What is the new procedure for stenosis?
Back pain is an extremely common ailment and one of its common causes is lumbar spinal stenosis, also known as LSS. For those who suffer with this condition, it is not a minor ailment, but one that seriously interferes with quality of life. Patients who have lumbar stenosis are unable to stand for longer than a few minutes, or walk more than a few hundred feet, without experiencing severe pain. For these individuals waiting on line in a store or taking the dog for a walk can be insurmountable obstacles.
Causes of Lumbar Spinal Stenosis
There are a number of possible causes of LSS. To understand these causes you have to understand the underlying anatomy. The spine (backbone) runs from the neck to the tailbone, forming a canal through which the spinal cord passes. The bones of the spine protect the more delicate tissues of the spinal cord. If the spinal canal narrows abnormally (stenosis), it causes nerve compression. When an individual with this condition stands or walks, the narrowing of the spinal cord increases and the pain intensifies. The low back pain of LSS is relieved by sitting or bending forward.
Some people are born with an unusually small spinal canal and are, therefore, congenitally predisposed to stenosis. More frequently, however, there are other reasons for LSS, including:
- Bulging discs
- Thickened ligaments
- Bone spurs (overgrowths of bone due to osteoarthritis)
- Herniated discs
- Tumors (uncommon)
- Spinal injuries, such as dislocations or fractures of vertebrae
Previous Treatments for LSS
For many years, there were only two options available to patients with lumbar spinal stenosis.
One was a conservative approach which included physical therapy, administration of oral nonsteroidal anti-inflammatories drugs (NSAIDs), and/or corticosteroid injections. The other was open spine surgery.
For many patients with the condition neither of these options were desirable. The conservative treatments often were only partially effective or made no difference at all in the patients’ pain levels. In patients for whom they were helpful, the relief they provided was usually temporary so repeated treatments were necessary.
The other option, open spine surgery, while it did work to relieve pressure on the nerves of the spine, also carried the risks inherent in any surgery as well as a significant period of recovery. Open spine surgery, like any surgery, was especially risky for older patients, the ones who were most often affected by the condition in the first place.
The New Option Is mild®
To the relief and gratitude of certain patients who suffer with LSS and the partial disability it involves, the new treatment known as “mild®” is a godsend. The name of this procedure stands for minimally invasive lumbar decompression. It is only appropriate for patients whose lumbar stenosis is the result of thickening of the spinal ligaments.
The Procedure Itself
During the mild procedure, the surgeon uses a special tool while guided by X-rays and injected contrast dye. The tool slides through a small opening between the bones to scrape out the excess ligament, thus widening the spinal canal. By widening the canal, compression of the nerve roots is reduced. This relieves the patient’s pain and increase the patient’s mobility.
Benefits of the Mild Procedure
One of the most important aspects of this procedure is that it does not disturb the fundamental integrity of the spine. Because the structure of the spine remains intact, recovery is typically quick. Patients can expect to return home within a few hours of the procedure and can almost immediately begin rehabilitative exercise which typically involves both regular walking and participation in physical therapy. So far, no major complications have been reported at follow-up visits after a year. Patients express pleasure at being able to return to a much more comfortable lifestyle after this simple lumbar procedure.