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Conditions

Lumbar Stenosis Treatment Options

Non-surgical management of lumbar stenosis

Non-surgical conservative management of lumbar stenosis is often effective at improving symptoms, though it will not address the underlying anatomic structures pressing on the nerve roots. Conservative management is aimed at decreasing pain and inflammation around the spinal cord and nerve roots, improving physical functioning, and preventing further injury. Conservative management includes:

  • A structured and supervised exercise program including stretching and strengthening to improve flexibility and stabilize the spine
  • Heat and cold therapy, ultrasound and electrical stimulation
  • Activity modification
  • NSAID anti-inflammatory medications
  • Steroid injections to reduce inflammation and pain
  • Physical therapy to improve flexibility

Surgical treatment of lumbar stenosis

Surgical management is aimed at decompressing the space around the spinal cord or nerves to decrease the underlying cause of symptoms. Surgical management is considered when conservative measures have not improved symptoms, and when the patient has red flag symptoms (loss of bowel or bladder function, sudden weakness in both legs, numbness in groin/genital area).

There are two primary kinds of minimally invasive spinal stenosis decompressive surgeries that Dr. Singh offers his patients:

A minimally invasive lumbar laminectomy, also known as a minimally invasive decompression, is a surgical procedure performed to relieve pressure on the spinal nerves in the lower back.

In this procedure, Dr. Singh will make a small incision, the size of a nickel, in the back at the level of nerve compression and insert a device called a tubular retractor. This thin tube-shaped tool allows for the creation of a tunnel, gently moving aside muscle and soft tissue, in the affected area of the spine to provide access to the compressed nerves. Dr. Singh then uses microscopy to insert small tools through the tunnel to decompress the affected nerves.

An endoscopic laminectomy is an ultra-minimally invasive surgery that uses a 10 millimeter or smaller skin incision (pen tip sized incision) and a camera to perform the procedure much like a knee arthroscopy.

During the procedure, the patient is typically placed under general anesthesia or local anesthesia with sedation. Through this incision, specialized surgical instruments and an endoscope (a thin, flexible tube with a camera) are inserted. Throughout the procedure, Dr. Singh uses the camera to capture and project real-time images of the operative site onto a monitor. The endoscopic camera also assists Dr. Singh and guides him during the surgical procedure. This endoscopic procedure is the least invasive of all surgeries and involves no muscle damage and no scar tissue formation.

Schedule a consultation

If you or a loved has low back and/or leg pain, contact Chicago spine surgeon Dr. Kern Singh who can assess your situation, provide an accurate diagnosis and guide you on the most suitable treatment options.

Dr. Kern Singh, MD is an internationally renowned spine surgeon specializing in outpatient minimally invasive and motion-preserving techniques and endoscopic spine surgery at Midwest Orthopaedics at RUSH and Professor in the Department of Orthopaedic Surgery at RUSH University Medical Center in Chicago, Illinois. Dr. Kern is one of the nation’s Top 100 spine surgeons and beloved by his patients for his compassionate care and excellent outcomes. He welcomes nationally and internationally-based patients.

References

  • Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022;327(17):1688–1699. doi:10.1001/jama.2022.5921
  • https://orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/
  • Inose H, Kato T, Sasaki M, Matsukura Y, Hirai T, Yoshii T, Kawabata S, Hirakawa A, Okawa A. Comparison of decompression, decompression plus fusion, and decompression plus stabilization: a long-term follow-up of a prospective, randomized study. Spine J. 2022 May;22(5):747-755. doi: 10.1016/j.spinee.2021.12.014. Epub 2021 Dec 25. PMID: 34963630.
At A Glance

Dr. Kern Singh

  • Minimally invasive and endoscopic spine surgeon
  • Inventor and surgeon innovator with multiple patents in spinal surgery and instrumentation
  • Author of more than 10 textbooks in minimally invasive spinal surgery
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