Your leg and back pain disappears when you are sitting, but quickly returns when you are standing and walking. The pain radiates down your leg, causing weakness, stiffness and numbness in your legs and buttocks. This pattern of pain is a classic sign that you may have lumbar spinal stenosis — it is time to see a pain management specialist.
Hess Panjeton, MD, is a Washington University physician who specializes in pain management. He explains, “Lumbar spinal stenosis is a degenerative disease that can occur in patients ages 65 years and older. As people age, the joints of the spine slowly start to break down. This degeneration can cause bulging discs, thickening of spinal ligaments, enlarged joints, and bone spurs.
These conditions reduce the amount of space around the spinal cord. When this spinal compression starts pinching nerves, the individual will feel shooting pain, numbness, tingling and/or weakness. This chronic lower back pain radiates down a patient’s extremities during prolonged standing and walking, but subsides when sitting.”
For patients who have not found relief from conservative treatments including rest, medications, physical therapy or steroid injections, there are other minimally invasive options.
MINIMALLY INVASIVE LUMBAR DECOMPRESSION or M.I.L.D is a procedure that increases spinal canal space by creating a tiny incision to remove small pieces of bone and ligament tissues in the spinal column. This space significantly reduces the pressure on the nerves and relieves the spinal nerve impingement.
The outpatient procedure is performed under local anesthesia and patients are able to resume normal activities within 24 hours which is significantly reduced compared to open back surgery. Patients are able to return to light activities within a few days, and resume usual activities with a few weeks.
SPINAL IMPLANT is an outpatient procedure performed under local anesthesia. It is designed to relieve back pain by restoring the normal space between the vertebrae, while preserving the range of motion in the lower back. Like the MILD procedure, it is an option for patients who have not had success with conservative treatments.
During the procedure an intervertebral spacer device is placed in between the spinous processes (the bony projection off the back of each vertebra) — spreading the compressed vertebrae apart and holding them in the proper position. Because this procedure restores the space between the vertebrae and where the nerves exit the spine, the pressure on the spinal cord and surrounding nerves can be relieved.
Dr. Panjeton adds, “It usually takes the body about six weeks to heal from this procedure, during this time the patient should take it easy. Most patients can resume light activity, such as walking, as soon as it can be done comfortably. The recovery process also includes physical therapy. For best long-term results, patients should exercise regularly (when cleared by doctor) and focus on improving core strength.”
To find out if you are a candidate for either of these procedures, for more information, or for an appointment, please call Dr. Panjeton at 314-966-8631.
Barnes-Jewish West County Hospital
Medical Building 4, Suite L4
1044 North Mason Road
Creve Coeur, MO 63141