Surgery Not only Option for Lumbar Stenosis


If you suffer from lower back pain, you’re not alone. Approximately 80 percent of adults will experience lower back pain during their lifetimes. In response to normal aging, as our vertebrae and discs wear, there can be a build-up of bone—often called bone spurs or arthritis—that can narrow the spaces for nerves. This condition, called lumbar stenosis, can put pressure on nerves causing leg pain and weakness. If persistent, the decrease in daily activity can be debilitating. Dr. Jeffrey B. Randall of the Pacific Brain and Spine Medical Group specializes in spinal stenosis, and his practice focuses on surgical and non-surgical treatment of brain and spinal disorders.


How does your practice differ from other physicians?

For more than 20 years, I have provided neurosurgical care to people in the Bay Area for a range of conditions including back and neck problems, brain and spinal trauma, and tumors. I specialize in the treatment of spinal stenosis. I truly enjoy interacting with my patients, and I believe the communication between doctor and patient is paramount to achieving the best outcomes. We review MRI images together and discuss options based on my experience, including performing over 3,000 spinal surgeries. Interestingly, many people don’t need surgery, but for those who do, I emphasize smaller incisions and less-invasive procedures, reducing post-operative discomfort and time spent in the hospital, and resulting in faster recoveries.


How has lumbar stenosis treatment changed in the past decade?

The combination of better imaging and computer-assisted techniques in the operating room allows for a higher level of surgical precision and accuracy. It also guides our surgical planning and provides real-time feedback in the OR during the procedure. Today, for example, lumbar stenosis is usually an outpatient surgery that does not involve the historically long recovery time that used to be associated with back surgery. Many years ago, before we met, when my wife had lower back surgery in Los Angeles, she spent five days in the hospital and several months in recovery. Now, patients are walking on the same day and showering the next, and can often resume driving in a few days. Within three to six weeks, they can typically get back to their regular exercise routine.


What are the typical concerns a patient has when he or she comes to you?

Most people who come to see me are interested in how long their recovery will take and what they can expect after surgery. We talk about alternatives to surgery, what we are aiming to accomplish, and what risks are involved in both nonsurgical and surgical options. Fortunately, surgical risks are now usually very low.


What should someone do if they think they might have lumbar stenosis?

Lumbar stenosis usually causes pain and heaviness extending from the buttocks to the legs, and it is often worse with standing or walking. An upright posture further decreases the room for the nerves, so you may be comfortable sitting or driving but have difficulty with exercise—for example, when you are walking or playing golf or tennis. You may walk more easily with a stooped posture or leaning on the grocery cart. Anyone with these kinds of symptoms should talk with their primary-care physician, and if they are not improving, see a specialist. Lumbar stenosis can be easily diagnosed by MRI scan.


What are the common misconceptions about lumbar stenosis?

Many people still believe that more invasive spinal fusion surgery—with metal rods and screws—is the only option. But the vast majority of people don’t require long incisions, a long hospital stay, a many-month recovery, and a less predictable outcome. Today, with minimally invasive surgical techniques, the likelihood of your success in returning to an active lifestyle is very high.


Pacific Brain & Spine Medical Group, Inc.
80 Grand Ave., Ste. 300, Oakland, 510-886-3138
20055 Lake Chabot Rd., Ste. 110, Castro Valley, 510-886-3138
1320 El Capitan Dr., Ste. 300, Danville, 925-884-2360

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