Narrowing of the spinal canal in your back

Lumbar spinal stenosis


All of the nerves that go into your legs and feet first pass through your spinal cord in your back. Your spinal cord is protected by the bones of your back called vertebrae. Over time the bones, ligaments, and disks meant to protect your nerves often shift and degenerate causing narrowing of these channels. This can result in pressure on your nerves, or spinal stenosis, which prevents signals from properly transmitting through your nerves. Technically this is called neurogenic claudication.

Often this results in pain and numbness in the back and legs, weakness, and poor balance or difficulty walking. Many patients with spinal stenosis have difficulty walking distances or going up stairs and will find themselves using an assist device such as a cane for balance. This can be a very slowly progressing process that happens over years or decades. Many patients do not realize how much their mobility has been compromised.

Back model with blue nerves visible. Arrow points to the spinal canal which in this model is open and without spinal stenosis.


If spinal stenosis is suspected by your doctor then x-ray is often used as a first step to evaluate the bones and discs in the spine. Unfortunately x-ray does not allow us to see nerves or provide a high level of detail.

An MRI is typically required to see the nerves in your back and any associated spinal narrowing, herniated disks, bone spurs, or other causes of inflammation. An MRI is a test that uses a magnet to give a high resolution image. MRIs take longer than an x-ray but both are painless.

MRI from a patient with spinal stenosis. Top arrow pointing to a normal, open spinal canal where wispy nerves can be seen floating freely. Bottom arrow points to area of spinal stenosis where nerves are clumped and kinked.

Same patient after minimally invasive same day surgery with Dr. Rossi through a 16mm port with less than one inch incision. Notice spinal canal now has normal dimension. Nerves now seen floating freely, no longer clumped. Patient's spinal stenosis symptoms resolved.


Dr. Rossi will review your imaging with you to identify and explain the source of your pain. If your symptoms are tolerable then it may be possible to obtain relief with conservative or nonsurgical Pain Management. This is in the form of medications, physical therapy, stretching and lifestyle modifications. Often anti-inflammatory drugs such as steroids are utilized to help reduce inflammation. These medications can be injected directly onto the nerve for even better relief.

However, if your stenosis is severe and you have evidence or nerve damage or dysfunction then surgery is often discussed. The purpose of surgery is to take pressure off of your nerves and give them the best chance at proper recovery.


Dr. Rossi commonly performs minimally invasive surgery to correct spinal stenosis. Surgery is performed with a microscope through an incision less than an inch long. Patients are typically home and doing their normal activities by lunch time the same day and can expect immediate relief. Sometimes the pain is severe, getting worse, or not responding to nonsurgical options. In these cases surgery may be required to remove the material irritating the nerve (be it bone, ligament, or disk) and provide long term relief.

Dr. Rossi is proud to be trained in the latest minimally invasive techniques. This means a smaller incision is used compared to traditional “open” surgery and less muscle and tissue damage occurs. This has been shown to decrease blood loss, length of stay in the hospital and a quicker return to activities.

Dr. Rossi has published articles related to minimally invasive spine surgery in the most prestigious neurosurgery journals in the world. His article was selected as “editor’s choice” with nearly 200 citations on his work.

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If you have been told or suspect you are suffering from any of these conditions, we are here to help.
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