Lumbar spinal stenosis is common among individuals over 60 years, and surgery for lumbar spinal stenosis is one of the most often performed procedures for the adult lumbar spine. The canal where the spinal cord travels through the bones of the spine becomes narrow due to wear and tear of the spinal discs and joints and the nerves that go through this narrowed canal may be squeezed when the person stands or walks any distance, causing nerve tingling, pain, numbness or weakness in the legs (this is called neurogenic claudication). Symptoms are relieved when the spine is flexed (when sitting or leaning forwards). Bending forward creates a slight increase in the space where the spinal nerves are situated, and thereby relief of symptoms.

This is the rationale of the interspinous spacers.

Interspinous spacers are implanted between the bones in the back of the spine - called the spinous process, at the affected level of the spine, and thereby forcing this level into forward bending. This relieves pressure on the nerves which leads to relief of pain in the legs. Often the surgery is performed under local anesthetic but can also be done under a general anesthetic.

Very many patients reported a significant relief of pain after implantation of this device and current evidence shows that these procedures are efficacious for carefully selected patients in the short and medium term, although failure may occur and further surgery may be needed.

Patient selection should be carried out by specialist spinal surgeons who are able to offer patients a range of surgical treatment options.

Figure:
Bending forward, or flexion in the affected level, creates a slight increase in the intraspinal space, and thereby relief of symptoms.