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Is surgery helpful for spinal stenosis? I have back pain severe enough to consider even going to such extremes.

Surgery isn't for everyone but it can be helpful for some patients. Studies show that about 20 to 40 per cent of patients with mild-to-moderate lumbar spinal stenosis will eventually have surgery. On the flip side, most of the 60 to 80 per cent who don't need surgery do get better over time.

The real question is does surgery improve the results? Does decompressive surgery to remove bone pressing on the nerve tissue reduce pain and improve function? It appears that patients with moderate-to-severe symptoms have an 80 per cent chance of improvement with decompressive surgery. They are less likely to be helped by conservative care.

Age doesn't seem to be an important factor. Younger and older patients were helped equally by surgery. Surgeons are comparing different types of surgical procedures to find the most effective for this group of patients. There may be subgroups of stenosis patients who are helped more by one technique over another.

It's not clear just if there is one single treatment or group of treatments that should be used with anyone who has painful or disabling stenosis. Talk with your surgeon about what might work best for you.

Many patients are helped by a simple decompression surgery. Others need decompression along with a spinal fusion. Special devices such as the X-stop can be surgically implanted to prevent motion at the diseased level.

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