Lumbar Spinal Stenosis and Scoliosis

Lumbar spinal stenosis and degenerative scoliosis often affect people age 60 or older, but they can also affect younger patients with developmental issues.

Lumbar spinal stenosis is a narrowing of the spinal canal that compresses the nerves traveling through the lower back into the legs, sometimes causing nerve inflammation that results in pain, weakness or numbness, depending on severity.

Degenerative scoliosis, or curvature of the spine, occurs most often in the lower back, with pain developing gradually as a result of activity. Curvature is often relatively minor, so surgery is only required when conservative methods fail to alleviate pain.

Innovative Treatments for Lumbar Spinal Stenosis and Scoliosis

The skilled neurosurgeons of North Texas Neurosurgical & Spine Center use innovative and minimally invasive surgical approaches to treat spine pain:

  • Decompressive laminectomy is the most common surgery we perform in the lumbar spine, or lower back. We remove parts of the vertebrae and create more space for the nerves, relieving pressure on the spinal cord and allowing patients to resume normal activities.
  • Spinal fusion is a complex and lengthy procedure performed during decompressive laminectomy surgery to stabilize the spine, particularly when scoliosis occurs with spinal stenosis. Rods, hooks, wires or screws are attached to the curved part of the backbone, and the spine is straightened. Small pieces of bone are then placed to grow together with the spinal bone, fusing it into the proper position.
  • Laparoscopic spinal fusion is a minimally invasive form of fusion using smaller incisions in the abdomen, through which a graft is placed into the disc space. Advanced fluoroscopy (X-ray imaging during surgery) and endoscopy (camera technology) allow for accurate incision and hardware placement, minimizing tissue trauma and shortening recovery and hospital time.
  • Endoscopic discectomy is a minimally invasive procedure performed through a very small incision. A small tube is placed between the muscle fibers, through which special instruments and microscopes are used to create a small window in the bone. Nerves are gently moved to the side, and the disc material compressing the nerve is removed.
  • Foraminotomy can be performed on any level of the spine to increase space over a nerve canal, remove pressure from a nerve, and allow the spine to move more easily. The procedure is performed through a surgical opening or enlargement of the bony opening traversed by a nerve root as it leaves the spinal canal.

Our goal with spine surgery is to relieve as many of the symptoms as possible. Our team will discuss all surgical options with you to help you determine the best treatment plan for you.

Beyond Degenerative Scoliosis

It’s normal for your spine to have natural curves, which round the shoulders and make your lower back curve slightly inward. However, some people have spines that curve side-to-side, a condition called scoliosis. When scoliosis is not brought on by a degenerative condition, it usually takes the form of a congenital or neuromuscular condition more commonly found in early childhood or adolescence.

Having one or more of the following signs could indicate scoliosis, and should prompt an appointment with a doctor:

  • Shoulders are uneven – one or both shoulder blades may stick out
  • Head is not centered directly above the pelvis
  • One or both hips are raised or unusually high
  • Rib cages are at different heights
  • Waist is uneven
  • The appearance or texture of the skin overlying the spine changes (dimples, hairy patches, color abnormalities)
  • The entire body leans to one side

Severe scoliosis may require spine stabilization surgery, but our surgeons will assess a number of issues before a treatment plan is developed:

  • Spinal/skeletal maturity: Is the spine still growing and changing?
  • Degree and extent of curvature: How severe is the curve, and how does it affect your lifestyle?
  • Location of curve: According to some experts, thoracic curves are more likely to progress than curves in other regions of the spine.
  • Possibility of curve progression: Patients who have large curves prior to their adolescent growth spurts are more likely to experience curve progression.

When Surgery Is Needed

Surgery for scoliosis aims to stop progression, normalize spinal function and minimize pain. A number of surgical treatment options are available, including several detailed above:

  • Spinal fusion with instrumentation
  • Bone grafting to create a permanent fusion of vertebrae
  • Decompressive laminectomy
  • Minimally invasive laparoscopic spinal fusion

Talk with our team about the approach that’s right for you.