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Lumbar Spinal Stenosis: Do I Need Surgery?

Authored by Dr. Christopher Good, MD, FACS. December 6, 2021

One of the most common conditions we see when diagnosing patients at Virginia Spine Institute is lumbar spinal stenosis. This common condition can cause people to suffer with constant back pain, or with pain and weakness that radiates from the lower back down the legs. Many of my patients’ first question when being told they have lumbar spinal stenosis is: “Do I need surgery?” Here’s how I explain their condition to them and what treatment options are available to create their customized plan of care.

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis is a condition in which some material within your lower spine starts to encroach or fill in the space where the nerves are located —  eventually getting to a point where this material causes the nerves inside of your back to become pinched. Stenosis literally means narrowing. Many common causes of this condition are degenerative and/or herniated discs, disc slipping (spondylolisthesis), and arthritic bone spurs (spondylosis).

Two black & white MRI images side-by-side of the lumbar spine depicting a patient with stenosis and without stenosis.

What Type of Pain Is Associated With Lumbar Spinal Stenosis?

People with lumbar spinal stenosis will feel levels of pain or pressure in their lower back and buttocks, but they’ll also commonly feel pain that radiates down their legs that can travel to their feet. For people with severe spinal stenosis, numbness or weakness in the feet or legs is not uncommon. Many people will describe a worsening of these symptoms with standing and walking, but find relief with sitting and leaning forward.

What Treatments Are Available For Lumbar Spinal Stenosis?

Through our all-under-one-roof comprehensive model, I am able to create a customized treatment plan built specifically for each individual. Once we know the patient’s medical history, their goals and preferences, and confirm their spinal stenosis isn’t severe, we can start their treatment with non-surgical options. These forms of treatments can be used both individually, or combined together to create an effective plan of action. For spinal stenosis, non-surgical treatment options include:

Is Surgery an Option for Lumbar Spinal Stenosis?

Luckily with this condition, a very small number of patients will actually need surgery to relieve the pain and symptoms they are feeling. These patients have severe stenosis that will not be fixed non-surgically. If a patient is starting to have progressive neurological problems, we would go straight to the surgical route in hopes to avoid long lasting effects of those symptoms. Surgery can also be the next step for patients who have tried the non-surgical treatments, but their condition did improve through those treatments.

What Surgery Is Available For Lumbar Spinal Stenosis?

Through the modern advancements in spine surgery, I am able to provide my patients with the most advanced minimally invasive options when surgery is needed to treat spinal stenosis. These surgeries are performed with smaller incisions using state-of-the-art tools, thus leading to less muscle disruption, less anaesthesia , faster recovery time, and reduced post-operative pain for the patient. While the exact type of surgery is something you and your spine surgeon will discuss together, here are a few of the advanced minimally invasive surgeries we perform to relieve the pressure caused by lumbar spinal stenosis:

Endoscopic Spine Surgery

Through a micro-incision (less than 1cm), we utilize the magnification of a scope to perform microsurgery. This technique allows the surgeon to visualize the compressed nerves and relieve this pressure using smaller instruments guided by the scope.

Microdiscectomy

This minimally invasive surgical technique is for herniated discs in the lumbar spine causing stenosis on one side of the spinal canal. The herniated disc is removed with micro tools, leaving only healthy disk material behind and decompressing the nerves on that side.

Laminectomy

During a laminectomy procedure, a portion of the spine bone, bone spurs, and thickened ligament are removed through an incision in the middle of the low back to make more space for the nerves.  This is often the surgery needed for patients with severe and extensive spinal stenosis.

Ultrasonic Decompression

This technique uses an ultrasonic blade at a specific frequency range to perform cuts into dense tissues, such as bone. The blade uses ultrasound waves to cut into the bone, allowing for greater accuracy and safety. By making these cuts, the pressure on the nerves becomes alleviated.


While lumbar spinal stenosis and other types of
degenerative disc problems are extremely common, the majority of people will never experience any major problems from their back. However, if you are in the minority, and develop worsening pain, numbness or weakness, or are unable to walk because of these symptoms —  seek treatment with a spinal specialist as soon as possible, as these symptoms warrant an evaluation. The earlier conditions like lumbar spinal stenosis are diagnosed, the better chance you have to avoid surgery to relieve your painful symptoms and get back to a pain-free life.

You deserve the best care in treating your lumbar spinal stenosis, and we’ve got just that. The nation’s top spine specialists working all together in one state-of-the-art facility, while providing the most advanced and unique treatments. Schedule a consultation today to take control of your pain, and let our physicians get you to a pain-free life.


Dr. Christopher Good is a double board certified spine surgeon and the President of Virginia Spine Institute. Established as a world expert in the field, Dr. Good has pioneered the use of robotics, navigation, and augmented reality (AR) in spine surgery. He performed the first two-level disc replacement in Metro DC, Maryland, and Virginia region, and continues to evolve motion-enhancing procedures for patients suffering from neck and back conditions. Dr. Good has been named “Top Doctor” consistently over the past decade.  Learn more about Dr. Christopher Good.

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About The Author

Dr. Christopher Good, MD, FACS

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