Spinal stenosis affects millions of Americans. It is a narrowing of the space around the spinal cord and nerve roots that can cause pain, numbness and/or weakness in the arms and legs. Spinal stenosis often occurs due to age-related degeneration of the spine in middle-aged to older people and herniated discs in younger patients. However, it can also result from injuries such as fractures, congenital (from birth) conditions, infections and tumors.
“Surprisingly, most patients that come to see us are better treated with non-operative options rather than with spine surgery,” says A. Jay Khanna, M.D., a Johns Hopkins Medicine spine surgeon practicing at Suburban Hospital.
These options include activity modification, physical therapy, anti-inflammatory medications and interventional pain procedures such as epidural and facet injections. Dr. Khanna says that the patients who are considered for surgical intervention typically have symptoms that persist after non-operative management and have findings of significant stenosis or other problems on their MRIs or other imaging studies. For many, the symptoms interfere with work, family and their ability to be productive and active. Dr. Khanna performs the newest techniques in minimally invasive surgery on patients with spinal stenosis and other conditions of the spine.
Many patients still require spine surgery through a conventional open incision; these techniques are tried and true,” says Dr. Khanna. “However, for the right patients with particular findings on their MRI studies, we can offer minimally invasive options that allow us to take care of the problem and get our patients back to their activities sooner.
Minimally invasive procedures are performed through smaller incisions, with specialized instruments and with imaging and other technology, such as an operating microscope that allows the surgeon to place his or her instruments precisely where they need to be. These techniques can make spine surgeries safer for patients because the risk of damage to surrounding tissue is minimized. Recovery times are generally shorter and patients typically return to daily activity much sooner.
Dr. Khanna coordinates the care of his patients with their physicians, including the patient’s primary care physician and other medical specialists. He says each provider has a different contribution to the patient’s well-being and it is important that they work together as a team or at least share their thoughts.