Stenosis in the lumbar spine sometimes requires surgery. The experts at Instituto Clavel explain the what recovery is like after this surgery.
This spinal pathology involves the narrowing of the lumbar spinal canal, which causes compression of the nerve roots that transmit feeling to the legs. This is why one of the main symptoms is pain in both legs, which can be accompanied by a tingling sensation and weakness or loss of strength. It can affect one or more vertebral levels, although it happens most often in L4-L5.
Lumbar spinal stenosis can be congenital or acquired. In the first case, it is due to a shortening of the pedicles in the area, which narrows the diameter of the lumbar canal. In the second case, the main causes are usually lumbar disc degeneration or facet degeneration. This explains why acquired stenosis is more common in elderly people.
There are various conservative treatment options, including pain relieving medication, changing life habits (weight loss, postural hygiene, physical activity), and specialized physiotherapy, which includes both manual and active therapies (exercises specifically adapted to this pathology).
However, these treatments are not always effective, and when dealing with a more advanced case, surgery may be necessary to end the pain.
What type of surgery is most often recommended for lumbar stenosis?
At Instituto Clavel, we generally recommend a lumbar laminectomy. This is a decompression procedure in which the posterior part of the vertebra, called the lamina, the hypertrophic yellow ligament and the osteophytic areas of the facets, are extracted to free the spinal canal and nerve roots.
If the compression caused by the narrowing is very localized, microsurgery will be performed, using state-of-the-art microscopes so that it is as minimally invasive as possible. There are also other techniques such as hemilaminectomy, indicated for unilateral stenosis, or expansive laminoplasty, which consists of widening the lumbar canal by raising the laminae and placing a bone graft.
If, in addition to the stenosis, the patient also has some other problem in the lumbar spine, such as lumbar instability associated with degeneration of the spine, or a herniated disc, it may be necessary to combine decompression surgery or laminectomy with other techniques such as lumbar fusion or artificial disc replacement (ADR).
For these reasons, the surgery for treating the lumbar stenosis will be determined on a case-by-case basis, taking into account the patient’s individual diagnosis.
Rehabilitation following surgery for lumbar spine stenosis
Rehabilitation after the operation will depend on the condition of the patient prior to the operation and which surgical technique is chosen.
At Instituto Clavel we are committed to minimally invasive techniques because they offer faster recovery, and we treat every case individually. Just as all the characteristics of the patient are taken into account for determining the appropriate surgery, they are taken into account when developing the rehabilitation plan. The development of this plan will be carried out with the team of physiotherapists at FisioSpine, our rehabilitation center specialized in the spine.
In any case, if the surgery is a laminectomy, at Instituto Clavel, the postoperative and rehabilitation phases are usually as follows:
- The patient is up and walking the day after surgery and is usually discharged two days after the operation.
- One week after surgery, the patient has an appointment with nursing staff to check how the incision is healing and to remove the stitches.
- After 4-6 weeks, the patient has an appointment with the neurosurgeon to evaluate the recovery process. At this time, it is recommended that the patient begin taking frequent, short walks each day, of about 5 to 15 minutes.
- Around week 10, the patient will be able to return to more physical activity, always following the recommendations of our physiotherapists, with non-impact exercises.
- Little by little, the patient can introduce different sports such as swimming, walking, or elliptical bike. Later, other sports with more impact such as tennis or soccer can be resumed. Although it is important to bear in mind that this can vary depending on the physical state of each patient.
We hope that you have found this information about rehabilitation after lumbar stenosis surgery useful. If case you have any questions or would like further information, please don’t hesitate to contact us at Instituto Clavel to receive personalized attention from our medical team.