Spinal stenosis is a pain condition that affects an estimated 500,000 people in the U.S. While some cases are mild and have little impact on daily life, other people experience debilitating pain and limited mobility. If you or someone you love is suffering, these are some of the best treatments for spinal stenosis.

What is spinal stenosis?

Spinal stenosis is a narrowing of the spine that occurs most often in the lower back (but can also occur in the cervical spine). This narrowing eventually begins to crowd the spinal cord and nerves in the spinal column. When this happens, radiating pain and mobility issues can quickly follow.

People over 65 are most at risk for spinal stenosis, but scoliosis and hypertension can contribute to its development also. The primary symptoms of spinal stenosis include:

• Radiating pain (called sciatica when it occurs in the lower back)
• Numbness or tingling in the arms, hands, legs, or feet
• Weakness in the extremities
• Neck pain (in cervical spinal stenosis)
• Clumsiness in the arms and hands (in cervical spinal stenosis)

If nerve compression is severe and untreated, it can lead to loss of bowel and bladder control, permanent damage, or even paralysis.

What are the best treatments for spinal stenosis?

The best spinal stenosis treatments are as individual as the person with this pain condition. There is no one miracle treatment that works for everyone. The best results occur when multiple treatments are put into place together.

Here’s where to get started, along with answers to frequently-asked questions.

Is walking good for spinal stenosis?

While some people might want to hit the couch when the pain of spinal stenosis comes on, a better idea is to lace up your shoes and hit the road. Walking is a full-body, low-impact exercise that improves overall health. The benefits of walking — especially in nature, if you can manage it — are countless.

• Group walks play a role in “undoing” the stressful effects of chronic pain
• Walking can ease anxiety and depression, which helps in treating pain conditions
• Exercise is not only good for spinal stenosis — it can provide the same level of pain relief as medication
• Walking not only decreases pain; it also increases quality of life

Walking is free, low-impact, available to most everyone, and a great primary treatment for spinal stenosis.

Stretches for spinal stenosis

Want one of the best spinal stenosis treatments that doesn’t cost a thing and is available to anyone at any level of fitness? Stretches. Targeted spinal stenosis exercises can help lengthen the spine and relieve pressure on your nerves.

Flexion exercises in particular decreased pain and lowered the risk of disability in people with spinal stenosis. Core stability stretches and exercises also resulted in an increase in walking capacity.

Flexion exercises bring space between the vertebrae, and core stability exercise helps build muscles to keep that space open. These exercises are portable, requiring little to no equipment, and can be done wherever you have space.

Yoga for spinal stenosis

For lower back pain, yoga is hard to beat. Yoga builds long, strong muscles and a tall, graceful spine. When it comes to yoga for spinal stenosis, research is growing.

• For both neck and lower back pain, Iyengar yoga outperforms other interventions when it comes to short-term pain relief and mobility
• Stretching in yoga improves gait, decreases pain, and increases well-being and the ability to deal with the mental aspects of pain

Overall, yoga is a great way to relax and manage the physical, mental, and emotional sides of chronic pain.

Back brace for spinal stenosis

In your everyday life, a simple back brace for spinal stenosis can be a lifesaver.

Note: This treatment does not work to fix the underlying mechanical issue; it’s a comfort measure that you can put in place as your back heals.

Acupuncture for spinal stenosis

How could medical practitioners working over 3,000 years ago have developed a treatment for spinal stenosis? Instead of looking only at symptoms, traditional Chinese medical doctors viewed the body as a whole, with energy lines called meridians running through it. When one of these lines becomes blocked, the energy (or Qi, pronounced “chee”) cannot flow. This causes pain and disease. Using hair-thin needles, acupuncture targets specific points in the body to release stuck Qi.

Western medicine has found that acupuncture creates a neurological healing response. It’s not well understood exactly how acupuncture works, but in a 2018 study, people receiving acupuncture for spinal stenosis had less pain and better physical function than the exercise and medication groups.

As a standalone therapy for sciatic pain, acupuncture relieved pain in a majority of patients in another 2015 study. Because sciatica is one of the primary symptoms of spinal stenosis, this is a promising result.

Massage for spinal stenosis

Massage for spinal stenosis does not have much focused research, but there is evidence that massage can help for non-specific lower back pain. One study found that weekly massage over a ten-week period provided pain relief for up to six months.

Other studies have supported this finding. It may be that massage therapy increases circulation in the area being massaged. Better circulation is associated with faster healing.

Another potential reason for massage’s healing touch is the relaxation and stress relief that massage provides. Struggling with chronic pain is exhausting. Massage offers a chance to get away from that struggle, one hour at a time.

Can a chiropractor help with spinal stenosis?

It makes sense to turn to a chiropractor when it comes to the structural integrity of the spine. After all, a chiropractor’s work focuses on correcting alignment in the spine that leads to pain or disease.

Since it is common to see a chiropractor for sciatica, it stands to reason that regular visits to the chiropractor can help with spinal stenosis.

Physical therapy for spinal stenosis

While all of the above treatments can have a positive effect on spinal stenosis, a 2019 study found that the biggest improvements occurred in those participating in physical therapy.

Why?

Working with a physical therapist means that exercise is specifically targeted to you and your particular condition. Of course it’s beneficial to move your body, but a physical therapist takes into consideration your starting point, the condition you are trying to improve, and other lifestyle factors or underlying health conditions. They can then develop specific exercises, just for you, and teach you how to do them properly.

This also gives you the most bang for your exercise buck — no more sloppy planks or half-hearted stretches when your physical therapist is standing next to you!

Physical therapy is another way to re-learn how to use your body in support of good health. And it just so happens to be one of the best treatments for spinal stenosis — one study in 2015 found that physical therapy had better outcomes than surgery when treating spinal stenosis.

Injections for spinal stenosis

One of the most challenging things about spinal stenosis treatments is that the person in pain is sometimes so debilitated that nothing has a chance to improve. Pain levels make it impossible to begin exercise or physical therapy. That’s where injections for spinal stenosis can help.

Injections for spinal stenosis consist of a corticosteroid to control inflammation and an anesthetic injected into the area above the affected nerve. This injection does not correct the underlying spinal stenosis, but it does give the person in pain some relief so that other treatments can begin.

Research has found that epidural steroid injections have both short- and long-term benefits in terms of pain relief and mobility. For people concerned about the side effects of corticosteroids, another study found that lidocaine-only injections offered the same benefits as lidocaine and a steroid.

While many people use injections as a long-term pain solution, others might receive only one or two in combination with other spinal stenosis treatments.

Vertiflex procedure for spinal stenosis

The Vertiflex procedure for spinal stenosis (also called the Superion® implant) is a new way to increase the space between the vertebrae — space that may collapse as spinal stenosis progresses.

This new procedure uses a small spacer inserted between the spinous processes (those bumps you can feel on your back). This spacer relieves pressure on the nerves, which in turn relieves pain and other symptoms of spinal stenosis.

In a long-term study of the Vertiflex procedure for spinal stenosis, 90% of study participants were pleased with their pain relief. Another study found that people were able to reduce their opioid intake by 85% after the Superion® implant was placed. All of this research builds on one of the very first studies — a two-year look that found pain score improvements similar to the usual first-line treatment of spinal stenosis.

This procedure is considered minimally invasive and only takes about 30 minutes. It can be a good option for people who are not finding relief from more conservative treatments but who also would like to avoid surgery.

Surgery for spinal stenosis

The big question: should I have surgery for spinal stenosis?

Surgery is generally a treatment of last resort, only suggested in cases where other measures have provided no relief (or when symptoms are getting worse). There are several different types of surgery that can help severe cases.

• Laminectomy: This involves removing part of the vertebrae (and potentially bone spurs and ligaments) compressing the nerves
• Laminoplasty: Laminoplasty is for cervical spinal stenosis, removing part of the bone and inserting plates and screws to maintain space
• Foraminotomy: Nerve roots exit the vertebra through the foramen, and this surgery removes bone to make more space there

Spinal fusion is offered when other surgeries and treatments have not helped maintain the space in the spine. This procedure joins two or more vertebrae to create stability and prevent further compression or deterioration in the spine.

New spinal stenosis treatments

The LimiFlex clinical trial has been in progress since 2017 and is focusing on a new type of spinal fusion. This treatment is specifically for people with spinal stenosis as a result of degenerative spondylolisthesis. The study will follow participants for five years, so this treatment is still on the horizon.

Another systematic review examining the safety and effectiveness of acupotomy has been underway since 2019. Acupotomy is a form of acupuncture that uses a scalpel-like needle to break up more muscle adhesions. Researchers hope to find a treatment for spinal stenosis like this that is less invasive and has fewer potential risks.

Rounding out potential spinal stenosis treatments is stem cell therapy. Injecting mesenchymal stem cells derived from adult fat and bone tissue may help repair damage done by spinal stenosis. This treatment focuses on repairing the cause of pain, not just treating symptoms.

These treatments may not be available yet, but talk to your doctor to learn more.

Find help for your spinal stenosis pain 

What are the best treatments for spinal stenosis?  The ones that work for you. This might be a combination of several treatments working together to relieve pain, increase mobility, and improve your quality of life.

You don’t have to live in pain. If you are looking for the best treatments for spinal stenosis, Arizona Pain can help you get your life back. Get in touch today.

Spinal stenosis is a chronic pain condition that can have a big impact on your life. Pain from this condition can make taking even a single step challenging. If you have tried other treatments options and they’ve been unsuccessful, the Vertiflex procedure for spinal stenosis (also referred to as the Superion® implant) is a ground-breaking new way to ease pain, increase mobility, and help you get your life back. Here’s what you should know.

What is the Vertiflex procedure for spinal stenosis? 

Spinal stenosis is a chronic degenerative condition that most often effects the lower back. With age, injury, and gravity, the spinal column begins to collapse and narrow. Eventually, this narrowing begins to pinch your nerves in the spinal column, including the sciatic nerve.

The sciatic nerve is the longest, widest nerve in your body. It carries sensation and movement all the way down to the toes. It starts at the lumbar spine (the lower back) on both sides of the body and runs across the buttocks to the outside of the hip and all the way down the leg to the feet.

When spinal stenosis causes pressure on the sciatic nerve, you might experience symptoms that include:

• Sharp pain anywhere along the nerve (e.g. lower back, hip, leg, feet)
• Tightness in the calves
• Weakness in the legs and feet
• Numbness, tingling, and pins-and-needles in the legs and feet
• Poor balance
• Difficulty walking
• Pain that worsens when sitting or standing for long periods

Without treating the underlying cause and relieving pressure on the sciatic nerve, symptoms will only worsen. They can even become permanent.

The Vertiflex procedure for spinal stenosis is a procedure that can help. During it, your doctor places a small spacer in the spine without removing any tissue or bone. This spacer lives up to its namesake, creating space in the spine and relieving pressure on sensitive nerves.

It’s located between the spinous processes—the bumps you can feel on your back. This spacer prevents the vertebrae from collapsing in on each other when you sit or walk. The Vertiflex procedure for spinal stenosis automatically creates the same space in your spine (and relief you feel) as when you bend over to ease the pain in your lower back.

Learn more about this procedure in the following video.

Why is this treatment approach so important? 

Severe spinal stenosis can have a devastating effect on your life. When every movement causes pain, the simplest daily tasks become nearly impossible. And when you cannot even rest at night because of the pain, your ability to deal with the challenges of every day decreases.

In case after case, the Vertiflex procedure for spinal stenosis has helped people get their life back. It relieves pain and preserves the structure of the spine. Because the Vertiflex procedure for spinal stenosis does not remove any spinal material, it is considered minimally invasive and has a shorter recovery time than more invasive procedures, too.

This treatment is also reversible. If the spacer is no longer needed, it can be easily removed, leaving the spine, its discs, and the muscles surrounding it intact.

Vertiflex procedure benefits and research 

The research supporting the Superion® implant for spinal stenosis is growing. A two-year study of the Vertiflex procedure for spinal stenosis found that pain scores improved for 75% of patients. These results are similar to the previous gold standard of care for spinal stenosis: the laminectomy.

Another five-year study found that 90% of patients were satisfied with their pain relief after their Vertiflex procedure for spinal stenosis.

And in even better news, another study in 2018 found that 85% of patients who received a Superion® implant for spinal stenosis reduced their opioid intake (or stopped taking opioids altogether).

Another benefit is not the focus of study but has been confirmed by patients and doctors.  Because there is no need to remove bone or compromise muscle, recovery time is much quicker. There is no need for hospitalization, and patients can leave the surgical center within hours of the procedure (instead of suffering through a multi-day hospitalization).

With full approval from the U.S. Food & Drug Administration after rigorous testing, the Vertiflex procedure for spinal stenosis is a safe and effective treatment option.

Am I a good candidate for the Vertiflex procedure?

If you have lumbar spinal stenosis that has not responded to more conservative treatments, you may be a good candidate for Superion® for spinal stenosis. Other people who might benefit from this procedure include:

• Patients who are not healthy enough for major surgery, or want to avoid surgery altogether
• People looking for a shorter recovery time
• Those who want to keep the mobility in their spine
• People who want a reversible procedure

If your severe spinal stenosis is not improving, and laminectomy or spinal fusion has been suggested, you might be a good candidate for the Vertiflex procedure instead.

Hear from our own Dr. Paul Lynch about the benefits of this approach.

Potential Vertiflex complications and risks

If you are getting good results from conservative treatment of your spinal stenosis (e.g. exercise and complementary therapy), you may not need this procedure. Likewise, if your spinal stenosis is mild, you may not require any kind of intervention.

This procedure is also not recommended for children — your spine must be mature and complete. Other instances where the Vertiflex procedure may not be indicated include:

• When there is a diagnosis of cauda equina
• If a patient has severe scoliosis, spondylolisthesis, or degenerative spondylolisthesis
• In the presence of morbid obesity
• In vertebrae with osteoporosis
• With an active systemic infection
• In those with an allergy to titanium or titanium alloy
• In a spine that is unstable and could cause the implant to be unstable

Vertiflex complications are rare, and typically do not occur as a result of the implant itself but are possible with any procedure that involves a surgical incision. These complications can include:

• Damage to nerve roots
• Spinous process fracture
• Allergy to the implant material
• Complications that arise from the procedure (e.g. infection)

Talk to your doctor for a complete understanding of the potential benefits, risks, and complications of the Vertiflex procedure for spinal stenosis.

What to expect during the procedure 

As always, working with your doctor is the key to a successful procedure. They can answer all of your questions and provide you with a better picture of the procedure (and recovery).

Here are some basics as to what to expect before, during, and after your procedure.

Procedure prep

To get ready for your procedure, you will generally stop taking any blood-thinning medications. Ask your doctor if you should also stop taking other over-the-counter medications, prescriptions, or supplements.

The Vertiflex procedure for spinal stenosis is an outpatient procedure that does not often require general anesthesia. If you know you would like to be completely “out” for any type of procedure, talk to your doctor about what that means for you. You might have to stop eating and drinking the night before.

The procedure itself

The Vertiflex procedure itself takes less than 30 minutes. You’ll lay face down on the examination table. The procedure area is cleaned and sterilized, and a topical analgesic is applied. Once the skin is numb, a local anesthetic is injected to numb the entire area.

Your doctor then makes a small incision in the area where the Vertiflex® interspinous spacer will be placed. They may use X-ray (fluoroscopic) guidance for this. In some cases, more than one spacer will be inserted, but the incision is still very small. The implant’s small arms project out and hold it firmly between the vertebrae.

After the implant is placed, the surgical incision is closed, and you’re done! After a brief stay in recovery, you will then be free to leave.

The vast majority of patients report a pain-free procedure, even with a simple local anesthetic. If you are concerned about pain, talk to your doctor about options. This might include a mild sedative taken before the procedure, twilight anesthesia, or even general anesthesia.

Recovery

The Vertiflex recovery time is swift and relatively painless, especially when compared to other surgical treatments for spinal stenosis. Take it easy on the day of your surgery and let your pain levels be your guide after that (with exceptions — see below!).

Have someone drive you home. You can immediately resume your normal diet. Ask your doctor about resuming your regular medications.

Aftercare instructions

It’s normal to have soreness at the surgical site after the procedure. This can be treated with over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) and should feel better in a day or two.

Keep the stitches or staples closing the surgical site clean and dry. This may mean sponge baths until your follow-up appointment. Do not take baths or showers or go swimming while the staples or stitches are still in place.

If the surgical area becomes hot, red, painful, or begins to ooze, talk to your doctor. This can be a sign of infection, as can fever or a feeling of being unwell.

The most crucial instruction after your Superion® procedure for spinal stenosis is to avoid vigorous activity for six weeks. This means no bending, twisting, or lifting anything over ten pounds. Sports that include any of these motions are to be avoided, as is sexual activity. Many people feel so much relief after their procedure that they find it hard to take it easy. Resist the urge for vigorous exercise and simply enjoy being symptom-free.

If you are craving some activity, gentle walks are okay. Talk to your doctor about other forms of exercise that may be allowed. There is no need to remain in bed for the recovery period, and a little movement can help boost your mood and help you heal.

Other spinal stenosis treatments

There are other treatment options for spinal stenosis, including complementary therapies that can complement interventional procedures.

Complementary therapies

Acupuncture and biofeedback are two common complementary therapies for spinal stenosis.

Chinese medical doctors believe that acupuncture works to open blocked channels in the body. These blocked channels can cause pain and disease. In modern Western medicine, doctors use acupuncture to stimulate the brain’s healing capacity in the area being treated.

Biofeedback is another complementary therapy that is helpful in dealing with the mental aspects of pain. It helps people to recognize physical symptoms of pain and trains them to slow their response. This does not directly treat the cause of pain, but it helps patients cope.

No side effects are associated with either of these therapies, which makes them ideal when paired with other treatments.

Spinal cord stimulation

If you have severe pain, spinal cord stimulation does not treat the mechanical structure of spinal stenosis but can help relieve your pain. A mild electrical current blocks pain signals to the brain and can provide profound relief.

Adhesiolysis

Adhesiolysis removes built-up scar tissue that further narrows the spinal column and increases pain.

Surgery

A laminectomy or foraminotomy is another treatment option for spinal stenosis. These surgeries are more invasive, but they can provide profound relief when other treatments have not been effective.

Integrated pain management at Arizona Pain

Spinal stenosis can have a debilitating effect on your life, but you don’t need to live with pain. At Arizona Pain, we believe in integrated and comprehensive pain management. If you are suffering from spinal stenosis that has not responded to treatment, schedule an appointment with our doctors!

The Vertiflex procedure for spinal stenosis is just one treatment option — we’ll work together to design a comprehensive treatment plan that can help you get your life back.

Get in touch today!

Recently, a study was published in the New England Journal of Medicine that focused on the efficacy of steroids in epidural spinal injections for spinal stenosis pain. We posted our response to the article earlier here.

The New England Journal of Medicine study suggested that the inclusion of a steroid in an epidural spinal injection does not improve the efficiency of the injection. To understand why this might matter to people suffering from spinal stenosis pain, it’s important to 1st understand the different variables at play, including the spinal condition that was treated.

Spinal stenosis is a narrowing of the spinal canal.

The spine, or backbone, is comprised of bones called vertebrae. The vertebrae are stacked on top of each other, forming the spinal column. Protected within the spinal column, a bundle of nerves travels along the spinal canal from the base of the spine to the base of the skull. This bundle of nerves is the spinal cord. The nerves from the rest of the body connect to the spinal cord, and it’s responsible for relaying information back and forth from the brain to the body.

Spinal stenosis usually occurs as a result of a degenerative disease, like arthritis, or conditions like bone spurs or bulging discs in the spine. Poor posture, excess weight, or an unbalanced gait can also contribute to the development of spinal stenosis. Sometimes, an individual is born with a narrow spinal canal, but this is much less common than spinal stenosis caused by degenerative conditions.

The narrowed spinal canal irritates the nerves in the spinal cord. Someone suffering from spinal stenosis might have difficulty walking, performing daily activities, or standing for long periods. He or she might also experience cramping in the lower back or aching pain extending into the legs or thighs. In severe cases of spinal stenosis, individuals might develop bowel incontinence, as well as weakness or loss of sensation in the lower extremities.

Overall, spinal stenosis is a severe back pain condition. Because of this, pain management is a primary concern in spinal stenosis treatment.

Since the pain from spinal stenosis can reach debilitating levels, the goal is often to relieve pain enough to allow people with this condition to resume their normal routines. In very extreme cases, surgery might be the best option. However, most physicians prefer to attempt less invasive methods of treatment first.

Sometimes, physical activity can help reduce symptoms in less severe cases. In fact, the American College of Rheumatology states that:

“Regular exercise can help you build and maintain strength in the muscles of your arms and upper legs (the hip adductors and abductors, quadriceps and hamstrings). This will improve your balance, ability to walk, bend and move about, as well as control pain.”

However, if a person’s spinal stenosis is advanced enough to cause significant pain, of the sort tested in the study, physical activity is not a realistic option for long-term pain management. There are a variety of non-surgical treatment options to consider for spinal stenosis, but many Arizona Pain doctors have suggested that since it’s a more severe back pain condition, epidural steroid injections may not be the best treatment option.

In his response to the piece in the New England Journal of Medicine, Dr. Lynch noted that:

“The study examined the use of epidural steroid injections for the specific condition of moderate to severe central canal spinal stenosis, which is a severe diagnosis. Patients with this condition are typically not the best candidate for epidural injections, and many patients with this condition need surgery. We typically do epidural steroid injections for conditions other than severe spinal stenosis–such as bulging discs or some other disc pathology, before surgery is necessary.”

The study reported in the New England Journal of Medicine also questioned the efficacy of steroids in epidural injections for spinal stenosis.

In the study, 400 spinal stenosis patients received epidural injections. Some received injections of an anesthetic only, while others received injections of an anesthetic plus a steroid. Patients received 1 or 2 injections, and the outcome evaluation was performed 6 weeks after the initial injection. The study concluded that the addition of steroids to the epidural injection provided “minimal or no short-term benefit”. However, several elements of this study have been called into question.

As noted, the focus of the study was on patients with moderate to severe spinal stenosis. Additionally, the injections were delivered to the interlaminar space, which is between the plate-like lamina of the vertebrae. Some research, though, has suggested that epidural steroid injections are more effective when delivered to the transforaminal space, which is the area surrounding a particular nerve root. Additionally, patients in the study received just 1 or 2 injections, even though many experts recommend a series of at least 3 epidural steroid injections to achieve the full effect.

Another major concern resulting from this situation is that a potentially-beneficial procedure for other types of back pain could be condemned prematurely. Physicians might opt out of offering epidural steroid injections, and insurance companies might deny coverage for epidural steroid injections. This procedure, while minimally invasive, does carry risks of course. However, all medications and medical procedures have potential risks.

Some physicians believe that the flaws in this study render it unable to conclusively judge the efficacy of steroids in epidural injections.

Dr. Lynch noted that:

“I’m shocked it was published in the first place and more shocked at the media’s spin on the story thus far. When a patient is a qualified candidate for an epidural steroid injection, comprehensive care should be provided in addition. For those who do not qualify for an epidural steroid injection, or for those who prefer not to receive one, we offer numerous other comprehensive and alternative treatment options that are highly effective for treating chronic back pain as well, and we have seen great success with the most severe cases of chronic back pain.”

Epidural steroid injections may be able to provide significant pain relief, perhaps even relief profound enough to delay or prevent corrective surgery. The Colombia Neurosurgeons, of Columbia University Medical Center, state that approximately 50% of patients experience pain relief from epidural steroid injections. For this reason, it can be hoped that more research is performed before epidural steroid injections are dismissed as part of a comprehensive pain management plan.

Have you discussed epidural steroid injections with your physician?

Image by winifredxoxo via Flickr

Back it Up

By Ted Swing, Ph.D.

The most common form of chronic pain, affecting of millions of Americans, is low back pain. Low back pain can have a number of causes. One of the most common is a condition called spinal stenosis. Spinal stenosis refers to a narrowing of the spaces in the spine. This narrowing can result in pressure on the nerve roots that pass through the spine, causing pain and numbness that may radiate downwards (e.g., into the legs). We will be taking part in a new clinical trial for the treatment of pain caused by spinal stenosis of the lumbar spine.

Current Treatments for Spinal Stenosis

It is often best to begin treating low back pain with conservative treatments, such as rest, ice or cold, physical therapy, or chiropractic care. Patients also take various medications to help control this pain. Epidural steroid injections also help some patients with spinal stenosis. If all of these treatments fail to control the pain, patients may have no other option than surgery, such as a spinal decompression procedure. In this procedure, small pieces of bone and ligament tissues are surgically removed from the narrowed part of the spine, relieving the pressure on the nerve root and the pain it causes.

New Treatment for Spinal Stenosis

Vertiflex has developed a new system for treating spinal stenosis called the Totalis Direct Decompression System. This system involves very small tools and enables doctors to operate through a small incision in the back. Compared to the standard spinal decompression procedure, this affects a smaller portion of tissues. This system could help the spine keep its stability better than surgery. Recovery time may also be shorter than with an open surgical procedure.

New Clinical Trial

Vertiflex will be testing this new system in a clinical trial approved by the Centers for Medicare & Medicaid Services (CMS) for treating primarily Medicare patients. Patients who take part in the study will be randomly assigned, with two-thirds (67%) receiving treatment with the Totalis Direct Decompression System and the other one-third (33%) receiving no study intervention. Because this is a double-blind study, patients and most study staff will be not be told whether a patient is receiving the study procedure during the study. Patients will then be followed up seven times over the next two years to assess the treatment’s efficacy in relieving pain and improving physical function.

Who is Eligible to Enroll?

Patients age 55 to 85 who have pain, numbness, tingling, and/or burning in the legs, buttocks, and/or groin caused may be eligible to take part in this study. Patients must have a diagnosis of central canal spinal stenosis in the lumbar spine (lower back), based on imaging (e.g., MRI). Eligible patients will often experience moderate to severe pain when they stand or walk and may experience relief when they sit or bend over. In order to enroll patients must have experienced these symptoms for over 6 months and failed to get relief from conservative treatments (e.g., physical therapy), medications and epidural steroid injections.

This clinical trial is expected to begin in the next few months. If you are interested in learning more about this study, you can speak with your pain management providers or contact me directly at Teds@arizonapain.com.

Ted Swing has more than nine years of research experience and four years of teaching experience in psychology, has published in top psychology and medical journals, and has presented his research at major conferences. He received his Ph.D. in Social Psychology from Iowa State University and has been the Research Director at Arizona Pain since May 2012.