Narrowing of the spinal canal can exert pressure on the nerves and spinal cord. Symptoms develop gradually — early recognition allows timely treatment.
Disc degeneration and the resulting abnormal motion (instability) can lead to overgrowth and hypertrophy of the tissues connecting the vertebrae — discs, ligaments, bone — thereby narrowing the spinal canal. Stenosis can develop in both the cervical and lumbar spine, with different symptoms.
Lumbar stenosis typically presents with leg pain during walking (neurogenic claudication) and difficulty walking. The process develops slowly, so emergency surgery is rarely needed.
A 3–4 cm midline skin incision is made over the posterior lumbar spine. With muscle retraction, the spine is exposed. A bony window is created in the posterior elements (laminotomy), decompressing the nerve roots and the dural sac.
Cervical stenosis can have more serious consequences, as spinal cord compression may cause gait disturbance, loss of manual dexterity, and other neurological symptoms (myelopathy).
The spine is accessed through a 3–4 cm incision on the anterior neck. The disc is removed and the neural elements are decompressed. Stability is ensured with a spacer and bone graft. The procedure can be performed at up to four segments.
The spine is accessed through a 5–10 cm midline incision on the posterior neck. Central laminectomy decompresses the nerve roots and spinal cord. If needed, titanium screws and rods stabilise the segments, with bone graft ensuring fusion.
An accurate diagnosis and personalised treatment plan is the first step towards recovery.
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