Spinal Stenosis: Who Opts For Surgery?

Spinal Stenosis: Who Opts For Surgery?


Spinal stenosis arises from the spine undergoing degeneration and the result is a very painful condition where the spinal canal is narrowed and actually compressing the spinal cord as well as the nerves in the spine. It is extremely painful and can be quite debilitating. It is also very common in people who are aged over 65 rather than younger people.


In addition a recent study in the US found that it was the major reason for spinal surgery in the age group of 65 plus. However it was not clear why people elected for surgery in the sense of why would people choose surgery over non invasive treatments; after all surgery does not come without risks and the recovery time is longer than with non invasive treatments.


The study undertaken by Mark F Kurd, MD found that there were three common reasons why people chose surgery, after he looked at 241 patients who had surgery and also 115 people who chose non-invasive treatments, so that he could ascertain why some people elected for surgery and others did not.




Age seemed to be a determining factor. Most of the patients who chose surgery were in the younger age group i.e. just over 65, whereas older people did not choose surgery.


To some extent this is common sense. The younger you are the more likely you are to recover quickly from surgery and the risks are less when it comes to undergoing surgery, so it is perfectly understandable to assume that those who are aged significantly over 65 would be much more reluctant to undergo surgery.


Pain and Extent of Disability


Pain and disability were also factors, with people asserting that if their condition was very bad and that it caused them a significant level of pain, they were more likely to choose surgery.


However, it may well be that these patients also had ‘age related’ issues. The younger you are the more likely you are to feel that you are not old enough to be confined to a life of pain and disability. Whereas if you are older then you are more likely to feel not only that surgery is too risky but also that the condition is painful but it is symptomatic of ‘old age’ and therefore little can be done about it.


Symptoms Progressing


The third determining factor was whether or not people felt that their symptoms were getting worse. If this were the case they were more likely to opt for surgery. It was only people who felt that their condition was stable who were more likely to refrain from undergoing surgery.


So the key criteria for electing for surgery are youth, extent of disability and whether or not the condition is stable. Yet the option of surgery should not be made by the patient alone. The surgeon has to play a part in terms of guiding the patient through the different option and which will suit their needs the best.


Obviously the surgeon has to advise as to whether or not s/he feels that it is appropriate for each individual patient and we should also consider that many patients over the age of 65 will have other secondary conditions such as heart problems, diabetes and so on. To put it simply, surgery is simply not appropriate for everyone with this condition but each individual needs to be guided through the treatment options available within the context of their own individual medical condition and the options evaluated carefully and in a considered manner. 


Thus people who are relatively young and have significant pain levels as well as symptoms that are getting worse may be more willing to undergo surgery but advice is still required as to whether or not it really is the best option for treatment, so prior to undergoing surgery it is worth exploring all the treatment options in consultation with your surgeon.






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