Minimally Invasive Options for Spinal Stenosis

Spinal stenosis, or narrowing of the spinal canal, is a common cause of chronic back pain,  Depending on which region of your spine is affected -- most often in the lumbar (lower back) and cervical (neck) areas -- stenosis may also cause symptoms of weakness, tingling, and numbness or a sensation of heaviness in your arms or legs.

The hallmark of lumbar spine stenosis is neurogenic claudication which is numbness, pain or heaviness in the back and the lower legs with standing or walking, that improves with leaning forward and sitting.

Up to few years ago, our only options to treat lumbar spine stenosis were physical therapy, chiropractic, medications and epidural steroid injections for the milder cases or very invasive surgery for the more involved cases. Luckily new minimally invasive procedure and services have bridged the gap in between, and offer great results with very minimal risk.

Ayman Tarabishy, MD is the Medical Director of Enhance Center in Livonia, Michigan. This top-rated specialist is double board-certified in interventional pain management and physical medicine and rehabilitation.

Dr. Tarabishy also specializes in minimally invasive surgery for spinal stenosis and often recommends his patients consider its advantages over traditional surgery, or for patients that are not candidates for more invasive surgeries due to age and other health complications.  

What causes spinal stenosis?

Spinal stenosis refers to narrowing of the canal through which your spinal cord travels. It most often occurs when changes in the bony and soft tissue structures of the spine cause them to encroach on the spinal canal. This compresses the nerves in your spinal canal and results in nerve inflammation, irritation, pain, and problems with mobility that typically worsen over time.  

Very often, spinal stenosis is traced to degenerative changes that occur with the aging process, which may include:

Spinal injuries sustained during a trauma, and very rarely, a tumor growing within or near the spinal canal can also cause stenosis.

What is minimally invasive surgery for spinal stenosis?

There are several minimally invasive surgery methods available to address abnormalities in the spine. Dr. Tarabishy selects the preferred surgical approach according to the location and nature of your stenosis.

One very effective procedure, for instance, is minimally invasive lumbar decompression (MILD). This method is reserved for lumbar spinal stenosis (LSS), which is by far the most common location of spinal stenosis. LSS can cause significant pain with standing for more than a few minutes. Walking for more than 100 feet can become a painful chore when you have LSS.

MILD is an outpatient procedure that does not require a lengthy hospital stay. Most patients go home within a few hours of surgical treatment and can begin rehab light activities right away, which typically includes walking and physical therapy exercises.

The MILD procedure requires an incision about the size of a baby aspirin. Guided by imaging X-rays (fluoroscopy), Dr. Tarabishy uses specialized surgical instruments to remove pieces of bone and excess ligament from the spinal canal. This widens the canal and reduces pressure on the affected nerves, which relieves your back pain as well as the numbness, tingling, and sensation of heaviness in your legs.

Traditional LSS decompression surgery requires a long surgical incision and forcible retraction of the muscles and other soft tissue structures surrounding your spine. This trauma can take months to heal. With traditional back surgery, you may spend 3-4 days in the hospital and are at greater risks for postsurgical complications, such as bleeding or infection.

MILD avoids the complications of traditional surgery by simply removing the problem and leaving the normal spine supporting structures intact.

MILD has been studied in 13 clinical studies nationwide with impressive results which include low complication rates, the safety equivalence to an epidural steroid injection, and proven long-term outcomes. Over 20,000 cases have been performed and a Cleveland Clinic Study showed a 7X increase in standing time and a 16X increase in walking distance. Click here for study details.

As technology continues to advance, options for minimally invasive back surgery expand. In cases where MILD is not feasible due to a specific anatomy or prior surgery, some lumbar spinous process expanders can offer a lot of help and improvement with minimal risks, for instance, Dr. Tarabishy uses the StabiLink® system and a 2-4 centimeter incision to place supportive implants that don’t impact the spinal nerves. This procedure provides an advantage over traditional spinal fusion, where one of the risks is nerve damage and resulting pain.

Other options include Cofelx® and Vertiflex® decompression spacers can be considered, especially when MILD is not feasible.  

For all your back health needs, including minimally invasive options for spinal stenosis, schedule an appointment today at Enhance Center. Call the office or book your visit online.



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