What To Expect

Depending on your health and the extent of the surgery, it may take several months or more before you are able to return to your normal daily activities.

How Well It Works

Surgery for spinal stenosis usually is elective but may be recommended if symptoms cannot be relieved with nonsurgical treatment. In general, experts feel that surgery has good results and relieves pain in the lower extremities for people who have severe symptoms of spinal stenosis and who have few other serious health problems.

Research shows that:

• Surgery may work better than nonsurgical treatments to relieve pain and help you move better. If nonsurgical treatments have not worked well enough, surgery might be able to help you.^{footnote 1}
• By 3 months, people who had surgery notice more improvement in their symptoms and can be more active than people who did not have surgery.^{footnote 1} This difference continues for at least 4 years after surgery.^{footnote 2}
• The benefits of surgery appear to last for many years. After 8 to 10 years:
  • People treated with surgery were as satisfied as those treated without surgery.
  • People who had surgery were generally able to be more active and had less leg pain than those who had nonsurgical treatment.^{footnote 3}
• Surgery appears to be more effective for leg pain than for back pain, but it may help both.^{footnote 4}

But symptoms may return after several years. A second surgery may be needed if:

• Spinal stenosis develops in another area of the spine.
• An earlier surgical procedure was not effective in controlling symptoms.
• Instability develops, or fusion does not occur.
• Regrowth of tissue (lamina) presses on the spinal cord or spinal nerve roots.

Spinal fusion may be done at the same time as decompressive laminectomy. Spinal fusion may help to stabilize sections of the spine that have been treated with decompressive laminectomy. In general, fusion is only done if an area of the spine is unstable, which means the bones of the spine (vertebrae) move too much or do not move in a normal way. This extra movement causes wear and tear on the nerves or other soft tissues, leading to irritation and pain. The goal of fusion is to keep the damaged bones in the spine from moving so that the soft tissues are protected.

What To Think About

Most experts recommend that people with spinal stenosis try nonsurgical treatments before choosing surgery.

Surgery for lumbar spinal stenosis is most likely to relieve pain, numbness, and weakness that are mostly in your legs. Surgery may not work as well for relieving pain that is mostly in your back.

Surgery is usually effective if you have severe leg pain and numbness and you have not been able to move around well for a long time. But in some cases, the symptoms return after surgery. It is also possible that nerve symptoms, including numbness and clumsiness, may not be relieved or may return.

After a laminectomy and fusion, spinal stenosis may develop directly above or below the surgery site. Repeated surgeries for spinal stenosis increase your risk of complications and instability in the spine.

Age should not be a factor in deciding whether to have decompressive laminectomy. But if you have other medical conditions that will make this procedure and follow-up rehabilitation less successful, surgery may not be recommended.