I'm 82-years-old. When I was 77, I had a roto-rooter surgery on my spine to make room for the nerves. I had pretty good pain relief but it seems to be starting up again. Am I too old to have it done again?

It sounds like you may have a condition called spinal stenosis. This is a common degenerative process that occurs with aging. The area inside the spinal canal gets smaller as bone spurs form and the ligaments hypertrophy (thicken). Sometimes the spinal nerves also get thicker making it more difficult to pass through the opening. Pressure on the nerves causes significant back and leg pain.

Conservative care is often advised first. Anti-inflammatory drugs, physical therapy, and steroid injections into the epidural space around the spinal cord may be tried. If improvement doesn't occur with conservative care, then decompressive surgery to take pressure off the neural structures is next.

This is usually done by removing some or all of the bone around the nerve roots. Laminectomy to remove the lamina is still the number one surgical choice. The lamina is a column of bone that forms an arch around the spinal cord. Any bone spurs around the nerve are also scraped away. Any disc fragments are removed.

Your first surgery was successful in providing pain relief. But as many studies have shown, this condition can recur. Results deteriorate over time as the degenerative process continues or as other vertebral levels are affected.

You may be a good candidate for surgery. The surgeon will re-evaluate your situation. The presence of stenosis will be confirmed first. After taking a history and performing clinical tests, you may be scheduled for an X-rays, an MRI, or CT scans.

Depending on your overall health and the results of the test, a treatment plan will be determined. Most likely, a course of conservative care will be tried first. Complications from surgery for stenosis can be very serious. Management with conservative therapy may be all you need.

Reference: 

Ra'Kerry K. Rahman, et al. Thoracolumbar Spine. Lumbar Spinal Stenosis. In Current Orthopaedic Practice. July/August 2008. Vol. 19. No. 4. Pp. 351-356.

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