Maybe you used to walk around the grocery store without thinking twice. Now you lean on the cart. A trip around the block requires a break, and you find yourself saying no to outings because you’re not sure how much walking they’ll involve.
Spinal stenosis can gradually shrink your world before you realize how much you’ve given up.
At McNulty Spine in Las Vegas, Patrick S. McNulty, MD, FABSS, FABOS, looks beyond what spinal stenosis looks like on an MRI. The bigger question is what that narrowing is doing to your nerves, your mobility, and your ability to live the life you want.
Spinal stenosis occurs when the spaces within your spine narrow, putting pressure on the spinal cord or nerve roots. It most commonly affects the lower back and neck.
Lumbar spinal stenosis can cause pain, numbness, tingling, or weakness in the legs, often making it difficult to stand or walk for long periods. Cervical stenosis can affect your arms and hands, but compression of the spinal cord in your neck may also cause problems with balance and walking.
The severity of narrowing seen on imaging doesn’t necessarily tell us how severe your symptoms will be. That’s why Dr. McNulty considers your imaging alongside a neurological examination and, importantly, your day-to-day function.
Can you walk comfortably? Are your legs becoming weaker? Are you losing your balance? Have you stopped doing activities you enjoy because of your symptoms?
Those answers matter.
Spinal stenosis doesn’t automatically mean you need an operation. Physical therapy, medication, activity modifications, and targeted injections may reduce symptoms and help you remain active. But at some point, conservative care may not adequately address significant nerve compression.
It may be time to discuss surgery when:
Certain symptoms need more urgent attention. New bowel or bladder dysfunction, significant weakness that interferes with walking, or other serious neurological changes can warrant prompt surgical evaluation.
The goal isn’t to rush you into surgery. It’s about recognizing when waiting may cost you more in function than moving forward.
When stenosis requires surgery, the basic objective is straightforward: relieve pressure on the compressed nerves or spinal cord.
Dr. McNulty uses decompression techniques such as laminectomy, laminotomy, foraminotomy, and discectomy depending on where and why compression is occurring. When appropriate, he can perform decompression using minimally invasive techniques with specialized instruments, imaging guidance, and robotic technology, while minimizing disruption to surrounding tissues.
Minimally invasive surgery can mean less muscle damage, blood loss, and scarring, along with a shorter hospital stay and faster recovery than a comparable traditional open procedure.
Not every person with stenosis needs spinal fusion.
If the primary problem is nerve compression and the spine remains stable, decompression alone may be enough. But stenosis can occur with instability, deformity, spondylolisthesis, or other structural problems. In other cases, removing enough bone to fully decompress the nerves could leave the spine unstable.
That’s when Dr. McNulty may combine decompression with spinal fusion to both free the nerves and restore stability.
His surgical experience includes minimally invasive instrumentation, decompression, lateral interbody fusion, and posterior or posterolateral fusion. He’s also extensively trained in traditional spine surgery. That breadth matters because the goal isn’t to use the newest or least invasive technique at all costs. It’s to choose the approach that relieves the compression without compromising the structural result.
Dr. McNulty is a double-board-certified orthopedic surgeon and spine specialist with more than 30 years of experience treating and reconstructing spinal disorders. His fellowship training in spinal surgery and expertise in complex reconstruction, minimally invasive techniques, and robotic surgery allow him to tailor treatment to the anatomy in front of him — and the person whose mobility is at stake.
Spinal stenosis doesn’t have to keep making your world smaller.
If you’re walking less, giving up activities, or noticing increasing weakness, numbness, or balance problems despite conservative treatment, schedule a consultation at McNulty Spine. Dr. McNulty can determine what’s causing your symptoms and whether it’s time to consider surgery.
