Disc prolapses are but one of several conditions that can cause nerve entrapment, leading to back pain and referred leg pain. In the older population, the nerves can be squeezed by the gradual narrowing of the nerve channels due to the accumulation of debris, gristle, and enlargement of worn joints, in a condition known as spinal stenosis. While many patients do derive good long-term relief with cortisone injections, a minority will constantly suffer from pains due to the trapper nerves. However, these patients only experience pain when standing or walking, and have good relief of pain when they sit down. This is because the nerve channels narrow down when the spine is in an upright position.
While surgery can be performed to widen the nerve channels, they do carry a small risk of nerve injury. More often than not though, it is the risk of general anaesthesia that contradicts surgery, as this condition occurs in the more elderly population.
Fortunately, we now have specially developed implants, known as interspinous spacers which are able to support individual spinal segments, and prevent the nerve channels from narrowing when the spine is erect. These supports are placed in between the spinous processes, the boney extensions at the back of each spinal segment. As such, they are relatively superficial and accessible, and can be inserted through little keyholes, under X-ray guidance without the need for general anaesthesia. An ideal solution for patients with high general anaesthetic risk.