Treatment for spinal stenosis can be both surgical and non-surgical. Some non-surgical options you can discuss with your doctor are: 

• Exercise, such as walking or biking 
• Over-the-counter (OTC) medications to help control swelling and pain: 
• NSAIDs (non-steroidal anti-inflammatory drugs), such as aspirin and ibuprofen (Advil, Motrin, etc) 
• Analgesics, such as acetominophen (Tylenol) that help reduce pain 
• Epidural steroid injections given by your doctor 
• Reduced physical activity 
• Use of a back brace or corset, depending upon the location of the discomfort

If the pain continues to be a problem, your doctor may recommend possible surgical procedures, including: 

• Decompressive laminectomy: This type of surgery allows the surgeon to reduce the pressure on the spinal cord by removing the lamina, or bony “shingles” that cover the spinal nerves. The surgeon may also choose to remove the spinous process, which are bones that project out directly from the spinal column. Any painful bony growths, or spurs, can also be removed during this procedure. A fusion procedure might be performed to help stabilize the spinal column after some of the bone has been removed.
  
• Fusion: The fusion procedure helps to stabilize the spine after surgical removal of portions of the bone in the spinal column. A fusion procedure involves attaching metal screws, plates, or other devices to the bones of the spine to help keep them properly lined up. This is usually done when two or more of the spinal bones (called vertebrae) have been injured. As well as metal devices, other small pieces of bone may also be attached to the injured bones to help them “fuse” into one solid piece. The bone used for this procedure is usually taken from another bone in the body – most often from the hip. This does not damage the hip, and makes the fusion more stable. If needed, a small surgery on the hip will be performed at the same time as the spine surgery.

Any surgery means some pain will be felt during recovery. Expert medical staff will work together with you to help you be as pain-free as possible. Although the staff may frequently ask if you are feeling pain, it is best not to wait until it hurts a lot to call the nurse. Pain is easier to treat when it is still not too bad.

Some people will likely spend time in an intensive care unit (ICU) after spine surgery. This includes anyone who needs support for breathing from a ventilator or special intravenous (IV) medications for blood pressure. Depending upon the type of surgery and the health status of the patient, some patients may be observed overnight in the ICU. Talk with your doctor about what you can expect for post-surgical recovery.

Many patients with spinal stenosis may be treated without surgery. The purpose of surgery is to relieve pressure on the spine. However, surgery may be required if a person has: 

• Persistent pain that cannot be treated by non-surgical methods 
• Numbness or weakness that interferes with walking 
• Impaired bowel or bladder function 
• Other types of nerve problems that may involve the spinal cord

In a young person who has achondroplasia, a genetic disease affecting spinal cord formation, the laminectomy or removal of bone may be performed without the spinal fusion procedure.

The American Association of Orthopedic Surgeons (AAOS) reports that overall the results of surgery range from good to excellent in 4 out of 5 (80%) patients. Here are some other advantages of surgery reported by the AAOS: 

• Fusion surgery reduces the causes of more back and leg pain 
• Using screws and rods helps the healing process for the spinal column 
• Fusion surgery may allow the patient to get out of the post-operative brace quicker

Your doctor will discuss the results you or your loved one can expect following surgery for spinal stenosis.

As with any surgical procedure, there are risks involved. For spinal stenosis surgery, the risks include: 

• Infection 
• Bleeding or blood clots 
• An reaction to anesthesia during surgery 
• A tearing of the covering of the spinal cord during the surgical procedure (dural tear) 
• Injury to the spinal cord 
• A failure or breakage of the implanted fusion device (such as rods or screws) 
• A return of pain or other symptoms after surgery

Patients face greater risks from surgery if they: 

• Are elderly 
• Are overweight 
• Smoke 
• Have diabetes

Talk with your doctor about he any concerns you may have about surgery. The experts at both Harborview and University of Washington Medical Centers are leaders in their field and have many years of experience in treating your type of spinal condition.

Surgery may be recommended without delay if a person has cauda equina syndrome, symptoms of which include: 

• Numbness or weakness that interferes with walking 
• Impaired bowel or bladder function