Spinal stenosis and myelopathy
Duke's expert spine specialists achieve excellent outcomes for the slow, progressive narrowing of the spine known as spinal stenosis, and compression of the spinal cord, referred to as myelopathy. Whenever possible, our goal is to avoid your need for surgery. However, when surgery is necessary, our spine surgeons specialize in procedures that minimize the pain and problems associated with spinal stenosis and myelopathy. We work with you to regain your normal function as quickly as possible.
Expert care for spinal stenosis and myelopathy
Stenosis and myelopathy can cause a range of symptoms, from pain and numbness to difficulty walking or problems with bladder and bowel function. If you have been diagnosed with either of these spinal cord conditions, choosing a highly specialized spine team is your best option for reducing your discomfort and regaining your function and mobility.
We treat the full range of spine conditions, an important consideration because stenosis and myelopathy may result from degenerative disc disease, spinal arthritis, or trauma such as a spine fracture or spine cancer. Our surgeons are among the best in North Carolina and have particular expertise with decompression surgeries often used to treat stenosis and myelopathy. These procedures relieve the pain and pressure caused by pinched nerves.
Choose Duke Spine Center for your spinal stenosis or myelopathy treatment because we offer:
- Surgical experience. Surgery for these conditions -- myelopathy in particular -- can be very challenging because they involve such a tiny, delicate area. Decompression surgeries require the removal of small parts of bone directly over, under or near sensitive nerve roots, and are not routine. Choosing highly specialized spine surgeons with advanced training and skill means you experience a safer procedure and better outcomes. We are one of the busiest spine centers in the area. We perform more than 1,200 spine surgeries and complex spine procedures every year.
- Intraoperative imaging technology. We are one of the few centers in the U.S. that offers advanced, intraoperative capabilities with CT and MRI. That means our surgeons use detailed, 3-D pictures of your spine and the tiny nerves and roots of your spinal cord in the operating room to guide them as they operate.
- Specialized team. In addition to our orthopaedic surgeons and neurosurgeons, our team includes nonoperative doctors and nurses, acupuncturists, a psychologist, pain management experts and physical therapists -- all of whom may play a role working with you to alleviate the pain, pressure and inflammation caused by your stenosis or myelopathy.
- Personalized therapy plans. Our therapeutic and nonsurgical options provide effective treatments without having surgery. We develop a personalized treatment plan that includes medication and/or injections with physical therapy. We also offer non-traditional options like acupuncture for interested patients.
STENOSIS AND MYELOPATHY
Stenosis treatment often involves very effective nonsurgical options, with surgery as a last option. With myelopathy, surgery is often necessary at the beginning.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which do not require a prescription, may be recommended. Your doctor may also recommend additional prescription-strength medications to treat damaged nerves caused by stenosis. A medication regimen is usually coupled with physical therapy.
You may work with your physician or a physical therapist in the community to learn exercises that can strengthen your spine, improve your balance and flexibility and improve your posture –- all benefits that can alleviate your pain and the pressure on your pinched nerves.
Treat inflammation and pain right at the source -- your pinched nerve roots. We inject these treatments in a special suite at the Duke Spine Center. You may see your physician and receive your treatment on the same day.
An acupuncturist on our staff can help reduce your pain. We also offer non-traditional supplements such as fish oil, which some people find effective. These treatments are offered as a complement to your regular treatment plan, not as a substitute.
Decompression relieves pain and pressure caused by pinched nerves and creates more room in the spinal canal. In some cases, a minimally invasive approach may be possible. Your doctor will decide whether it’s right for you. Lumbar decompression surgery includes:
- Laminotomy/laminectomy. Removes the affected lamina (back part of the vertebra).
- Microdiscectomy. Removes a small portion of the bone over the nerve root and possibly part of the disc under the nerve root.
STENOSIS AND MYELOPATHY
Your doctor will order one or more of the following tests to diagnose your condition:
Takes pictures of bones inside your body. X-ray pictures will show any areas of instability in your spine. Because X-rays only show bones, and not discs or nerves, another imaging test is usually needed.
Magnets and radio waves are used to take detailed pictures of your spinal disc and the nerve roots of your spinal cord.
A series of cross-sectional pictures produce detailed, 3-D images of your spine and spinal cord.
Injects a dye into the sac around the nerve roots in your spinal cord to help them show up better on a CT scan.
Electrodes are inserted directly into muscle with a thin needle to record electrical activity. EMG tells your doctor how well muscles and nerve cells are working in a certain area of your body.