There are multiple causes of spinal stenosis in the lower back. All of them can cause limited tolerance to standing or walking. Most people with spinal stenosis find that they can walk better when bending forward or leaning on a shopping cart.
Side view normal lumbar spine
Top view normal lumbar spine
Severe Central Canal Spinal Stenosis side-vie
Severe Central Spinal Stenosis top view of the area
marked by arrows in the side view picture
Central Spinal Stenosis due to thick ligament in the back of the central canal and at the exit canals
Inflamed Spinal Nerve due to compression
The usual treatment is surgery where an incision is made, muscles and tendons attached to the back of the vertebrae are disconnected and bone is removed. This is very invasive.
Disconnect the tendons, ligament and remove back part of the bone to decompress the nerves
There are minimally invasive options that can treat the structural problem causing the stenosis, which avoids standard surgical treatment. One method is to implant a spacer between the vertebrae to prevent compression on the nerves in the central canal and exit canals when the patient is standing up straight. This is the Vertiflex Superion technique.
Vertiflex Superion Implants of various sizes
Vertiflex Superion Spacer in position between the Vertebrae
By making more room for the nerves, function improves so walking distance and standing tolerance gets better. By keeping the vertebrae apart, there is more room for the nerves passing through and exiting from the narrowed canals. This procedure is performed through a small incision, using fluoroscope to guide the placement, as an outpatient, under local anesthesia with sedation or general anesthesia. Another minimally invasive method to treat spinal stenosis is to remove some of the ligament inside the back of the spinal canal, making the ligament thinner. This is accomplished without the disconnection of tendons, ligaments and removal of bone. This is the MILD technique (Minimally Invasive Lumbar Decompression). It is by Vertos Medical and has been available for nearly seven years.
Thinning the ligament in the back of the spinal canal
This method is also performed as an outpatient, using very small incision(s), under local anesthesia, using a fluoroscope to guide the technique.
Courtesy of Vertos Medical
Dr. Rogers and Dr. Boyajian have been performing these techniques since they have been FDA approved in the United States.s