Spinal stenosis is a condition in which the spinal canal is narrowed. Spinal stenosis can decrease blood flow to the nerves exiting the spinal cord, causing “neurogenic claudication,” a medical term used to describe the pain in the arms and legs associated with spinal stenosis. Any condition that decreases the space in the spinal canal can lead to spinal stenosis. These include disc herniation, facet arthropathy, degenerative disc disease, and bony overgrowth. Ligamentum flavum hypertrophy may also lead to spinal stenosis as the redundant and thickened ligament encroaches upon the spinal canal. Spinal stenosis affects millions of people throughout the world and is estimated to affect over 2 million Americans by 2021. The elderly are particularly prone to developing cervical and lumbar spinal stenosis as a result of aging process in the spinal canal.
The symptoms of spinal stenosis vary depending on the region of the body that is affected. Cervical spinal stenosis may cause neck pain and arm pain. Lumbar spinal stenosis may cause low back pain and leg pain that is worse with walking. Typically, the symptoms of lumbar spinal stenosis are exacerbated by walking and sitting. The “shopping cart” position, in which the back is flexed forward typically relieves the pain associated with lumbar spinal stenosis. More serious signs of spinal stenosis include weakness, numbness, balance problems or loss of bowel or bladder control. These require immediate medical attention to prevent permanent spinal cord damage.
Treatment for symptomatic spinal stenosis begins with conservative therapy, including non-steroidal anti-inflammatories, analgesics, muscle relaxants and adjuvant treatments such as physical therapy or acupuncture. Epidural steroid injections(link to epidural page) have also been shown to be of benefit in treating refractory spinal stenosis. The epidural steroid injection acts to decrease inflammation in the spinal canal that is contributing to spinal stenosis symptoms. If epidural injections fail to relieve the pain associated with lumbar spinal stenosis, your pain management doctor may recommend a revolutionary non-surgical treatment for spinal stenosis known as MILD or minimally-invasive lumbar decompression.
Minimally-Invasive Lumbar Decompression (MILD for short) is a cutting edge non- surgical treatment option for lumbar spinal stenosis. MILD is performed on an outpatient-basis, with patients typically going home within one hour after the procedure. Minimally-Invasive Lumbar Decompression is an attractive alternative to spine surgery in patients who may not tolerate the effects of surgery or general anesthesia. This is particularly relevant for elderly patients, who often have multiple medical comorbidities, rendering them unsuitable candidates for surgical decompression.