What is the X-Stop procedure?

X-stop

X-Stop is a minimally invasive spinal surgery procedure that may be performed to treat cases of lumbar spinal stenosis that don’t respond to more conservative treatments, such as physical therapy and medication. X-Stop is also the name of the titanium implant used in the procedure, a device in a category termed “Interspinous Process Decompression Systems.” This lumbar spinal surgery procedure was approved as safe and effective by the FDA in 2005.

Lumbar spinal stenosis is an unnatural narrowing of the spinal column in the lower, or lumbar portion of the spine. The constricted spinal canal that characterizes spinal stenosis puts pressure on the spinal cord and the nerves emanating from it at the affected vertebrae, which can cause pain and restrict mobility. In the X-Stop procedure, the titanium implant is inserted into the spine through a small incision made between two spinal “processes” of the vertebra affected by stenosis. Spinous processes are the protrusions of the individual vertebra visible along the back. The X-Stop device distracts two vertebral segments and relieves the pressure on the nerve roots caused by the stenosis, which in turn often relieves leg and back pain. The X-Stop, a recent advance in spinal stenosis surgery, is not an alternative to spinal fusion back surgery, a procedure that eliminates the natural flexion and rotation of the fused vertebrae. The X-Stop is ideal for patients with very mild spinal stenosis. For more advanced disease, the X-Stop is not applicable because the implant cannot be used when decompression surgery is necessary to remove the bony elements pressing on nerve roots. In such situations, where decompression surgery is performed in conjunction with spine stabilization, the TOPS System may be a more relevant solution for maintaining the spine’s native motion.

As developers of treatments for advanced spinal stenosis and associated conditions, we at Premia Spinerecommend that patients learn about all their treatment options. If you have a back condition that’s causing pain or is affecting your mobility, be certain to learn about all the choices available to you.

Why are some spinal surgeons more successful than others?

Surgeons

It’s a fact that some spine surgeonshave higher success rates for the operations they perform than their colleagues. What accounts for these differences in surgical outcomes of spinal procedures? A number of factors influence surgical success rates and should be considered when interpreting what the rates say about a particular spinal surgeon’s abilities.

Spine surgery is a highly complex endeavor requiring years of training and experience to perfect. Surgeons with more experience tend to have more successful outcomes than less experienced surgeons. The success rates of board certified or board eligible spine surgeons are also typically higher than those of non-board certified or eligible surgeons. Another factor to consider: some surgeons specialize in specific areas of the spine – such as lumbar spinal surgery – and some specialize in treating particular conditions – such as slipped disc or spondylolisthesis – while other back surgeons do not specialize in any one type of treatment. Specialists have higher success rates than those of their colleagues who do not focus on the type of surgeries they perform.

Beyond the skill of the surgeon, success rates are also linked to the type of procedure chosen to treat a particular problem. The decision to utilize one procedure – perhaps because the surgeon is more familiar with it – rather than an alternative treatment, can also affect a surgeon’s success rate. For example, there is a choice in surgical stabilization procedures to employ following decompression spinal surgery, which is performed to treat conditions including spinal stenosisspondylosis, and spinal cord injuries. In the past, spinal fusion back surgery has been virtually the only surgical stabilization option, but today an alternative procedure, the TOPS™ (Total Posterior Solution) System has been proven in clinical trials around the world to provide better success rates that spinal fusion. Thus, a back surgeon might have a better than average success rate performing spinal fusion procedures, but still not reach the success rates achieved with a new procedure. That’s why it’s important to be familiar with the full range of available treatment options when evaluating the success rates of any spine surgeon.

Choosing a Spinal Surgeon

Surgeon

Choosing a spinal surgeon is among the most important medical decisions a patient can make. A spinal surgeon does more than perform an operation. A spinal surgeon consults with you, explains options and answers questions, and plans your treatment and recovery. You need to trust your spine surgeon, and to feel free to discuss all medical matters frankly.

You should choose a spinal surgeon who is board certified or board eligible, and trained in a fellowship program. If possible, choose a surgeon who specializes in the area of the spine that requires treatment– for example, a lumbar spinal surgery specialist if your problem is in the lower back. Alternatively, choose a spine surgeon who specializes in treating the specific condition affecting you, such as spondylolisthesis or spinal cord injuries.

Recent years have witnessed tremendous advances in treatment of spinal conditions, such as minimally invasive procedures that provide better outcomes than traditional open back surgery. It is essential that you choose a back surgeon that has experience with advanced procedures, to ensure you have access to the very latest treatments and the greatest spectrum of surgical options. For example, surgery to treat spinal stenosisslipped disc and a variety of other conditions that can result in pinched nerves, have often utilized spinal fusion back surgery as a means of stabilizing the spine, following spinal decompression therapy. Today the TOPS ™ (Total Posterior Solution) System provides a clinically proven superior alternative to spinal fusion surgery. Moreover, the TOPS implant preserves the full range of movement of the spine’s individual vertebrae, whereas spinal fusion eliminates the spine’s natural motion between fused vertebral segments. Examples like this illustrate why it’s important to work with a spine surgeon who can offer a complete range of surgical options. Thoroughly investigate all your treatment options as well as the qualifications of the specialists you consider working with, and you’ll be sure to make a wise choice when it comes to selecting a spinal surgeon.

How long after a spinal surgery before I can return to athletics?

Surgery Recovery

Near the top of the list of questions from almost every spinal surgery patient is how long they will have to wait following surgery before they can resume their normal activities. When those normal activities include athletics – golf and tennis, bowling and the like, pastimes that put tremendous strain on the back – the answer becomes more complex. The factors influencing the time before they can get back in the game include the level of the patient’s physical condition and health. Just because one engages in strenuous physical activity doesn’t mean he or she is in good physical condition or healthy. Recovery times are faster for surgery patients in good physical shape because their bodies heal faster. Of course the operation itself will play a large role in deciding when you’ll be back on the tennis courts, golf course, taking a job or engaging in a simple walk. The post-operative physical therapy program also plays a large role. But the type of back surgery is the primary factor affecting the time required to get back into sports action.

Athletics

In some cases the surgical treatment chosen for a given spinal condition will affect not only the time needed to get back on the playing field, but the degree to which you will ever be able to recover your old form. Take the stabilization procedure following spinal decompression surgery, for example. Spinal decompression is performed to relieve pressure on nerves within or emanating from the spine caused by conditions including spinal stenosisspondylolisthesis, and other degenerative changes, or as a result of spinal cord traumaSpinal fusion back surgery has been the primary stabilization procedure. But the fused vertebrae lose their independent motion following stabilization, and often patients are restricted from physical activity for up to 6 months while waiting for the biological fusion process to complete. However, today the TOPS™ (Total Posterior Solution) System provides an alternative to spinal fusion. The TOPS System, a surgical implant, stabilizes the spine while preserving each vertebra’s independent motion – and good news is that there are no restrictions on your physical activity after surgery. That’s going to ensure better performance whenever it’s time to get back in the game.

Should I stop taking medications before spinal surgery?

Medication

You have a pinched nerve, slipped disc, a spinal cord injury, or other back problem that has not responded to conservative treatments, and you have reached the decision to have spinal surgery. You and your back surgeon will discuss many aspects of your pre- and post-operative treatment, and the subject of the medications that you are currently taking – and whether you should continue their use – is high on the list of topics.

Usually patients are advised to continue use of prescription medications such as those for controlling blood pressure, even on the day of surgery – provided the medications are taken with just a small sip of water. However, use of blood thinners, aspirin, anti-inflammatory drugs, and diabetic and herbal medications should be discontinued prior to surgery. Your surgeon and staff will ask for a complete list of all medications you are taking, and it’s important to provide accurate answers.

One of the goals of post-operative care is effective pain management, and that requires patients to be free and weaned from any narcotic pain medications and muscle relaxants before the back surgery is performed. Fortunately, the open back surgery procedures of just a few years ago have in many cases been replaced by less invasive surgical procedures performed to relieve common back problems such as spinal stenosis, or symptoms of sciatica. These minimally invasive procedures cause little damage to collateral tissue, and therefore produce less pain and require less palliative medication, further speeding recovery. Other recent advances provide improved post-operative outcomes. For example, patients can now choose the TOPS™ (Total Posterior Solution) System instead of spinal fusion back surgery after a spinal decompressionprocedure. The TOPS System provides better clinical outcomes than spinal fusion, and preserves the full range of the individual vertebrae. Spinal fusion eliminates the independent motion of fused vertebrae, and has been shown to promote deterioration of adjacent vertebrae.

The procedure selected to treat your back problem is also a critical part of the discussions you will have with your orthopedic surgeon. Be sure to discuss all your surgical options, including advanced, proven procedures that can provide the best outcomes for your spinal condition.

Preparing for Spinal Surgery

Preparation for Surgery

Whether for a slipped disc caused by the normal aging process, or to treat a traumatic spinal cord injury, spinal surgery is never undertaken lightly. When selected as the preferred treatment option, it’s an indication of the severity of the problem being addressed. Back surgery is performed with the expectation that it offers a reasonable expectation of a meaningful improvement in one’s medical condition, and those improvements include reduction of pain and restoration of movement. So there’s actually much to look forward to when preparing for a back surgery operation! Here are things any patient can do to ensure the surgery and recovery goes as smoothly as possible:

Get in the best shape you can – mentally and physically. Exercise and eat a healthy diet. Lose weight, as extra weight puts mechanical stresses on the back and can complicate back surgery and recovery.  Lose weight sensibly!  If you smoke, now is the time to quit! If you won’t quit, you will have to stop prior to surgery, due to the many serious health risks the results of smoking can cause for surgical patients. Talk to your doctor about the medications you are taking. Be very thorough – even herbal supplements can impact recovery or interact with other medication prescribed for surgery.

Also, prepare for surgery by learning as much as you can about all facets of your spinal condition, and its treatment. For example, the last few years have seen dramatic advances in spinal procedures that can  provide dramatically improved clinical outcomes. The TOPS™ (Total Posterior Solution) System, often used in the treatment of spinal stenosisspondylolisthesis, and other back problems that can cause a pinched nerve, is one such advanced procedure. TOPS is an implant system approved for use as an alternative to spinal fusion back surgery following a spinal decompression procedure. The TOPS System preserves the independent flexion and bending of the individual vertebrae following spinal decompression therapy, unlike fusion spine surgery, which eliminates this independent motion and can contribute to deterioration of adjacent vertebrae. The TOPS System has also been shown in clinical studies conducted around the globe to provide better short- and long-term outcomes than spinal fusion.

Make sure you learn all you can about your condition, and understand all your surgical options, thoroughly discuss your treatment with your physician, and you’ll be well prepared for your back surgery!

What is Neural Claudication?

Neurologic Claudication

Recently we addressed the topic of claudication, pain typically felt in the legs as a result of vascular, or blood vessel problems, or back problems such as spinal stenosis that can result in pinched nerves in the lower back. Neurogenic claudication is a common symptom of lumbar spinal stenosis, an abnormal narrowing of the spinal canal in the lumbar, or lower portion of the spine. Neurogenic refers to the problem’s genesis in the nerves, and claudication, Latin for limp, refers to the painful weakness or cramping the patient feels in his or her legs. Neurogenic claudication can be bilateral (in both legs) or unilateral (in one leg).  The pain may be triggered by walking or prolonged standing, and is typically alleviated by changing position or flexion of the waist, not simply by resting, as happens with vascular claudication.  In severe cases, the pain may be persistent. Bone spurs, bulging discs and herniated discs can also cause neurogenic claudication.

Conservative treatments such as physical therapy, medications and injections may be sufficient to relieve neurogenic claudication, but surgery may be recommended in moderate to severe cases that don’t respond to conservative protocols. Spinal decompression surgery is typically performed to remove portions of the vertebrae impinging on a nerve. This pinched nerve is the source of the pain, weakness and cramping of neurogenic claudication. Following the spinal decompression treatment, a secondary operation is performed to stabilize the spine in the area where vertebral material was removed. In the past, spinal fusion back surgery was the sole available surgical stabilization procedure performed with spinal decompression. However, spine fusion surgery eliminates the natural independent motion of the fused vertebrae, and can contribute to deterioration of adjacent vertebrae. Now the TOPS (Total Posterior Solution) System provides an alternative to spinal fusion that preserves the full range of natural motion of each vertebrae. If you experience pain that interferes with your quality of life, seek qualified medical help. Today’s advanced procedures provide excellent outcomes. Get the facts about all your treatment options.

What is Lumbar Spinal Stenosis?

spinal stenosis exercises

Spinal stenosis – one of the most common spinal conditions – is an abnormal narrowing of the spinal canal. (“Stenosis” refers to a narrowing, or constriction.) As the spinal canal progressively narrows over time, it puts pressure on the nerves branching out from the spine, causing pain, tingling, and numbness in the extremities. The condition can occur in the lower, or lumbar region of the spine – lumbar spinal stenosis, which is the most common form – or in the neck, or cervical region of the spine – cervical spinal stenosis.

The majority of cases of spinal stenosis develop for unknown reasons, but the causes of spinal stenosis can be traced to several components of spinal anatomy, including the intervertebral discs, the facet joints that connect the vertebrae to each other, and the spinal cord. The narrowing of the spinal canal may result from abnormal bone growth and/or tissue growth, or due to a hereditary disorder. Maintaining a healthy lifestyle including exercise, good nutrition and maintaining proper weight can help prevent spinal stenosis.

Options for treatment of spinal stenosis include spinal stenosis exercises, physical therapy that can relieve pressure on the spinal cord, and medication to reduce pain and inflammation. In extreme cases, surgery for spinal stenosis may be recommended. The surgery removes potions of the vertebrae that are impinging on the roots of nerves emanating from the spine. Following this spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae, and can contribute to the deterioration of adjacent vertebrae. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that maintains the spine’s full range of motion, and that has been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery. So patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever.

What is Spinal Decompression?

Spinal Decompression

It may sound like something only a deep sea diver needs to be concerned about, but spinal decompression is an important topic for many people suffering from debilitating back pain. Spinal decompression refers to the process of relieving pressure on one or more pinched, or impinged nerves in the spinal column. The pressure on such nerves can cause pain, restrict mobility, and result in a host of other physical problems that can manifest in almost any part of the body. A host of spinal conditions, including spinal stenosis, disc degeneration, bulging, herniated or slipped discs, and facet syndrome can put pressure on nerves emanating from the spinal column.

Spinal decompression can be performed both surgically and non surgically. Non-surgical spinal decompression utilizes mechanical, computer controlled traction devices to reduce the pressure placed on nerves in specific portions of the spine. Inversion therapy, in which patients hang upside down, is another from of non-surgical spinal decompression.

For patients who do not respond to non-invasive methods, spinal decompression surgery can achieve dramatic improvements. In this surgical procedure, portions of the bone or tissue of the spine that impinge of a nerve are cut away, relieving the pressure. Historically, a spinal fusion procedure was performed in conjunction with spinal decompression surgery, in order to stabilize the spine at the point where the decompression procedure was performed. But spinal fusion, in which two vertebrae are fused to enhance spinal stability, eliminates the independent motion of the fused vertebrae, and may accelerate degeneration of adjacent vertebrae. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

If you’re a patient whose pinched spinal nerve is not responding to non-invasive decompression methods, make sure you discuss all your surgical options with your physicians.

What is Lumbar Spinal Decompression?

Spinal Stenosis

Imagine if the branches of a tree were just as big at the top as they are at the bottom, and that sometimes, heavy loads were placed on the ends of the very highest branches. Think of the stress that would put on the lower portion of the tree trunk. Well, that’s analogous to the situation we humans experience with our spinal columns. Our spinal column is like the trunk of a tree, but we’re just as big at the top of our trunks as at the bottom. The stress this puts on our lower backs – also called the lumbar region of the spine – is exacerbated by the cumulative affect of a lifetime of lifting and twisting in combination with degenerative changes of the spine that occur as a result of aging. So it’s not surprising that the majority of back problems that bring patients to spinal specialists are centered in the lower, or lumbar region of the spine.

These stresses, along with our genetic makeup, disease or injury, can result in a host of spinal disorders such as bulging or herniated discs, slipped disc and spinal stenosis. These disorders, in turn, can result in unnatural pressure being put on nerves that emanate from the spinal column, potentially causing pain, restricted mobility, and other symptoms of pinched nerves. We talked about the problem of pinched spinal nerve and spinal decompression in general in a previous blog. As we noted, spinal decompression is a means of easing pressure on impinged spinal nerves, and can be performed either non-surgically or surgically. Lumbar spinal decompression simply refers to decompression procedures performed on the lower portion of the spine.

The surgical solution for a lumbar pinched nerve involves removing tissue from vertebrae in the lumbar region that impinge, or put pressure on a nerve. This is called lumbar spinal decompression surgery. Historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. This provides an important more treatment option for individuals with moderate to severe symptoms of pinched nerves who do not respond to non-surgical lumbar decompression procedures.