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Patients

Frequently Asked Questions

What is lumbar spinal stenosis (LSS)?
Your spine provides support for your back and body. It also protects the spinal cord, the bundle of nerve tissues that runs from your brain to your lower body.

The bony channel that encloses the spinal cord is called the spinal canal. Usually, there is enough space between the spinal cord and the spinal canal so that the nerves that flow through and exit the spinal canal are free of obstruction.

As your body ages, however, the ligaments and bones outside the spinal canal can thicken. And as they do, they begin to press on the spinal canal, causing it to narrow. The narrowing of the spinal canal is called spinal stenosis. When that occurs in the lower part of the spine it is called lumbar spinal stenosis. This narrowing can cause the nerve tissues to become compressed or pinched, resulting in pain, numbness and disability.

LSS may be the reason you are experiencing nagging pain in your lower back - and why you may not be able to do some of the activities you used to enjoy.

What are options for treating LSS?
Non-surgical treatments include medication, rest, or physical therapy. Medications such as non-steroidal inflammatory agents, pain relievers, or corticosteroid injections are prescribed primarily to lessen pain. Physical therapy can help to increase flexibility and stabilize the spine.

Your doctor will often recommend non-surgical treatments first for LSS. But non-surgical treatments do not correct the conditions that cause LSS. They are used mainly for the temporary relief of pain. Many people find that they still have pain or that their pain and disability increases over time.

Most severe cases of LSS usually require surgery, which provides a more permanent solution to treating LSS. The goal of most surgery is to relieve pressure on the spinal cord and nerves by widening the spinal canal. This is referred to as decompression.

Most surgical options are invasive in the sense that a surgeon must first make a large incision into the back to allow room to operate. Through the incision in the back, the surgeon then uses instruments to trim or remove tissue or bone, or to realign the vertebrae as necessary. In other cases, the surgeon might implant a device, and/or fuse or stabilize areas of the spine that are contributing to the problem.

Surgery often requires general anesthesia and may involve lengthy hospital stays and long recovery times.

 

Newer therapeutic options, like Vertos Medical's mild procedure, are also available, offering a safe alternative to the surgical options mentioned above. The mild procedure allows the surgeon to operate with a very small incision, using a set of proprietary devices to gain access to the affected area of the spine to restore space by decompressing the area of spinal stenosis.

Who suffers with LSS?
LSS most often results from normal wear-and-tear on the spine as we age. The condition is usually first seen in people over 50, and the likelihood increases as we age further. It is estimated that about 10% of people 65 and older have LSS, making it a fairly common condition. LSS affects all types of people, including those that have had a healthy and active lifestyle.

Is lower back pain the only symptom of LSS?
Lower back pain is the most common symptom of LSS, but there are others. See the list below and check with your doctor:

  • Lower back and leg pain.
  • Pain or cramping in your legs, particularly when standing for long periods of time or when walking
  • Numbness, weakness, or a tingling sensation in the legs or feet
  • Problems controlling bladder or bowels (usually seen in more severe cases of LSS)

How is LSS diagnosed?
In addition to taking a medical history, other exams and tests may be performed to verify your condition. These may include:

  • Physical examination
  • X-Ray
  • Bone scan
  • CAT Scan (Computerized Axial Tomography)
  • MRI (Magnetic Resonance Imaging)
  • Myelogram (Spinal Canal X-Ray)

Are there any specific risk factors for lumbar spinal stenosis?
Lumbar spinal stenosis is a degenerative process that can affect anyone. However, some people are at greater risk than others. Those with a congenitally (who are born with) small spinal canal are at an increased risk as they age. Sometimes one vertebral body will slip forward relative to its adjacent vertebral body. As the vertebra slips forward, the canal narrows and this can accelerate the degenerative process that produces LSS.

What can happen if I do not treat my LSS?
LSS does not go away on its own. Left untreated, pain and discomfort may increase over timeand it may become increasingly difficult to enjoy activities that require mobility, including walking short distances.

How long does the mild procedure take?
The mild procedure is minimally invasive, so it is easier on both the patient and the physician. In most cases mild can be performed in under an hour.

Can the mild procedure be done under local anesthesia?
This is up to the physician, but in most cases, the mild procedure is performed under local anesthesia or under monitored anesthesia care (MAC).

What are the potential benefits of the mild procedure?
mild is a therapeutic option that provides an alternative decompression treatment to address the cause of pain in patients with LSS. It can be done in an outpatient setting under local anesthesia or MAC support. Operation and recovery times are generally reduced compared to more invasive surgical procedures where the patient enters a physical rehab/therapy program shortly following the procedure.

Potential benefits of the mild procedure include:

  • Less chance of infection and other complications associated with major back surgery
  • Minimal discomfort during surgery, with most procedures done under local anesthesia
  • Limited hospital stay - usually one day at the most
  • Reduced recovery time versus other more invasive surgical options
  • May prevent or delay the need for more invasive surgical interventions