Vertos Medical Clinical Publication

Pain Management Interventions in Lumbar Spinal Stenosis: A Literature Review

Source— Cureus Author— Kashif N. Malik, Curren Giberson, Matthew Ballard, Nathan Camp, Justin Chan Published August 25, 2023

Originally published in Cureus, this literature review summarizes the important findings pertaining to pain management of spinal stenosis. There are many potential causes of spinal stenosis, including developmental abnormalities (e.g., achondroplasia) or age-related degenerative changes, such as osteoporosis, osteoarthritis, disc degeneration, and spondylosis.

Lumbar spinal stenosis (LSS) occurs due to the narrowing of the space within the vertebral canal and or intervertebral foramina. This results in the compression of the spinal cord and possibly the roots of the spinal nerves. Lower back pain and neurogenic claudication (NC) are major symptoms of spinal stenosis.

This study aims to summarize the key management strategies in the management of LSS. Both invasive and non-invasive modalities were assessed by referencing twenty-four original articles. Conservative techniques include physical exercises, epidural corticosteroid injection, local anesthetic injection therapy, and oral analgesics. Surgical intervention deals with the decompression of the affected spinal region, with or without vertebral fusion surgery. Other novel surgical techniques include the implantation of specific equipment, known as interspinous spacer devices, and minimally invasive lumbar decompression, mild®.

The article concludes that non-invasive interventions can alleviate symptoms and have consistent evidence to support their use, while patients with severe symptoms and/or neurological deficits will often require surgeries. However, there are newer devices and procedures, such as mild®, that may allow patients to avoid the risks of surgery and experience symptom relief.

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