Surgical Management of Spinal Stenosis
Edited By: Richard J. Bransford, M.D.
Last updated Friday, December 23, 2005
Preparing for surgeryPreparation Before surgery,
patients should consider the limitations, alternatives and risks of surgery.
Successful surgery depends on a partnership between the patient and the
surgeon. Patients should optimize their health so that they will be in the best
possible condition for this procedure. Smoking should be stopped a month before
surgery and not resumed for at least three months afterwards.
The surgeon needs to be aware of all health issues,
including allergies and the non-prescription and prescription medications being
taken. Some of these may need to be modified or stopped. For instance, aspirin
and anti-inflammatory medication may affect the way the blood clots.
The patient needs to plan on being less functional than
usual for six to 12 weeks after the procedure. Driving, shopping and performing
usual work or chores may be difficult during this time. Plans for necessary
assistance need to be made before surgery. For individuals who live alone or
those without readily available help, arrangements for home help should be made
well in advance.Timing In most cases of spinal stenosis, there is no rush to have
surgery. Generally, more conservative options are used first and only after
these have not worked is surgery performed. Surgery can be done on an elective
basis when timing is favorable for the patient and medical conditions are
optimized.Costs The surgeon’s office should provide a reasonable estimate
of:
- The
surgeon’s fee
- The
hospital fee and
- The
degree to which these should be covered by the patient’s insurance.
Surgical team Most spine surgery is done by either a fellowship trained
orthopedic surgeon or a neurosurgeon. These surgeries generally require the
patient be admitted to the hospital after surgery so they are usually done in a
hospital as opposed to an outpatient center.Finding an experienced surgeon There are many ways to find an experienced spine surgeon.
One of the best ways is through word-of-mouth from family members or friends
who have had positive experiences with a surgeon. The majority of the most
qualified surgeons are known in the medical community so a referral from a
primary care physician is a reasonable means of finding a qualified surgeon.
In addition, surgeons specializing in spine surgery may be
located through university schools of medicine, county medical societies, or
state orthopaedic societies. Facilities Stenosis surgery is usually performed in a major medical
center, although stenosis from a disc hernia may be dealt with in an outpatient
surgery center. In major medical centers, there are specially trained teams
involved in the care, including the surgeon, an anesthesia team, as well as
nurses and technicians.Surgery for at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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