Lumbar Stenosis

What you need to know

Refers to the narrowing of the spinal canal in which the spinal cord and nerve roots travel. It most often occurs due to degenerative changes in the spine as a result of aging and wear and tear. The discs which are the cushions between the bones start to collapse and decrease in height. The discs begin to bulge into the spinal canal, narrowing the area for spinal nerves. The bones begin to rub against one another and form bone spurs which further narrow the space for the nerves. It most often causes pain to shoot down the legs which is usually worsened by standing and walking. The location and side of the body affected is related to which nerve is being compressed. Patients also complain of decreased endurance during physical activities. Symptoms usually improve when sitting and leaning forward.

MRI is the most common way to diagnose the presence of nerve compression. CT scans may also be used in certain cases to make the diagnosis. As the stenosis worsens, whereby more pressure on the spinal nerves occurs from the bone spur formation getting bigger, the symptoms can include numbness, prickly feelings in the buttocks and legs, weakness, difficulty walking and bowel and bladder incontinence.

One can try a conservative route of treatment if no neurological symptoms exist such as nonsteroidals, physical therapy and lifestyle modifications. Severe flare ups can be treated with oral steroids and pain medications. If these modalities do not help then an epidural steroid injection can be considered to reduce swelling and inflammation. If pain symptoms persist or neurological symptoms develop, then surgery can be recommended.

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Lumbar Laminectomy

A lumbar laminectomy entails removing bone and thickened tissue to enlarge the space available from the squeezed neural elements either going in from the side or back of the lower spine. The procedure may also involve fusing the spinal column with plates, screws, rods and cages if the decompression produces any spinal instability.
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Lateral Lumbar Interbody Fusion

The minimal invasive LLIF (Lateral Lumbar Interbody Fusion) procedure performed through a 1 inch incision in the side of the body can be used to restore the disc height to indirectly take the pressure off the nerves within the foramen with less risk of damaging the spinal nerves.
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Transforaminal Lumbar Interbody Fusion

The minimal invasive TLIF (Transforaminal Lumbar Interbody Fusion) procedure can be used to directly remove all the pressure on the nerve in the foramen and provide stability to the spinal segment, all performed through a one inch incision in the back of the lower spine.

Patrick J. Horan, MD, MBA, FACS

Patrick J. Horan is an orthopaedic surgeon and sports medicine specialist with two decades of experience. He is board-certified in orthopaedic surgery and sports medicine. After receiving his undergraduate degree from Duke University in Durham, N.C., Dr. Horan earned his medical degree from Tufts University School of Medicine in Boston. Residency and Internship were both completed at Walter Reed Army Medical Center in Washington, D.C. He also received an MBA from Auburn University in Auburn, Ala.

Dr. Horan served 10 years on active duty in the US Army as an orthopaedic surgeon before entering into private practice. Dr. Horan is the founder of the Westchase Orthopaedic and Rehabilitation and the official surgeon of the Tampa Bay Rowdies. He maintains professional memberships with the American Academy of Orthopaedic Surgeons, the American Academy of Orthopaedic Sports Medicine and the Arthroscopy Association of North America.

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Dr. Patrick Horan and the other orthopedic surgeons and specialists at Westchase Orthopedics & Rehabilitation have served hundreds of patients in the Tampa Bay area. Our patients choose us because we are able to offer them viable solutions to their pain. We offer hope to patients who have been athletes for years and suddenly find themselves faced with the possibility of never playing again, to elderly patients who want to maintain their independence and do things like drive and grocery shop alone, to parents who aren’t sure what is wrong with their children’s knees or elbows and want answers. Unlike in many other practices, you are not treated like just a number; we take the time to listen to your concerns and symptoms, accurately diagnose the source of the problem, and walk you through what will happen during the course of treatment. Get in touch with our office today to schedule an appointment!

Testimonials

Dr Horan has done a few of my knee surgeries and has always been the best surgeon. Dr Lao has been my physical therapist for every knee surgery and his results are proven and outstanding. I’d be in bad shape if it wasn’t for dr Lao and his staff who go above and beyond to do what’s needed.

Testimonials

Dr. Lao is simply the best! His intense educational training and specialty of the spine are something that you seldom come across these days. When I lived in Bradenton for 9 months I would drive over an hour just to see him because he was the only one I trusted with my physical issues. His assistant Sam is wonderful and Lisa at the front desk is always very helpful! There is another PT there that I have not treated with, but I only hear great things about him! 🙂 I will not go anywhere else.

Testimonials

This review encompasses both Dr Horan's orthopaedic side of the business & Dr Lao's physical therapy side. I have no idea if their practices are actually related, but there's only one street sign & only one Yelp check-in. Luckily, I think both doctors are excellent.

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