LSS is a gradual narrowing of the space in the spine where nerves pass through. The narrowing of the space can cause a “pinching” on the nerves in the lower back which can result in an aching, dull pain spreading down the buttocks and into the legs. LSS is a natural, degenerative condition and is most often the result of aging and “wear and tear” on the spine from everyday activities. This condition affects more than 14 million Americans and is usually common in adults age 60 or older. If left untreated, LSS can worsen over time, significantly restricting a person’s mobility and quality of life.


Symptoms & Causes

  • Pain while walking
  • Numbness or “tingling” feeling in the legs, calves, and/or buttocks
  • Weakness and/or loss of balance
  • Decreased endurance during physical activities
  • Aching dull back pain spreading down the buttocks into the legs
  • Relief when leaning or bending forward
  • Using a cane,  walker, or shopping cart to move around more comfortably
  • Frequently needing to lean/bend over or sit down

LSS is a natural, degenerative spine condition due to age and “wear and tear” from every day activities. Sometimes it can be caused by trauma and even more rarely by genetics, but most are at risk for LSS simply from the wear on our backs over a lifetime of activity. It can occur at any age, but is most common in adults age 60 and older.


Risk Factors

Testing & Diagnosis

  • During a consultation, your doctor will ask you questions about your symptoms. Specifically what they are, when they occur, and how disruptive they are. They will also ask you about what makes your symptoms feel better.
  • Your doctor may also do a physical exam to see how you stand or move. This usually includes standing up straight, walking, and bending forward.
  • Depending on the results from your consultation, your doctor may request pictures of your spine with an MRI or CT-Scan and X-Ray to determine the diagnosis and discuss what treatment options are available.

Treatments

Conservative care is the first treatment for almost all patients. This includes options such as physical therapy, over-the-counter medicine or braces. Unfortunately in many cases, these treatments do not provide enough relief.


Epidural Steroid Injections are another treatment option in which a steroid is injected into the local area that is causing the symptoms. Injections do not change the narrowing of the space that pinches the nerves but it may be able to quiet the pain from the pinched nerve for some patients.


The Vertiflex® Procedure is a small spacer that prevents the opening around the nerves in your lower back  from getting compressed when you stand up straight or walk. This spacer is placed under the skin between the bumps you can feel on your spine. It is placed through a small tube about the size of a dime.


Laminectomy with or without spinal fusion is a surgery under general anesthesia that removes some of the tissues that are pinching the nerves in your lower back. Once those tissues have been removed there is more space for your nerves and the symptoms disappear. This surgery may be performed through an incision that opens the back or with tools that go through smaller holes in the skin to get to the tissues of the spinal column. Most of the time, these surgeries are reserved for patients whose LSS has not been diagnosed or treated earlier and is now severe. These surgeries have been shown to have longer recovery times and may have other complications, but produce good results with stenosis symptoms.


Outcomes/Recovery

  • Conservative care results vary greatly, while steroid injections have been shown to provide a few weeks or months of relief for about 50% of patients.
  • The Vertiflex® Procedure was studied in hundreds of patients before the Food and Drug Administration approved the product, and it has now been performed on thousands of patients in the U.S. Over 80% of patients have reported success with the procedure overall, with a 75% improvement in leg and back pain. More than 75% of patients have been able to return to the activity they most missed because of their pain and discomfort. Most importantly many patients have been documented to experience  continued relief for five (5) years.
    • Patients leave the medical center within a couple of hours, there is no overnight stay required, and normal activity can resume within a few weeks. One caution is that the reduction in back and leg symptoms  may lead to too much activity too soon. The body needs time not only to heal from the procedure but to rebuild strength and endurance to levels that will support previous activity levels. Gradually build back into your desired activities.
    • More specifically: recovery time for each patient can be different so it’s important to always follow your treating physician’s instructions regarding activity restrictions. It’s recommended that for 6 weeks after the procedure, limit all strenuous activity.
  • Laminectomy with or without spinal fusion has also been well studied and shown to provide relief in many instances. It is primarily aimed at patients whose condition is severe. Recovery times in the hospital vary by procedure type.