Lumbar stenosis is one of the most common problems that neurosurgeons see in the office. Patients usually have back pain that travels down their legs, which can get worse with walking. Many patients are surprised at the number of ways there are to treat this common problem. Options include: physical therapy, injections, minimally invasive surgery, microscopic hemi-laminectomy, open laminectomy, and laminectomy with instrumentation and fusion.
In my practice, I find that all these approaches can be best depending on the individual patient’s situation. We make decisions based on a patient’s symptoms and exam findings and careful review of imaging studies.
The patient in the images had mostly back pain that was worse with standing for 5 minutes associated with her L4-5 instability. Therefore, she was best served with a laminectomy and fusion surgery. Don’t settle for a one-size-fits-all approach to surgery. Talk to your surgeon about all the options, and if you don’t understand completely, seek out a second opinion.
