Q: What is a laminectomy, and is it the best option for spinal stenosis?

Dr. Christopher Taleghani, Neurosurgeon, Maui Brain and Spine: Laminectomy is a type of spinal surgery. It’s commonly used to treat back pain, including spinal stenosis, a condition that occurs when the canal in your spinal column narrows over time. The most common causes of acquired (developed after birth) spinal stenosis includes bone spurs, overgrown ligaments and overgrown joints. During a laminectomy, the surgeon will usually remove all three. This helps stop them from pressing on the spinal cord and nerves, relieves pressure in the spine and opens up more space in the spinal canal.

Bony growths in the spine can be caused by arthritis, or they can just be part of normal aging. In addition to causing back pain, they can cause pain and numbness to radiate down the arms or legs.

As many as 70 to 80 percent of patients who undergo laminectomy surgery report improvement or relief from their symptoms. However, because the surgery doesn’t fix the underlying cause of spinal stenosis, symptoms sometimes return as the condition progresses over time.

Often your doctor will recommend trying other options to treat back pain before turning to surgery. Other treatment options for spinal stenosis include physical therapy to improve flexibility and strengthen stabilizing muscles. Over-the-counter and prescription medications can help manage pain, reduce inflammation and treat nerve pain.

Other medical options include corticosteroid injections directly into the area around the spinal cord, to reduce inflammation and pain. Nerve blockers can also be injected into the area, reducing pain from damaged nerves.

However, if these other treatments don’t help, or if your symptoms are severe, it might be time to consider surgery. Talk with your doctor about what treatment approach is right for you.

Maui Brain & Spine’s neurosurgery program at Maui Memorial Medical Center Outpatient Clinic offers world-class care right here on the island, including minimally invasive spine surgery. For more information, contact the Maui Memorial Medical Center Outpatient Clinic at (808) 442-5700 or visit mauihealth.org/neurosurgery.

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Q: What are the stages of grief and how long do they last?

Dr. Fatima M. Imara, Behavioral Health, Pacific Permanente Group: Grief is an inevitable response to loss, and it can involve a range of uncomfortable emotions, from sadness to anger. While everyone handles loss differently, grief researcher Elisabeth Kübler-Ross described five common stages people go through during the grieving process:

• Denial. It may feel like the loss isn’t real. You might avoid thinking about it, or pretend everything is normal.

• Anger. Anger is normal. You might blame others or yourself for what happened, or you might feel irrationally angry towards people for no apparent reason.

• Bargaining. Bargaining can involve dwelling on how things might have been different, thinking about how you can reverse the loss, or focusing on “if only” thinking.

• Depression. You might feel deep sadness and sorrow, as well as other symptoms of depression, like loss of focus, changes in sleeping or eating, or even physical pain.

• Acceptance. Acceptance means learning to live with the loss, acknowledging both sadness and positive memories of the past.

While many people find the framework of the five stages helpful to their healing process, it’s important to know that these are just descriptions. Not everyone goes through all the stages, and the stages might look different for different people. Some people experience the stages in a different order. Your healing journey will be unique to you.

Along the same lines, everyone takes a different amount of time to grieve. For most people, the process of grief unfolds within the first two years after a loss.

However, if you experience intense, prolonged grief that interferes significantly with your ability to function, you may be going through “complicated grief.” Talk to a doctor or mental health provider about getting professional support as you move through the grieving process.

* Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.