Spinal Stenosis and Myelopathy

Spinal Stenosis and Myelopathy

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Duke's expert spine specialists in Raleigh and Durham achieve excellent outcomes for the slow, progressive narrowing of the spine known as spinal stenosis, and compression of the spinal cord, referred to as myelopathy. Whenever possible, our goal is to avoid the need for surgery. However, when surgery is necessary, our spine surgeons specialize in procedures that minimize the pain and problems associated with spinal stenosis and myelopathy. We help you regain your normal function as quickly as possible.

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Expert Care for Spinal Stenosis and Myelopathy

Stenosis and myelopathy can cause a range of symptoms, from pain and numbness to difficulty walking or problems with bladder and bowel function. If you have been diagnosed with either of these conditions, choosing a highly specialized spine team is your best option for reducing your discomfort and regaining your function and mobility. 

We treat the full range of spine conditions, an important consideration because stenosis and myelopathy may result from degenerative disc disease, spinal arthritis, or trauma such as a spine fracture or spine cancer. Our surgeons are among the best in North Carolina and have particular expertise with decompression surgeries often used to treat stenosis and myelopathy. These procedures relieve the pain and pressure caused by pinched nerves.

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Duke Health offers locations throughout the Triangle. Find one near you.


Spinal stenosis treatment often involves very effective nonsurgical options, with surgery as a last option. With myelopathy, surgery is often necessary at the beginning.


Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which do not require a prescription, may be recommended. Your doctor may also recommend additional prescription-strength medications to treat damaged nerves caused by stenosis. A medication regimen is usually coupled with physical therapy.

Physical Therapy

You may work with your physician or a physical therapist in the community to learn exercises that can strengthen your spine, improve your balance and flexibility, and improve your posture -- all benefits that can alleviate your pain and the pressure on your pinched nerves.

Epidural Steroid Injections

These injections treat inflammation and pain right at the source -- your pinched nerve roots. We give these injections in a special suite. You may see your physician and receive your treatment on the same day.

Alternative Treatments

An acupuncturist on our staff can help reduce your pain. We also may recommend nontraditional supplements such as fish oil, which some people find effective. These treatments are offered as a complement to your regular treatment plan, not as a substitute.

Lumbar Decompression Surgery

Decompression relieves pain and pressure caused by pinched nerves and creates more room in the spinal canal. In some cases, a minimally invasive approach may be possible. Your doctor will recommend the procedure that's right for you. Lumbar decompression surgery includes:

  • Laminotomy/laminectomy: The doctor removes the affected lamina (back part of the vertebra).
  • Microdiscectomy: The doctor removes a small portion of the bone over the nerve root and possibly part of the disc under the nerve root.
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Your doctor will order one or more of the following tests to diagnose your condition:


Takes pictures of bones inside your body. X-ray pictures will show any areas of instability in your spine. Because X-rays only show bones, and not discs or nerves, another imaging test is usually needed.


Magnets and radio waves are used to take detailed pictures of your spinal discs and the nerve roots of your spinal cord.

CT Scan

A series of cross-sectional pictures produce detailed, 3-D images of your spine and spinal cord.

CT Myelogram

A dye is injected into the sac around the nerve roots in your spinal cord to help them show up better on a CT scan.

Electromyography (EMG)

Electrodes are inserted directly into muscle with a thin needle to record electrical activity. EMG tells your doctor how well muscles and nerve cells are working in a certain area of your body.

Duke University Hospital is nationally ranked in 10 adult specialties
Best Hospital for Orthopaedics, Neurosurgery in NC
Where you receive your care matters. Duke University Hospital’s nationally ranked orthopaedics, neurology, and neurosurgery programs were named best in North Carolina by U.S. News & World Report for 2019–2020.

Why Choose Duke

Surgical Experience
Surgery for these conditions -- for myelopathy in particular -- can be very challenging because they involve such a tiny, delicate area. Decompression surgeries are commonly practiced under a surgical microscope and involve the removal of bone spurs, disc material, and scar tissue surrounding the nerve roots or spinal cord. Choosing highly specialized spine surgeons with advanced training and skill means you have a safer procedure and better outcomes. We are one of the busiest spine centers in the area. We perform more than 1,200 spine surgeries and complex spine procedures every year.

Minimally Invasive Spine Surgeries
Many patients benefit from minimally invasive procedures, which rely on microscopes and tiny instruments to access the spine through small incisions. This technique avoids the need for significant muscle damage, results in less pain, and helps you recover faster. 

Intraoperative Imaging Technology
We are one of the few centers in the U.S. that offers advanced intraoperative capabilities with CT and MRI. That means our surgeons use detailed, 3-D pictures of your spine and the tiny nerves and roots of your spinal cord to guide them as they operate.

Specialized Team
In addition to our orthopaedic surgeons and neurosurgeons, our team includes nonoperative doctors and nurses, acupuncturists, a psychologist, pain management experts, and physical therapists -- all of whom may play a role in helping to alleviate the pain, pressure, and inflammation caused by your stenosis or myelopathy.

Personalized Therapy Plans
We offer effective therapeutic and nonsurgical treatment options. Your doctor will develop a personalized treatment plan for you that includes medication and/or injections with physical therapy. We also offer nontraditional options such as acupuncture.