How can you decide about surgery for lumbar spinal stenosis?

What is lumbar spinal stenosis?

Lumbar spinal stenosis is the narrowing of the spinal canal in the lower back. This occurs when bone and other tissues grow inside the openings in the spinal bones. This can squeeze the nerves that branch out from the spinal cord. The squeezing can cause pain, numbness, or weakness. It happens most often in the legs, feet, or buttocks.

You may choose to have surgery to ease your symptoms. Or you may try other treatments instead. These include medicines, exercise, and physiotherapy.

What are key points about this decision?

• If your symptoms are mild to moderate, then medicine, physiotherapy, and exercise may be all you need.
• You may want surgery if you have tried other treatment for a while and your symptoms are still so bad that you can't do your normal activities.
• Your symptoms may come back after a few years. You may need surgery again.
• Surgery will most likely help leg pain. But it may not help back pain as much.

Why might you choose to have surgery?

• Surgery can relieve pain. It can also improve how well you can walk.
• You have tried other treatment for a while and your symptoms are still so bad that you can't do your normal activities.
• Without surgery, your symptoms may still bother you. If symptoms are very painful, they most often will not improve on their own.
• Your doctor may advise surgery if you can't control your bladder or bowels as well as you used to. Surgery is also an option if you notice sudden changes in how well you can walk or you are more clumsy than before.

Why might you choose not to have surgery?

• You may try other treatments to help your symptoms. These include medicine, exercise, and physiotherapy. These other treatments work best for people with mild to moderate symptoms.
• Risks from surgery include nerve injury and tissue tears. And you could have chronic pain, trouble passing urine, and a spine that is not stable.
• All surgery has some risks. These include bleeding, infection, and risks from anesthesia.
• You may not be able to return to all of your normal activities for many months.
• Your symptoms may come back in a few years. You may need surgery again.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.