Back Pain Home > Back Surgery
Spinal stenosis is the narrowing of the spinal canal, through which the spinal cord and spinal nerves run. This condition is often caused by the overgrowth of bone resulting from osteoarthritis of the spine. Compression of the nerves caused by spinal stenosis can lead to:
- Numbness in the legs
- Loss of bladder and/or bowel control.
People may have difficulty walking any distances and may also have severe pain in their legs, as well as numbness and tingling.
The only back surgery option for spinal stenosis is a laminectomy. In this procedure, the doctor will make a large incision down the affected area of the spine and remove the lamina and any bone spurs (overgrowths of bone) that may have formed in the spinal canal as the result of osteoarthritis. A laminectomy is a major back surgery that requires a short hospital stay and physical therapy afterwards to help regain strength and mobility.
(Click Spinal Stenosis Surgery for more information.)
Spondylolisthesis is a condition in which a vertebra of the lumbar spine slips out of place. As the spine tries to stabilize itself, the joints between the slipped vertebra and adjacent vertebrae can become enlarged, pinching nerves as they exit the spinal column. Spondylolisthesis may cause low back pain and severe sciatica leg pain.
The back surgery option for spondylolisthesis is spinal fusion. When a slipped vertebra leads to the enlargement of adjacent facet joints, surgical treatment generally involves both laminectomy and spinal fusion. In spinal fusion, two or more vertebrae are joined together using bone grafts, screws, and rods to stop slippage of the affected vertebrae. Bone that is used for grafting comes from another area of the body, usually the hip or pelvis. In some cases, donor bone is used.
Although the back surgery is generally successful, either type of graft has its drawbacks. Using your own bone means surgery at a second site on your body, and with donor bone, there is a slight risk of disease transmission or rejection. In recent years, a new development -- bone morphogenic proteins -- has eliminated these risks for some people undergoing spinal fusion. Bone morphogenic proteins are used to stimulate bone generation, thereby eliminating the need for grafts. The proteins are placed in the affected area of the spine, often in collagen putty or sponges. Regardless of how spinal fusion is performed, the fused area of the spine becomes immobilized.