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My 72-year old father was told he has "mixed" type of spinal stenosis. I think I understand what stenosis is. What does the mixed part mean?

Spinal stenosis refers to a condition in which the spinal canal narrows pressing on the spinal cord and spinal nerves. It is a problem that occurs as we get older. It is usually caused by degenerative processes. Arthritic bone spurs form around the joints, discs flatten out putting even more pressure on the joints, and the ligaments start to thicken. All these things impinge on the opening where the spinal cord or spinal nerve roots are located. Spinal stenosis may affect any part of the spine but the neck and low back seem to be involved most often. Lumbar spinal stenosis is the most common. Patients with lumbar spinal stenosis have low back and/or buttock pain. They often have abnormal sensations, discomfort, or pain in the lower legs. In severe cases, there can be loss of bladder and bowel control. There are different ways to classify stenosis. The international classification system breaks it down into several subgroups based on the underlying cause. These groups include (1) degenerative, (2) congenital/developmental, (3) spondylolytic spondylolisthesis, (4) iatrogenic, (5) post traumatic stenosis, and (6) combined. Congenital/developmental is present at birth. Spondylolysis refers to a fracture in the supporting structures of the vertebrae. If the fracture line opens and the bone separates, one vertebra can move forward over the vertebra below it (spondylolisthesis). Iatrogenic means it occurs as a result of some other treatment. Patients with the combined type may have several types of stenosis going on at the same time. This is apparently what is happening with your father. Treatment depends, in part, on the cause and type of stenosis present. In some cases, conservative care can be very effective. For anyone who does not get pain relief with nonoperative care, surgery may be needed.

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