As the arthritis/disc degeneration worsens, the spinal canal (the space containing the crural medulla and nerve roots) narrows and one of the large ligaments (ligamentum flavum) that spans the space between the two vertebrae shortens and becomes thicker. These structures will compress the nerves in the neural canal. Symptoms and Diagnosis: This compression, or narrowing, causes pain in the leg when standing and walking, but the symptoms are relieved when sitting or lying on the floor. These symptoms are called neurologic claudication and must be distinguished from the same pain involving the leg caused by circulatory disease, arthritis in the hip, or diabetic nerve problems. A CT or MRI scan can be used to diagnose spinal stenosis. TREATMENT: Non-surgical treatment includes anti-inflammatory medications, exercise and physical therapy. Sometimes local anesthesia or steroids are injected into soft tissues, such as muscles and ligaments, or into the spinal canal (outside) near specific nerve roots. If these methods do not relieve symptoms, then surgical decompression of the involved vertebrae may be necessary. This procedure is quite effective and allows the patient to walk farther and stand longer without pain. Surgery involves decompression of the nerve roots by eliminating the spinal canal cap (laminectomy) and enlarging the space where the nerve roots exit (foramen magnum). Fusion of the affected vertebrae may also be necessary if symptoms of instability are significant. It is important to remember that a crural fusion is a procedure that heals/connects the crural segments by using bone from the pelvis (ilium), or bone bank. In most cases, metal implants consisting of screws and rods are used to help maintain stability during the fusion phase until healing occurs. The length of hospitalization is relatively short if fusion surgery is not done and relatively long if it is done. In both cases, especially if the patient had some pre-operative weakness, then a temporary stay in a rehabilitation facility is necessary to regain strength and make adjustments. The actual details of post-discharge care, resumption of normal physical activity, driving, and possible use of braces will be provided by the patient’s surgeon on a case-by-case basis for each patient.