The most common form of a nerve root entrapment is a single disc prolapse which is described in the relevant section of this website. It is, however, not uncommon, particularly in patients over the age of 50 – 60, that the spine develops more generalised degenerate changes. These degenerate changes are characterised by thickening of the ligamentum flavum and facet joints (hypertrophy) and this narrows down the diameter of the spinal canal. Given that the spinal canal is containing the nerve roots, when the ligamentum flavum and facet joints hypertrophy, they can compress the nerve roots and produce either sciatica or spinal claudication. The primary objective of surgery in this case is precisely the same as for a single disc prolapse, namely to decompress the nerve root. However, if the underlying problem is more generalised spinal stenosis, the operation itself needs to be more extensive with removal of the thickened tissues. Most commonly, this does not require combination with a discectomy and the incision of a similar size. If the spinal stenosis is extensive, over more than 1 segment of the spine, then the incision will need to be equally extensive in order to access the relevant area. Although it can be a larger operation, like a discectomy, mobilisation is most commonly the next day, if not indeed the day of the surgery, and the patient can go home within a couple of days, independently mobile.
Spinal stenosis before and after surgical decompression