As the arthritic/disc degeneration worsens, the spinal canal (the space containing the spinal cord and nerve roots) narrows and one of the large ligaments (ligamentum flavum) that span between the two vertebral bodies shortens and becomes thicker. These structures will compress the nerves in the neural canal. Symptoms and diagnosis: This compression, or narrowing, can cause 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 due to circulatory disease, arthritis in the hip, or diabetic nerve problems. Spinal stenosis can be diagnosed with a CT or MRI scan. 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 inside (outside) near specific nerve roots. If these methods do not relieve symptoms, then surgical decompression of the affected vertebrae may be necessary. This surgery is quite effective and allows the patient to walk farther and stand longer without pain. Surgery involves decompression of the nerve root by eliminating the lamina cribrosa (laminectomy) and enlarging the space for the nerve root outlet (foramen). Fusion of the affected vertebrae may also be necessary if symptoms of instability are evident. It is important to remember that a spinal fusion is a procedure that heals/connects spinal cord segments by using bone from the pelvis (iliac bone), or bone bank. In most cases, the metal implant consists of screws and rods that are used to help maintain the stability of the fusion phase until it heals. The hospital stay is relatively short if fusion is not performed and relatively long if it is. In both cases, especially if the patient had some preoperative weakness, a temporary stay in a rehabilitation facility is necessary to regain strength and make adjustments. Practical details of post-discharge care, resumption of normal physical activity, driving, and possible use of a brace will be provided by the patient’s surgeon on a case-by-case basis.