable, or to keep it from further degrading and again creating compression. Also, as mentioned above, removing the lamina decreases stability in that section of the spine.

In fusion procedures, Dr. Tinley removes the damaged spinal disk, replaces it with a spacer/cage and fills and surrounds it with bone graft material. Then he uses rods and screws to stabilize the two vertebrae. The bone graft then grows around the cage and rods and screws, making the two vertebrae into a single piece. This eliminates movement that was causing nerve compression.

Anterior lumbar interbody fusion

This procedure enters from the abdomen. It typically is used to remove herniated disc material causing nerve compression. Then the fusion is performed as detailed above.

Posterior transforaminal interbody fusion

This is the same procedure as above, but the entry is made from the back. The offending disc material is removed, a cage is inserted, and the two vertebrae are connected with rods and screws to fuse them together.

Do you have chronic pain in your arms or legs? You could have spinal stenosis. Call Dr. Tinley at DFW, (817) 916-4685, and schedule an appointment.

Posted in: Degenerative Disc Disease

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