Column What Is the right timing to have spinal stenosis surgery? The Guidelines as Recommended by Doctors.

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07.11.2025

What is spinal canal stenosis?

Spinal canal stenosis is a condition in which the spinal canal, which acts as the pathway for the nerves, becomes stenosed (i.e., narrowed), causing compression on the nerves. When it is caused by instability of the lumbar spine, physical movement is often painful.

When suffering from lumbar spinal stenosis, numbness and pain from the waist down is bound to appear. This is characterized by intermittent claudication, a condition in which walking causes pain and numbness in the buttocks and legs, but usually disappears after a short rest, only for the pain to return when the patient resumes walking.

Key points to determine if you need conservative therapy or surgery

Treatment of spinal canal stenosis includes conservative therapy (medication and physical therapy) and surgical intervention (one-day minimally invasive procedures, or surgical intervention).

In most cases, treatment begins with conservative therapy, but surgery may also be directly suggested depending on the degree and advancement of the symptoms.

The following is a set of recommendations regarding when to undergo surgery.

When conservative therapy is ineffective

If symptoms do not improve after several months of conservative therapy, surgery is then recommended.

When symptoms are so severe that they affect daily life

When persistent pain or numbness is present and significantly interferes with daily life, or when intermittent claudication (a condition in which the patient cannot walk because of pain or numbness in the legs when walking, only to recover after a short rest) is quite severe, and the fact that the spinal stenosis is progressing is taken into consideration , then surgery is usually recommended.

In the presence of urinary or stool issues

Any difficulty in urinating or passing stool means that the spinal stenosis has progressed. In this case, surgery may be deemed necessary to improve the symptoms.

In the presence of muscle weakness

If there is significant muscle weakness, the patient may not be able to walk anymore and may become bedridden. In this case too, surgery at an early stage will be considered.

Early diagnosis of spinal canal stenosis is essential

Lumbar spinal canal stenosis is a common condition among the elderly.

Symptoms such as intermittent claudication can make walking difficult and interfere with daily life. Some patients choose to stay inside their house and end up becoming bedridden, and many become depressed as a result.

In addition, the more advanced the symptoms become, the more likely it is that only a surgical operation performed under general anesthesia, in which the spine is shaved off and secured with metal plates become the only option left, and even during the post-operative stage, the patient may fail to witness the desired improvement.

Therefore, it is of the utmost importance to receive a proper diagnosis and appropriate treatment as early as possible before the symptoms become too severe.

Our clinics’ treatments: the Florence and Q-Florence Method

Our clinics perform the Florence Method and the Q-Florence Method as treatments for spinal canal stenosis.

The Florence and Q-Florence procedures are minimally invasive, low-risk treatments for spinal canal stenosis.

Under partial anesthesia and sedation, a device is percutaneously inserted to widen the narrowed spinal canal.

The device is inserted to stabilize the vertebral body while maintaining spinal rotation and flexion, widening the spinal canal and reducing disc protrusion and the thickening of ligamentum flavum. Pain is eliminated by widening the narrowed spinal canal.

The Florence and Q-Florence methods are minimally invasive and low-risk procedures, and there have been no reports of post-treatment complications or recurrence of symptoms.