Column I never want to go through this ordeal again… Points to keep in mind before spinal stenosis re-operative surgery
March 22, 2024
Spinal stenosis is a condition due to the narrowing of the spinal canal, through which the spinal cord passes, causing compression of its nerves.
It often occurs in middle-aged and older patients, and is diagnosed in around 10% of the population. *1
In addition to lower back pain, spinal stenosis can also cause pain and numbness in the lower limbs, and intermittent claudication (where pain occurs in the buttocks and legs when walking, but eases after a short rest, only to return shortly after walking is resumed), which can interfere with daily life.
＊1: Hiroshi Hashizume, Noriko Yoshimura, Hiroshi Yamada, Muneto Yoshida, “Epidemiological Indicators of Age-Related Degenerative Diseases of the Spine and Their Relationship to Motor Function: The Wakayama Spine Study,” Journal of Physical Fitness and Sports Medicine, Vol. 65, No. 1, 2016
Surgical Treatment for Spinal Stenosis
While lumbar spinal stenosis may be treated with a block injection in some cases, in many cases a surgical treatment has to be performed.
The most common surgical treatments for spinal stenosis are lumbar laminectomy and spinal fusion.
In a lumbar laminectomy, the patient is put under general anesthesia and an incision in the skin on the back is made under fluoroscopy, part of the lamina and the thickened ligamentum flavum are removed, decompression is performed on the nerves and the spinal canal is widened.
In spinal fusion surgery, an incision is made in the skin of the back under general anesthesia, the degenerated intervertebral disc is removed, and a cage filled with bone fragments taken from the hipbone is inserted, before the vertebrae are firmly secured with screws and rods. This may also be performed consecutively to a lumbar laminectomy.
Reoperation for spinal canal stenosis and points to keep in mind
Potential risk of reoperation
Once surgery has been performed for spinal stenosis, it is not uncommon for the narrowing of the spinal canal to develop again and for symptoms to recur. In such cases, a high percentage (10% to 23%) of patients will require re-operation. *2
If you make any sudden movements immediately after the initial operation, the risk of needing to have re-operation will also increase.
＊2：Atlas SJ, et al. Long-term outcomes of surgical and nonsurgical management of lumbar spine stenosis: 8 to 10 year results from the maine lumbar spine study. Spine, 2005, 30(8). Kim CH, et al. Reoperation rate after surgery for lumbar spinal stenosis without spondylolisthesis: a nationwide cohort study. Spine Journal, 2013, vol.13-10.
Reoperation usually means fusion surgery
Once surgical treatment has been performed for spinal stenosis, instability often tends to occur again at a later stage after the operation. In addition, the facet joints may degenerate after the initial surgery, and spondylolisthesis may occur. In such cases, reoperation will usually involve fusion surgery.
Duration of the reoperation
If you need a second operation to treat spinal stenosis, it will take longer than the first operation (about 1-2 hours). This is because of the scar tissue that has formed around the nerves.
Increased risk of complications
Just like the first operation, the second operation will also be carried out under general anesthesia. As mentioned above, because the second operation takes longer than the first, the strain on the body and the risk of complications will be even higher.
If you have a history of respiratory or cardiac problems, peripheral vascular disease due to arteriosclerosis, diabetes, or other conditions, the risk of complications from re-surgery will also increase, and in some cases re-surgery may not even be possible.
Our clinic’s treatment
The Florence method is a low-risk, minimally invasive treatment for spinal canal stenosis.
A spacer is inserted percutaneously under partial anesthesia and sedation to widen the narrowed spinal canal. It remains possible to remove the spacer if complications should arise after the treatment has been performed.
The Lobster spacer is inserted inside the vertebral body to stabilize it while preserving spinal rotation and flexion, widening the spinal canal, reducing disc protrusion, and reducing the thickening of the ligamentum flavum. Thus, the narrowed spinal canal is widened, and the pain is relieved.
It is recommended for patients whose condition has failed to improve with conservative treatment and who wish to avoid surgical procedures performed under general anesthesia, such as spinal fusion.
Spinal canal stenosis occurs when a disc cracks, causing the central component to protrude and the protruding portion to cause the spinal canal to narrow. If the disc crack is not repaired, herniation can recur, and the spinal canal can become narrowed again.
The Cellgel method used at our clinics provides a fundamental treatment by injecting a drug that fills the cracks in the disc, which then forms a gel that replaces the cracks. It is characterized by the fact that the volume of the disc is not reduced, and the drug remains in the disc as a gel-like implant after treatment, thus preserving the disc.
In addition, our clinic also offers “specialized back pain rehabilitation”, designed to address a wide range of lower back pain conditions and to cater to patients of all ages.
ILC’s Specialized Back Pain Rehabilitation
If you have been diagnosed with spinal stenosis now or in the past, please consider booking a consultation at our clinic.
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Is it already too late! ? What should I do about spinal canal stenosis that has been left untreated?
What are the recommended rehabilitation methods for spinal stenosis that you can do yourself?
