While usually a last resort, surgical treatment for spinal stenosis produces consistently positive results and can be noninvasive as well.

Spinal stenosis is a painful condition that happens when the space inside your backbone is too small for your nerves to pass through. Some people who have spinal stenosis have no symptoms at all, but many people experience pain, weakness, and numbness.

Severe spinal stenosis can lead to disability without treatment. In most cases, spinal stenosis can be treated with methods such as medication, physical therapy, and steroid shots. However, surgery is sometimes needed to correct severe spinal stenosis.

Surgery can help stabilize your spine and create more space for the nerves. Let’s look at the different options available to you, as well as the pros and cons.

There are several surgical options for spinal stenosis. Depending on the primary issue affecting your spine, you might have stabilization surgery, decompression surgery, or both.

Stabilization is a surgical process that creates space between the vertebrae, while decompression is a surgical procedure that removes tissue pressing against nerves to make more space in the spinal canal. Surgeons perform decompression in a number of different ways.

Types of decompression surgery for spinal stenosis include:

  • Laminoplasty: A laminoplasty is a surgery done on the spinal bones of your neck. This procedure uses metal pieces to create space in the upper spinal column.
  • Laminectomy: A laminectomy is a surgery that removes the back part of your affected spinal bone. This part of the bone is called the lamina. By removing the lamina, pressure on your nerves is lessened.
  • Laminotomy: A laminotomy is a surgical procedure that removes only part of the lamina. During the procedure, the surgeon creates a hole relieving pressure on the nerve.
  • Foraminotomy: A foraminotomy is a surgical procedure done if a bulging disc or bone spur is causing your spinal stenosis. During a foraminotomy, the surgeon will remove the part of the spur or disc that is pressing on the nerve.
  • Indirect decompression: An indirect decompression spreads the spinal bones apart. It’s commonly done by inserting artificial discs between your vertebrae to restore height.

Is surgical treatment for spinal stenosis “minimally invasive”?

Spinal surgery can be minimally invasive and done through several small incisions. This type of spinal surgery is generally done with a small camera and tool called an endoscope that allows a surgeon to see inside your body without large incisions. However, minimally invasive surgery isn’t always an option.

It depends on your specific vertebrae, the number of vertebrae, and the type of spinal stenosis surgery.

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Spinal stenosis surgery can lessen the symptoms of spinal stenosis. It can relieve pain when other options haven’t helped and can restore the quality of life for people with severe spinal stenosis.

It can also help to prevent complications of spinal stenosis, such as severe pain, permanent disability, and paralysis.

The success rate for spinal stenosis surgeries

Spinal stenosis surgery is often very successful. In studies, various spinal stenosis surgical methods generally have between 80% and 90% success rates. Overall, most people who have spinal stenosis surgery experience pain relief after surgery and recovery.

All surgery has some risks. Spinal stenosis surgery has risks that other treatments for spinal stenosis don’t. A doctor will discuss risks specific to you and your health during planning and consultation.

General risks of spinal stenosis surgery include:

Surgery for spinal stenosis vs. physical therapy

Spinal stenosis surgery is always the last option.

Less invasive methods, such as physical therapy, are always tried earlier in spinal stenosis treatment plans. For many people, physical therapy can be just as effective as surgery without any of the risks. This means that surgery isn’t always necessary.

It’s generally best to try several months of physical therapy before looking into surgery. You and your doctor can discuss your symptoms, pain level, and any treatments you’ve already tried. These factors, along with your overall health, will determine whether physical therapy or surgery is recommended first.

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Back surgery can take 4 to 6 weeks of recovery time. During this time, you’ll be advised not to lift, bend, or take on other tasks that could interrupt your healing. It’s a good idea to prepare your home before your surgery. That way, you can come back without stress and recover successfully.

Some helpful tips include:

  • Set up a room on your first floor that can be your primary location for a couple of weeks.
  • Move blankets, pillows, and other comfortable objects to this room.
  • Move your laptop, books, and other activities to this room.
  • Prepare or purchase meals that will be easy to prepare.
  • If you live alone, arrange for someone to stay with you or check in frequently.
  • Pick up pain medications from the pharmacy ahead of time and place them in your first-floor room.

Your exact recovery timeline from spinal stenosis surgery will depend on the exact procedure you had and on the number of vertebrae that were operated on. However, there are some general things you can expect.

  1. After most procedures, you’ll be up and moving after about 24 hours.
  2. You’ll likely have physical therapy scheduled on this first day and throughout your first few weeks.
  3. You’ll be ordered pain medication to help you manage your pain during your first 2 to 4 weeks.
  4. Most people are able to return to work or school after 4 to 6 weeks.

If you live alone, it can help to have someone stay with you, or check in on your regularity, for the first few weeks after your spinal stenosis surgery.

Your doctor and physical therapist will let you know when it’s safe to resume activities. It will be important to follow instructions carefully and not rush your healing and your body. Even activities like sitting, standing, and walking will need to be done carefully and slowly. Your team will show you the best way to handle this and all other activities.

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Medicare and other insurance companies will normally cover spinal stenosis surgery if all other spinal stenosis treatments have failed to relieve pain and if you’re at risk of disability. Not all companies cover all spinal stenosis procedures. Your exact coverage and cost will depend on your insurance, location, and diagnosis.

As an example of possible costs, Medicare has information about the average costs for laminotomy in 2022. According to Medicare, the average cost for a laminotomy without insurance is $4,001 at a surgical center or $7,400 at a hospital. If you have Medicare, your cost would be $799 at the surgical center or $1,479 at the hospital.

Need more details? You can learn more about spinal stenosis by checking out the answers to some common questions below.

How long does a spinal stenosis surgery take?

Spinal stenosis surgery takes an average of between 2 and 4 hours. However, it can take longer if the procedure is complex or needs to be done on multiple vertebrae.

How long is the hospital stay for a spinal stenosis surgery?

The length of your hospital stay will depend on the exact procedure you have. You can often go home the next day or same day if you have a minimally invasive procedure. A more traditional open surgical procedure will require a hospital stay of 3 to 4 days.

How long does it take to fully recover from spinal stenosis surgery?

Most people recover from spinal stenosis surgery in about 4 to 6 weeks. Your individual recovery will depend on the extent of your surgery and your progress in physical therapy.

Is there an age limit for spinal stenosis surgical treatment?

Your overall health is more important than your age when it comes to spinal stenosis surgery. In fact, people in their 70s and 80s who are in good health can see benefits from spinal stenosis surgery.

What happens if you don’t fix spinal stenosis?

Spinal stenosis can lead to disability if it’s left untreated. This can be due to severe pain, paralysis, limited mobility, or weakness. However, it’s important to note that surgery isn’t the only treatment option. Even severe spinal stenosis can often be treated without surgery.

Living with spinal stenosis

Spinal stenosis can be painful and isolating. However, you don’t have to manage it alone. There are great support resources you connect with, including:

  • Chronic pain management support group: You can connect online with others who are managing spinal stenosis and other painful conditions with the Chronic Pain Management Support Group.
  • United Spinal Association peer support groups: The United Spinal Association allows you to search for peer support groups in your local area on their website.
  • Spinal stenosis Facebook support group: This Facebook support group is a great place to build community and connect with resources.
  • Mental health and chronic pain: If your spinal stenosis takes a toll on your mental health, this online forum hosted by SpineNation can help you connect with people in similar circumstances.
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Surgery is an option for severe spinal stenosis. There are a few different types of surgery that can relieve the pain of spinal stenosis. The right type for you depends on the part of your spine affected and on the exact cause of your pain.

Recovery from spinal stenosis surgery takes about 4 to 6 weeks and requires physical therapy. Most people who have spinal stenosis surgery see significant pain relief after surgery and recovery.