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3 Very Real Spinal Stenosis Surgery Risks

3 Very Real Spinal Stenosis Surgery Risks

Dr. Michael Derry, DPT, PT, OCS Jacksonville, Florida
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Spinal stenosis affects about 11% of the adult population and diagnoses is often made when someone reports they have leg pain when they try to walk and have relief when they sit down. When I treat patients, the nerve pain in their legs and difficulty walking are the most common symptoms.

When conservative care such as physical therapy, which focusing on improving pain in the lower back or leg, doesn't work, surgery such a decompression or laminectomy may be appropriate. There are important things to consider before surgery and one of those are the risks related to spinal stenosis surgery.

I want to discuss the risks related to surgery that my patients wish they knew before hand.


Is Spinal Surgery Considered high Risk?

While every surgery has its risk, especially back spine surgery, the overall risk is associated with the type or procedure done. Most are now considered minimally invasive and I have seen may patients do well. Most spine surgeries are relatively low risk.

3 Spinal Surgery Risks I wish more People Knew Before They Had Spinal Stenosis Surgery

The overall risk for a severe complication related to spinal stenosis surgery is 3%. That risk does increase slightly in those who receive a fusion and those greater than 80 years old. This risk also increases in those who are diabetic, obese and have other co-morbidities such as heart conditions or in overall poor health.

Overall, spine surgery is risky but decompressions or laminectomies are often seen as low risk.

3 Very Real Risks for Spinal Stenosis
3 Very Real Risks for Spinal Stenosis

1. Nerve or Spinal Cord Damage

While the goal of spinal stenosis surgery is to relieve pressure on nerves, there is a risk of unintended damage to nerves or the spinal cord during the procedure. This risk can lead to new or worsened neurological symptoms.

2. Failure to Relieve Symptoms

Despite a successful surgical procedure, some patients may not experience complete relief from their symptoms. Factors such as the severity of stenosis, the presence of other spine conditions, or individual variations in response to surgery can contribute to the persistence of symptoms.

3. The Need For a Fusion

We know that those with a fusion are more likely to have greater complications and have an increased chance of having another fusion later in life.

Other common surgery risks are dural tears, infections, and hematomas.

What is the Success Rate of Surgery for Spinal Stenosis

The overall success rate for surgery for spinal stenosis is about 30%. That is complete resolution of symptoms, improved ability to walk and reduction in nerve pain. That said, nearly all have some sort of relief immediately, it just may not be 100%. It's important to modify your expectations based on what your physical therapists and surgeon discussed based on your body.

Every person is different and some have a lot of changes in their spine such as degeneration, and others may not.

Also, if you receive a one level decompression or laminectomy vs. a fusion that will also impact your recovery and success rate.

Success after surgery for spinal stenosis is variable. People have so many different types of pain and limitations before hand. What we see is that those with spinal stenosis, who are motivated, and take care of their body have better success.

Consider improving your strength and mobility prior to surgery with skilled physical therapy. I know its time consuming, costly, and hard but I have never seen a client regret feeling stronger and more mobile prior to surgery.

Is Surgery a Good Option for Spinal Stenosis?

Surgery can be a great option for spinal stenosis if you are appropriate. You want to make sure you are good candidate, but if you are many can expect immediate and long term relief.

Is surgery a good option for you?
Is surgery a good option for you? 

To further ensure you a good candidate, consider these factors: 

  • Confirmed diagnosis from a functional examination
  • Confirmation on an MRI
  • Relief with a diagnostic injection

I often see patients with these factors have immediate significant relief after surgery.

That said, surgery often doesn't improve back pain because the major goal of spine surgery is to protect your nerves. Stenosis means the space around your nerve is decreasing so the goal is to decompress the nerve, or relieve pressure around it.

You will want to have a plan to improve your lower back flexibility after surgery.

What is the Recovery Time for Spinal Stenosis Surgery?

For those with spinal stenosis surgery they should expect about a 6-8 week recovery time frame. Many have relief in symptoms right away and others take a little longer. You have to remember no spine is the same and every recovery is different. It also depends on if you receive a fusion, simple decompression, or a multi-level decompression.

This is what I would do to make sure I have the best recovery possible.

In conclusion, spinal stenosis surgery, though not without risks, offers significant benefits for many. While most procedures, particularly decompressions or laminectomies, are generally considered low-risk, patients should be aware of potential complications.

The decision to pursue surgery, especially with the potential need for fusion, should be informed by factors such as age, health conditions, and lifestyle. Despite a 30% overall success rate, surgery can be effective, particularly when the diagnosis is confirmed, and postoperative care, including tailored physical therapy.


1. Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921. PMID: 35503342.

2. Ma XL, Zhao XW, Ma JX, Li F, Wang Y, Lu B. Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials. Int J Surg. 2017 Aug;44:329-338. doi: 10.1016/j.ijsu.2017.07.032. Epub 2017 Jul 10. PMID: 28705591.

3. Imajo Y, Taguchi T, Neo M, Otani K, Ogata T, Ozawa H, Miyakoshi N, Murakami H, Iguchi T. Complications of spinal surgery for elderly patients with lumbar spinal stenosis in a super-aging country: An analysis of 8033 patients. J Orthop Sci. 2017 Jan;22(1):10-15. doi: 10.1016/j.jos.2016.08.014. Epub 2016 Sep 16. PMID: 27646205.

Dr. Michael Derry is a Doctor of Physical Therapy and board certified in orthopedics. He is very passionate about treating lower back pain and helping people build their resiliency. He has spent time assisting at universities as well as managing large clinics before starting his own practice in Jacksonville, FL.

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