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  • Dr. Payne

    Minimally Invasive Approach Treats Spinal Stenosis. Another WellMoment brought to you by WellGroup HealthPartners Often referred to as a pinched nerve in spine, lumbar spinal stenosis is a gradual narrowing of the space where nerves pass through the spine. Conditions that may bring about spinal stenosis are aging, arthritis, a slipped vertebrae, or general "wear and tear."

The most common symptom of spinal stenosis is a shooting pain down the back of the legs when walking. Additional symptoms may include numbness and tingling in the legs, calves or buttocks; decreased endurance during physical activities; weakness and loss of balance; and decreased standing tolerance.

Spinal stenosis typically worsens over time and an increase in severity may make surgery more complicated or difficult. If left untreated, patients may experience increased pain or, worse yet, nerve damage that leads to permanent pain, weakness or loss of sensation.

A physician will perform a physical examination followed by tests to diagnose spinal stenosis. An x-ray can help rule out things such as a fracture, tumor, or infection that may be causing the symptoms. It will also indicate the integrity of the bone. An MRI is performed to show the disc, the nerve and spinal sac and to enable the doctor to see how badly the nerves are being pinched.

Once diagnosed, the initial course of treatment includes physical therapy and strengthening exercises, rest and restricted physical activity, corticosteroid injections, and medications and analgesics to reduce pain and swelling. If conservative measures fail to bring appreciable relief, one minimally invasive procedure that can be used to treat spinal stenosis is ILIF or Interlaminar Lumbar Instrumented Fusion.

ILIF was developed as an alternative to standard lumbar spinal stenosis treatments and can be done as an outpatient procedure. Patients who need to have the procedure performed on more than one level of the spine will require a one-day hospital stay.

In ILIF, the patient receives a general anesthetic and a small incision is made in the back. The surgeon uses a surgical tool to open up the space between the two spinous processes, which are the "shark fins" on a person's spine. A bone spacer made of donor bone is placed between the two vertebrae to create more space for the nerves, and a plate is affixed to hold the spacer in place.

With this highly successful procedure, appropriately selected patients can expect several years of relief. If you suffer from spinal stenosis symptoms, ask your doctor if you might be considered for ILIF. While not all patients are good candidates for ILIF, there are many different minimally invasive applications that can be performed.

William Payne, MD, is an Orthopedic Surgeon at WellGroup Health Partners in Chicago Heights.