Lumbar Spinal Stenosis Treatment Options

The symptoms of lumbar spinal stenosis (LSS) are pretty clear: severe pain when walking more than 50 feet, and relief when bending over or sitting. And the cause is usually clear-cut, too; it’s another sign of aging.

The good news is there are effective outpatient surgical procedures available when physical therapy, chiropractic and other conservative measures have failed to ease the pain of spinal stenosis.

What is Lumbar Spinal Stenosis?

LSS is a degenerative condition that typically comes from a lifetime of the lower spine supporting the supper body. As people age, the discs between the vertebrae, or spinal bones, become worn down. This causes the spinal canal to slowly narrow, effectively squeezingthe nerves that exit the spine. This pressure often leads to tingling, numbness, or sciatic nerve pain that radiates to the buttock, leg and groin. It can be excruciating.

Lumbar Spinal Stenosis Back Pain Treatment

People with LSS typically cannot walk father than 50 feet without feeling this pain and find relief when sitting down or leaning forward. A typical scenario is the older person at the grocery store hunching over a shopping cart to relieve the pain.Left untreated, muscle weakness, loss of reflexes, and sometimes a condition called foot drop can develop.

The goal in treating LSS with surgery is to gently widen the narrowed opening in the spinal canal, giving the spinal cord and nerves more room to function normally. While injections of numbing medication can keep the pain away for a certain period of time, sometimes surgery is the best option.

Minimally Invasive Spine Surgery (MISS)

Skilled surgeons no longer need to treat low-back stenosis with traditional open back surgery, which involves a 5- to 6-inch incision and the cutting of muscles to reach the spine. Instead, specialists can use narrow dilation tubes that spread muscles like a curtain, and tiny endoscopic instruments outfitted with cameras. This approach avoids damage to muscle and tissue.

“A cut or torn muscle is essentially damaged forever. It becomes weak and never functions the same way again,” says Dr. James St. Louis, an orthopedic spine surgeon with Physician Partners of American Minimally Invasive Spine Group. “In minimally invasive spine procedures, the muscle fibers are left intact. There’s less bleeding and pain, and the recovery is days or weeks, not months.”

A laser maybe used in these procedures to ablate pain-causing nerves and shrink bulging discs that cause spinal stenosis.

Foraminotomy – This procedure increases the width of the intervertebral foramen, or opening between a pair of vertebrae in the treatment area. A small tool called a Rongeur is used to remove small slivers of spinal bone.It allows more room for the exiting nerve and alleviates the painful compression.Thisis a minimally invasive outpatient procedure that requires only two or three stitches and allows the patient to go home the same day.

Laminotomy – This procedure targets the lamina, the bony cover of the spinal canal. The surgeon removes a small part of the lamina to relieve pressure on the nerve exiting the spinal cord. In experienced hands, this procedure will not harm the structure of the spine.

Interspinous Process Spacers for Lumbar Spinal Stenosis

Another alternative to traditional surgery is a spacer, which helps keep spinal bones separated while the patient is standing. This small device, implanted by an experienced surgeon, relieves pressure on the spinal nerves. Its effectiveness has been validated by years of clinical research and is FDA approved.

While the idea of “back surgery” may seem scary, minimally invasive procedures are nothing like traditional open back surgery. They are highly effective and safe, allowing the patient to walk out of the surgery center the same day and heal quickly. Most people report a steep reduction in pain and some are immediately pain free.

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