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Regain natural spine motion.

Conquer lumbar spinal stenosis and spondylolisthesis.

  • Freedom 
from fusion
  • Protect your adjacent levels
  • Keep
    moving
Premia Spine’s TOPS™ System Breakthrough Implant

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    Our Patients Stories

    • Bill M.

      Bill M.
      I hiked Yellowstone with my kids

      “After TOPS surgery, I healed and started rehab exercises. By 6 months, I was pain free, and I could touch my toes again. I’ve been able to hike trails in Yellowstone as well as walking 3-4 times a week!”

    • David B.

      David B.
      I’ll be dancing at my kid’s wedding

      “15 days after surgery I was walking almost two miles. I can feel my legs again. Before the surgery, the neuropathy was in the bottoms of my feet, and I haven’t felt the bottoms of my feet for three years.”

    • David F.

      David F.
      I got my life back
      “Almost immediately after the TOPS surgery the discomfort was gone. I was able to climb stairs the day of the surgery and began walking the next day. The investment in gaining your life back is worth it.”
    • Eric M.

      Eric M.
      I’m back to hunting, riding, & skiing
      “TOPS has given me my life back! I’ve been snowmobiling at Crater Lake and had a motorcycle weekend to Mt. Hood and Mt. Adams. I’m back to hunting elk again, which is a passion of mine.”
    • Heather V.

      Heather V.
      I’m skiing & playing tennis again

      “I am now 8 months post-op and doing very well! I went back to tennis and weight training, and I can do my job and daily activities normally. It makes me feel thankful, grateful and happy post-surgery.”

    Listen to Surgeons

    • Can patients return to an active lifestyle & sports after TOPS?

      Can patients return to an active lifestyle & sports after TOPS?

      Surgeons explain how patients resume active lifestyles post-op, including skiing, fishing, mountain biking, hiking, and running. Returning to these activities can help rebuild strength and retrain muscles.

    • How does TOPS reduce adjacent segment disease compared to spinal fusion?

      How does TOPS reduce adjacent segment disease compared to spinal fusion?

      Surgeons explain how TOPS preserves motion at the treated level which helps reduce stress on levels above and below. Fusion eliminates motion at the treated level and may increase stress on nearby levels.

    • Is the TOPS procedure covered by Medicare or commercial insurance?

      Is the TOPS procedure covered by Medicare or commercial insurance?

      Medicare coverage for the TOPS procedure is generally more straightforward than commercial insurance. Surgeons explain that Medicare Advantage patients may still face issues with insurance, but appeals can often help resolve denials.

    • What is recovery like for TOPS surgery compared to fusion?

      What is recovery like for TOPS surgery compared to fusion?

      Surgeons explain that TOPS patients often experience much faster recovery and earlier return to activity than fusion patients. Fusions take longer to heal due to bones needing to heal across the fused segment.

    What is TOPS™?

    The TOPS™ System is the leading proven treatment to relieve back and leg pain while helping you move naturally.
    Unlike fusion, it stabilizes your spine while preserving motion. TOPS helps you become more active. The implant supports normal bending, twisting and rotation so you can return to your desired activities.
    Most patients experience immediate and lasting pain relief and are walking the same day of surgery.
    Clinical studies show TOPS effectively reduces back and leg pain and helps improve mobility and overall quality of life.
    In fact, the FDA for the first time granted TOPS the label of “superior to fusion.” While fusion places extra stress on nearby joints of the spine, TOPS helps preserve motion to reduce strain on adjacent levels.

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    From the Blog

    • Back Pain After an Epidural

      Epidurals are prominent pain relief treatments for childbirth, surgery, and back pain; they involve injecting medication into the space around the spinal nerves in the lower back. Unfortunately, back pain is a prevalent epidural side effect: in a Medicina study, 30.38% of postpartum women who received epidural analgesia reported back pain in the days after delivery, and 31.65% of the epidural group still had back pain six months post-delivery.

    • Symptoms of Loose Screws After Spinal Fusion

      In spinal fusion and other spinal procedures, hardware is essential for stability. Pedicle screws are commonly used to secure the vertebrae and encourage healing. Unfortunately, screw loosening is a prevalent complication of spinal fusion, occurring in up to 60% of patients.  

    • What Are the Symptoms of L4-L5 Nerve Damage?

      Lumbar nerve damage is a common cause of chronic lower back pain. Left untreated, it can pose the risk of permanent complications. The most common symptoms of L4-L5 nerve damage are lower back pain that radiates into the leg(s); numbness or tingling in the thigh, shin, or top of the foot; and weakness when lifting the foot or straightening the knee (called “foot drop”). In more severe cases, it can cause bladder or bowel dysfunction, sudden, severe numbness, and difficulty walking. 

    • Lower Back Pain and Nausea: What’s the Connection and How to Find Relief

      Nausea is never a welcome sensation. But when it occurs along with other symptoms, like lower back pain, you may worry that a deeper issue is at play.

    • Causes of Back Pain in Men

      Back pain affects people of all ages and genders. Although back pain is more common in women than in men, it also affects a significant portion of the male population: In 2018, 28% of men and 31.6% of women experienced lower back pain in the last 3 months, according to a CDC survey. Given that back pain can lead to diminished mobility and a decreased quality of life, it should be given prompt medical attention. 

    • What Causes Lower Back Pain in Females?

      While lower back pain is a universal health concern, it’s been proven to affect women more often than men: In the results of a CDC survey, 31.6% of women experienced lower back pain in the last 3 months, compared to 28% of men. Although conditions like sprains, strains, and spinal conditions affect both men and women, menstruation, menopause, pregnancy, and gynecological conditions contribute to the higher prevalence of lower back pain in females. 

    • Buttock Pain After Laminectomy: Causes, Treatment, and Recovery

      Buttock pain after laminectomy is possible, particularly in patients who develop post-laminectomy syndrome or piriformis syndrome. Other possible causes include scar tissue formation, sacroiliac joint dysfunction, and weakened glute muscles. The root of your pain depends on the spinal level that was operated on, whether fusion was involved, and how effectively your body heals.

    • Scar Tissue and Chronic Pain After Spinal Fusion Surgery: Causes, Timelines, and Advanced Treatments

      Scar tissue is your body’s normal response to tissue damage. It helps your body close wounds and recover. But when it develops in excess or too close to a nerve, it can trigger ongoing pain and compromise the benefits you expect to gain from spinal surgery. And if you’re affected, you’re not alone: persistent pain after spinal surgery has a prevalence rate of 14.97%, according to a meta-analysis from Cureus. 

    • What Is a Spinal Fusion? Overview, Types, & Recovery Timeline

      Spinal fusion is a type of spinal surgery that permanently joins two or more vertebrae (the bones that form the spine) into a single bone. This eliminates all motion at the affected spinal level, helping to reduce the pain, instability, or nerve compression associated with conditions like spinal stenosis, spondylolisthesis, or herniated disc. Over 400,000 spinal fusion surgeries are performed each year in the U.S. (according to The Spine Journal), making it one of today’s most common spine procedures. 

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