My aging mother lives with us now. We are seeing some gradual changes (decline) in her ability to walk and get around. She’s most bothered by her lumbar stenosis. She can’t really have the surgery they suggested for her spine because of too many problems. I’ve heard you can get some kind of IV treatment for this problem. What is that?

In Japan, a group of surgeons have been experimenting with the use of prostaglandin E1 (PEG1) for lumbar spinal stenosis. Prostaglandins have a wide range of functions in the body. In this case, they are used to vasodilate (open) the blood vessels in the spine.

The result is improved blood flow to the spinal cord, spinal nerves, and nearby tissues. This has been shown to help patients who have both compression and blood loss in the epidural area. The epidural space is where the spinal cord is located inside the spinal canal.

Some patients may benefit from the use of a device called the X-STOP®. The X-STOP® is a metal implant that is inserted through a small incision in the skin (using a local anesthetic). It is designed to fit between the spinous processes of the vertebrae in the low back. It stays in place permanently without attaching to the bone or ligaments in the spine.

Before trying something like the PEG1 or X-STOP, physicians recommend a trial of conservative (nonoperative) care. A fair trial of antiinflammatory drugs, physical therapy, and epidural injections is usually indicated. “Fair trial” refers to at least three to six months’ time.

If symptoms have not changed, function has not improved, and quality of life remains impaired, then surgery is the next step. With today’s minimally invasive procedures, even patients with complications may be a candidate.