Comparing Treatment Options

Who Is Each Treatment Best Suited For?

Conservative Treatment

Good fit Not a good fit
Mild to moderate symptoms Severe symptoms
Mild neurological symptoms Muscle weakness
Daily life is not greatly affected Walking is severely limited
Prefer to avoid surgery Bladder or bowel problems
Overall health is a concern Symptoms are worsening rapidly

Decompression Surgery

Good fit Not a good fit
Compression is the main cause Slippage or instability is present
Stenosis at 1-2 levels Widespread stenosis
Conservative treatment has not helped Surgical risk is too high
Intermittent claudication is the main symptom Chronic pain is the dominant problem

Fusion Surgery

Good fit Not a good fit
Spondylolisthesis (vertebral slippage) is present Stenosis is stable
Spinal instability is present Severe osteoporosis
Deformity (such as scoliosis) is present Multiple prior surgeries
Extensive decompression is needed Overall health is poor

SCS

For Patients Who Have Not Had Surgery

Good fit Not a good fit
Imaging does not match symptoms Decompression alone could help
Degeneration at multiple levels Structural instability is present
Neuropathic pain is the main problem A mental health condition is the primary cause
Surgical risk is high (older age, health conditions) Active infection
Multi-level fusion is needed but surgical risk is high Severe dementia
Younger and wish to avoid fusion

For Patients Who Have Had Surgery

Good fit Not a good fit
Pain persists after surgery Clear compression remains
Reoperation carries high risk A mental health condition is the primary cause
Chronic pain is the dominant problem Active infection
Trial showed good results Pacemaker present (requires discussion)