What is spinal stenosis?
The spine is made up of an alternating series of bones (vertebrae) and discs. The vertebrae have holes that line up and the spinal cord passes through these holes and extends nerves out to the body to provide sensation and make the muscles move.
Spinal stenosis means that the central canal or opening where the spinal cord passes through has become narrowed. It happens most often in the neck or lower back (lumbar) and is often caused by either a bulging disc or bone growth from arthritis.
The symptoms of lumbar spinal stenosis depend on the severity of the narrowing but most with this narrowing have back, buttock or leg pain that worsens with standing or walking and improves with leaning forward slightly or with rest. Patients will classically report that if they lean on a grocery cart, they can walk a little easier or further than they would without that support. Additional symptoms can include numbness and tingling or even sharp, stabbing pains and in more severe cases, there can be weakness in the legs and even loss of control over the bowel and bladder.
What can be done to treat spinal stenosis?
A diagnosis must first be confirmed by a physical examination as well as either a CT scan or an MRI. Treatments will depend on the severity of the stenosis but will often begin with simple measures such as anti-inflammatory medications, anti-seizure medications, physical therapy and possibly pain medications. If these conservative measures fail, then steroid shots (epidural steroid injections) are often the next consideration. If you want more information on these, please click the link.
If epidural steroid injections are ineffective or are no longer effective, then minimally invasive options are generally the next consideration. These procedures include the Vertiflex implant or the minimally invasive lumbar decompression (MILD) which will be the subject of our next blog.
Vertiflex™ works for mild to moderate lumbar spinal stenosis that has failed to respond to at least 6 months of conservative treatments. It is a small implantable device made of titanium alloy that is inserted through an incision about an inch long. This is done as an out-patient, under deep sedation, and takes about an hour. More than one level can be treated but no more than two at one time.
Patients who benefit from this procedure are those whose symptoms improve with being bent forward. The implantable device essentially keeps the spine in this “bent forward” position but just at the one or two levels where it is needed rather than requiring the entire spine to be bent forward. So, you may be able to stand back up straight again! The procedure provides just enough extra space for the pinched nerves so that symptoms can be relieved.
The titanium alloy device is strong enough to last for years but can easily be removed if more invasive surgery is needed later. It is a good option for those with symptoms who prefer to avoid more major surgery or who cannot have more invasive surgeries because of other medical problems that make them poor surgical candidates.
How can I learn more?
Lumbar spinal stenosis is a common problem affecting an estimated 10% of the adult population. If you think that you are suffering from lumbar spinal stenosis and want to learn more about this procedure, call for an appointment today.
Lumbar spinal stenosis is not the only cause of low back and leg pain and Vertiflex is not the only treatment available. Your particular problem and treatment options can be determined by one of the experienced physicians at Pain Specialists of Oregon so call today.