Spinal stenosis · Louisville, KY

Spinal stenosis surgery

The front desk at miiSpine in Louisville

Find out what's narrowing the space around your nerves.

Signs of spinal stenosis.

Leg pain or cramping when you walk

Pain, heaviness or cramping in the buttocks, thighs or calves that starts with walking or standing and eases when you sit or lean forward.

A walking distance that keeps shrinking

Having to stop and rest after a short distance, then being able to go on after sitting for a minute.

Numbness, tingling or weakness

Tingling or pins and needles in the legs, or a foot that's harder to lift, that gets worse the longer you're on your feet.

What spinal stenosis is.

Your spinal cord and nerves run through a canal in the middle of your spine. With age, arthritis in the small joints, bone spurs and thickened ligaments can slowly crowd that canal. When the space gets tight enough, the nerves get squeezed, most of all when you stand up straight, because standing narrows the canal a little more. That's why people with stenosis can walk farther leaning on a shopping cart: bending forward opens the canal. The medical name for leg pain that comes on with walking and eases with sitting is neurogenic claudication.

Inside the miiSpine clinic in Louisville

What to expect.

Before

A visit with Dr. Vemuri and your imaging reviewed with you. Stenosis often looks milder lying down, so if your MRI doesn't match your symptoms, our standing MRI can show the canal under load.

The day of surgery

Most single-level and many multi-level decompressions at miiSpine are outpatient surgery. You arrive in the morning and, if all goes as planned, go home the same day.

After

Walking is the first thing we ask you to do, because it's the thing stenosis took away. You get a written plan for activity, driving and work, built around you rather than a generic timeline.

When surgery makes sense, and when it doesn't.

Stenosis is slow, and so is the decision. Physical therapy, medication and epidural injections help many people live with it comfortably for years. Surgery is for the people whose walking distance keeps shrinking despite that, who have numbness or weakness in the legs, or whose quality of life has narrowed along with the canal. Dr. Vemuri goes over your MRI with you and tells you plainly whether decompression is likely to help. If you're better served by waiting, he'll say so.

How decompression goes.

Small incisions over the tight level

Dr. Vemuri works through narrow tubes that move the back muscles aside rather than cutting them. For some patients he uses UBE, an endoscopic technique with two openings each smaller than a fingertip.

The crowding is cleared

The bone spurs and thickened ligament pressing on the nerves are removed. The surgical names are laminotomy and laminectomy. The goal is to open the canal while leaving as much of your natural structure as possible.

Nothing is fused, unless it has to be

Most stenosis is treated with decompression alone. A fusion is added only when a level is also unstable or a bone has slipped. Dr. Vemuri will tell you which you need before surgery, not after.

Leg pain when you walk, relief when you sit. That pattern has a name, and a fix.

Spinal stenosis is a narrowing of the canal your nerves run through. As the space closes in, walking and standing start to hurt and sitting makes it better. Conservative care comes first. When it isn't enough, Dr. Vemuri does a minimally invasive decompression that takes the pressure off the nerves through small incisions, usually as outpatient surgery. No referral needed, and same-week appointments are available. Hablamos español: (502) 362-1780.

Call (502) 242-6370

Home

The same day, for most decompressions

Standing

MRI that shows the canal while you're upright

Referral needed

5,000+

Spine surgeries by Dr. V

Home

The same day, for most decompressions

Standing

MRI that shows the canal while you're upright

Referral needed

5,000+

Spine surgeries by Dr. V

Dr. V on stenosis

“The job is to make room for the nerves and leave everything else alone. Nothing gets fused unless it has to be.”

Questions about spinal stenosis.

What causes spinal stenosis?

Mostly wear and tear. Arthritis in the small joints of the spine, bone spurs and thickened ligaments slowly crowd the canal the nerves run through. Less often, a slipped vertebra or a bulging disc adds to it.

What surgery treats it?

Decompression. The surgical names are laminotomy and laminectomy. Dr. Vemuri does it through small incisions, removing the bone and ligament that are pressing on the nerves and keeping as much of your natural structure as possible.

Is it outpatient surgery?

In most cases, yes. Single-level and many multi-level decompressions at miiSpine are done as outpatient surgery.

How long does recovery take?

It varies, so we don't promise a date. Walking is encouraged right away. Dr. Vemuri gives you a written plan for activity, driving and returning to work.

Can stenosis come back?

The level that was opened usually stays open. Over the years, the levels above or below can narrow on their own, because the same wear and tear continues. Dr. Vemuri will go over what that means for you.

¿Hablan español?

Sí. Llame al (502) 362-1780, las 24 horas, o visite miispine.com/accidentes.

What if I have stenosis at more than one level?

That's common, and it can often still be done through small incisions. Dr. Vemuri looks at your imaging and tells you which levels actually need opening.

Do I need a referral?

No. Call (502) 242-6370 or request an appointment online. Same-week appointments are available.

Does insurance cover stenosis surgery?

Most plans cover decompression when it's medically necessary. Our team checks your benefits before surgery and tells you what to expect. If you're paying cash, we'll give you the price before you book.

This content is for general information and isn't a substitute for a medical evaluation. Every spine is different. Talk to a spine specialist about your specific symptoms.

5,000+

Spine surgeries

4,000+

Office visits per year

1,000+

Outpatient procedures in five years, in surgery centers since 2014

Dr Venu
Vemuri

Dr. Venu Vemuri, D.O. (Dr. V) is a fellowship-trained spine surgeon and is board-certified by the American Osteopathic Board of Orthopedic Surgery. He opened miiSpine in 2021 as an independent alternative to corporate medicine. He has performed more than 5,000 spine surgeries, has done minimally invasive spine surgery in ambulatory surgery centers since 2014, and decompression for stenosis is one of the operations he does most often.

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