Lumbar Stenosis Treatment Options

Lumbar stenosis is a condition characterized by the narrowing of the spinal canal, which can compress nerves and lead to symptoms such as back pain, leg pain, numbness, and weakness. This condition is often caused by age-related degenerative changes, including thickening of ligaments, bone spurs, and disc degeneration.

Conservative/Nonsurgical Treatment

For many patients, nonsurgical management is the first line of treatment. This may include physical therapy to strengthen the muscles that support the spine, improve flexibility, and enhance overall mobility. Anti-inflammatory medications, such as NSAIDs, can help reduce swelling and alleviate pain. Epidural steroid injections may also be used to target inflammation directly at the source of nerve compression, providing temporary relief for patients experiencing severe symptoms.

Surgical Treatment

When conservative measures fail to provide adequate relief, Dr. Boden may recommend surgical intervention. One of the most common procedures for lumbar stenosis is a laminectomy, a decompression surgery in which the lamina, or the back part of the vertebra covering the spinal canal, is removed. This creates more space for the spinal nerves, alleviating pressure.

Dr. Boden’s expertise in minimally invasive techniques allows her to perform laminectomy with smaller incisions, reducing muscle disruption and promoting faster recovery. In cases where instability is present, a spinal fusion may be performed to stabilize the affected segments.

A lumbar herniated disc occurs when the soft, gel-like center of a spinal disc pushes through its tougher outer layer. This can press on nearby nerves, causing lower back pain, sciatica, and even muscle weakness. Herniated discs often result from wear and tear or sudden trauma.

Conservative/Nonsurgical Treatment

Most patients with lumbar herniated discs begin with nonoperative treatments. Rest, activity modification, and physical therapy are essential components of care. Physical therapy focuses on core strengthening, posture correction, and exercises to relieve pressure on the affected nerve. Oral medications, such as NSAIDs or muscle relaxants, can alleviate inflammation and discomfort.

For more severe cases, epidural steroid injections may help reduce nerve irritation and provide symptom relief, allowing patients to participate more actively in physical therapy.

Surgical Treatment

If symptoms persist despite conservative therapy or if nerve problems develop, surgical options may be considered. A microdiscectomy is the most common surgical procedure for a herniated lumbar disc. During this minimally invasive procedure, Dr. Boden removes the portion of the disc that is compressing the nerve.

Dr. Boden’s minimally invasive approach minimizes damage to surrounding tissues, resulting in reduced pain, shorter hospital stays, and quicker recovery times. For large or recurrent herniations, additional procedures such as a disc replacement or a spinal fusion may be necessary to restore stability and maintain spinal alignment.

Lumbar spondylolisthesis occurs when one vertebra slips forward over the one below it, often due to degenerative changes or a stress fracture in a part of the vertebra. This condition can cause back pain, nerve compression, and, in severe cases, spinal instability.

Conservative/Nonsurgical Treatment

Dr. Lauren Boden always starts with nonsurgical treatments to help patients manage lumbar spondylolisthesis. These may include physical therapy to strengthen the muscles around the spine and provide extra support. Sometimes, wearing a back brace can help by reducing movement in the problem area, which can ease pain and allow healing. Medications to reduce inflammation and steroid injections near the spine can also help relieve pain caused by irritated nerves.

Surgical Treatment

If nonsurgical treatments don’t provide enough relief, or if the condition causes severe pain, nerve problems, or instability in the spine, surgery may be necessary. Dr. Boden may recommend spinal fusion surgery, a procedure that connects the affected bones using bone grafts and small devices like screws and rods to stabilize the spine.

Whenever possible, Dr. Boden uses minimally invasive techniques for surgery. This means she makes smaller incisions, which can lead to less pain after surgery and a quicker recovery. In some cases, she may also perform procedures to relieve nerve pressure, like removing part of the bone or widening nerve pathways, along with spinal fusion.

In minimally invasive procedures, Dr. Boden can achieve the same stabilization goals through smaller incisions, which leads to less postoperative pain and faster recovery. In select cases, decompression surgery, such as a laminectomy or foraminotomy, may be performed in conjunction with fusion to relieve nerve compression.