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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is the treatment for severe spinal stenosis?

Hi, I have severe spinal stenosis - L4/L5. Per MRI, the L4-5 disc space ;evel demonstrates moderat to severe spinal stenosis secondary to a bulging disc as well as ligamentous and bony facet hypertropic change. The L neural foramen demonstates severe stenosis. I also have some scoliosis. Originally had pain radiating down my R thigh but with 2 epidurals was able to walk for several miles at a time (up to 4 miles per day) during a recent vacation. But the one symtom that has not improved is difficulty changing floor surfaces. I feel as though I am drunk when I first step on linolium. I also have efforts of severe sweating that just started. Is this due to the stenosis. I am 60, 5 2 and 158 #. I also have hi BP and hi cholesterol. What treatment would you suggest. If surgery, is it possible to microsurgery rather than a laminectomy. I am concerned about a possible spinal fusion with a laminectomy. Thanks Anna
Tue, 24 Nov 2020
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Internal Medicine Specialist 's  Response
Hi,
The ideal options for you who does not have adequate response to therapy and has difficulty in changing floors (neuro deficit) are decompressive laminectomy and spinal fusion. Your MRI is not showing spondylolisthesis - laminectomy without fusion (fusion involves with or without instrumentation). Urgent surgical consultation is needed - difficulty in urination, stools emptying, sensation loss over perineal region between scrotum and anus and inner thigh.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Suneel V. Babu, Internal Medicine Specialist
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What is the treatment for severe spinal stenosis?

Hi, The ideal options for you who does not have adequate response to therapy and has difficulty in changing floors (neuro deficit) are decompressive laminectomy and spinal fusion. Your MRI is not showing spondylolisthesis - laminectomy without fusion (fusion involves with or without instrumentation). Urgent surgical consultation is needed - difficulty in urination, stools emptying, sensation loss over perineal region between scrotum and anus and inner thigh. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Suneel V. Babu, Internal Medicine Specialist