Winter 2008 Issue

Taking A Shot At Avoiding Surgery
Epidural Injections Help Ed Karp To Manage The Pain Of Lumbar Spinal Stenosis

Ed Karp has lived with lumbar spinal stenosis for nearly a decade. The intense pain this condition causes in his left calf can make it difficult to walk. Yet thanks to periodic epidural injections, physiatrist John Welshofer, MD, has helped Ed manage the pain and avoid surgery for 10 years.

When Ed first began experiencing discomfort and was diagnosed with lumbar spinal stenosis, he tried physical therapy and medications with limited success. Doctors recommended surgery for his condition, but he wanted another option. He was referred to Dr. Welshofer, who assessed his condition and offered epidurals as an alternative to surgery.

“By all accounts Ed’s condition is bad enough to warrant surgery; however, we’ve taken care of him with occasional shots for years,” said Dr. Welshofer.

Lasting Relief
The injections have provided Ed with excellent relief. Some shots have been effective up to 18 months; others have lasted as little as three. He receives injections from Dr. Welshofer at the practice’s surgical center, Carolina Center For Specialty Surgery. He is allowed to have three to four shots per year as needed.

“I know it’s not a permanent solution,” said Ed. “Eventually, surgery will probably be needed.” He has also been evaluated at the practice by neurosurgeon Hunter Dyer, MD. They are considering the possibility of using a new decompression surgery to treat Ed’s condition.

“My experience with Dr. Welshofer over the years has been wonderful,” said Ed. “It’s great to know that in one practice I can get conservative treatment and also explore my surgical options.”

A Debilitating Condition
Lumbar spinal stenosis is the most common reason for back surgery in people over the age of 50 in the United States. Nearly two million office visits per year are related to the symptoms of this condition. Spinal stenosis is a degenerative narrowing of the spinal canal which causes compression of the spinal nerves and nerve roots. The condition causes pain to radiate down a patient’s back to the thighs and legs.

Diagnosis of lumbar spinal stenosis can usually be made with an MRI. Prescribed treatment can include weight loss, and activity modification. Epidural steroid injections may also help relieve the leg pain. If the symptoms are more severe, a laminectomy or foraminotomy may be needed to decrease pressure on the spinal nerve. The X-Stop device, approved by the FDA for treatment of lumbar spinal stenosis in 2005, has also proven to be an effective, minimally invasive option.

To learn more about epidural injections, treatment of lumbar spinal stenosis, or the other conservative therapies available at Carolina Neurosurgery & Spine Associates, call 1-800-344-6716.

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