My aging mother needs to have some surgery for her spinal stenosis. Evidently there’s enough arthritis and bone spurs built up around the joints in her low back that the discs and joints are being destroyed. The situation has recently gotten worse as the L4 vertebra has slipped forward. Just what do they do for this problem?

Your mother’s condition is called degenerative spondylolisthesis. The word degenerative refers to the age-related changes causing the discs and joints to break down. Spondylolisthesis describes the condition where the vertebra slips forward over the bone below it.

Surgery is done to stabilize the spine. As the vertebral body moves forward, the spinal nerve gets stretched and sometimes pinched. Back and leg pain, especially when walking is common. They may have numbness and weakness of the legs, too.

There are several different types of operations that can be done for this problem. The first is a decompression of the nerve. This is done by removing the bone around the nerve to take pressure off it. Depending on how it’s done, the procedure is called a laminectomy or laminotomy.

Sometimes decompression is all that’s needed. In other cases, spinal fusion may be done. A solid fusion helps stabilize the spine. There are two basic ways fusion is done: with or without instrumentation. Instrumentation refers to the screws or metal plates used to hold the spine in place until full fusion takes place.

The surgeon will take into consideration your mother’s age, health, and condition of her spine when making the decision about the best procedure to offer.