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Tue, June 18

Procedure helps relieve spinal stenosis pain

Les Stukenberg/The Daily Courier<br>
Connie Kotch of Prescott Valley said a relatively new procedure that thins ligaments to relieve pressure on the nerves in the spinal canal helped her stand upright without pain for the first time in years.

Les Stukenberg/The Daily Courier<br> Connie Kotch of Prescott Valley said a relatively new procedure that thins ligaments to relieve pressure on the nerves in the spinal canal helped her stand upright without pain for the first time in years.

For seven years, Connie Kotch of Prescott Valley searched for something to relieve the pain in her back and lower legs caused by lumbar spinal stenosis.

Kotch said she used a bar stool so she could sit to wash dishes at the sink, and sought out chairs whenever she went out in order to relieve the pain she felt from standing and walking.

Kotch saw chiropractors, did physical therapy, drove to Chandler to receive injections of the homeopathic remedy turmeel, tried acupuncture, and even underwent a medial branch block, but nothing worked long-term to relieve her pain.

Then one day while in the car, Kotch heard a commercial on the radio about a year-and-a-half-old procedure known as minimally invasive lumbar decompression (MILD) that relieves pressure on nerves by thinning ligaments or bone compressing the spinal canal.

"I had no pen to write to write it down," Kotch said. "Another day I heard it, and I did (have a pen). Then I made an appointment with the doctor."

Kotch said she was screened by Dr. Glenn M. Lipton at his office in Cottonwood. He determined that she was a good candidate, and she later underwent the procedure at the Verde Valley Medical Center in November.

Kotch said after the local anesthesia from the procedure wore off, she was able to stand upright without pain, and go out to lunch with her husband, Tom, who has been so supportive.

"I noticed the change immediately when I walked out," Kotch said. "Before the procedure it was like trying to walk with a rock in your shoe. It was painful. Now I can move easily. I'm so grateful for the procedure."

The type of patient who benefits most from the MILD procedure has lower leg pain caused by lumbar spinal stenosis, said Lipton, a fellowship-trained, double-board-certified internist and pain management specialist.

Spinal stenosis is the narrowing of the spinal canal that nerves pass through. As the body ages, ligaments and bones outside the spinal canal may thicken and begin to press on the spinal canal, causing it to narrow, which can compress or pinch nerves and cause pain, numbness and disability.

The crowding of the nerves causes the nerves to become irritated, said Lipton.

"The patient recognizes that as pain and numbness in the legs," Lipton said.

In the past, doctors could administer epidural injections to try to relieve the pain, Lipton said.

"If the epidural injections did not work or alleviate enough pain for a long enough time, then another option was to send patients for open spinal surgery," said Lipton.

It could mean for a patient a day or more to in the hospital after open spinal surgery and an extended recovery time at home, Lipton said.

Vertos Medical from California developed the MILD procedure as another option for patients that retains the structural stability of the spine. This procedure can be "done in less than an hour, no stitches are required, and patients are up and walking around shortly after the procedure, and they can go home that day with no rods or screws inside them," Lipton said.

During the MILD procedure, Lipton said he inserts needles into the spinal canal to thin ligaments or remove bone pressing on the spinal canal. He uses an MRI before surgery to determine where and how much must be removed to relieve the pressure.

X-rays are used throughout the procedure to see how the procedure is going, said Starla Collins, spokeswoman for the Verde Valley Medical Center and Flagstaff Medical Center.

Lipton said he has done 60 to 70 MILD procedures at the Verde Valley Medical Center and that the procedure has helped people with lumbar spinal stenosis between the ages of 40 and 90.

Kotch said she met Dr. Lipton's first MILD procedure patient in the waiting room during her first visit, and the woman told her that she felt immediate relief after the procedure, Kotch said.

Kotch said she is happy to stand and walk without pain again and encourages people with lumbar spinal stenosis to talk with their doctors about the MILD procedure.

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