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    What is Spinal Stenosis?

    by admin

    Table of Contents

  • Understanding Spinal Stenosis
  • What Causes Spinal Stenosis?
  • Spinal Stenosis Symptoms
  • Severe Spinal Stenosis Symptoms
  • Spinal Stenosis and Walking Problems
  • What is Considered Severe Spinal Stenosis?
  • Can Spinal Stenosis Be Treated At Home?
  • What Is The Best Treatment For Spinal Stenosis?
  • What Is The Latest Treatment For Spinal Stenosis?
  • spinal stenosis

    “What is spinal stenosis?” is one of the most frequently asked questions in any spinal specialist’s office. Given that up to 95% of people develop degenerative spinal changes by age 50, it’s no surprise that spinal stenosis is a prevalent medical concern today. 

    Although spinal stenosis is a common back problem, many affected patients have never heard of it at the time of their diagnosis. With this in mind, we’ll provide a detailed explanation of spinal stenosis below, including the causes, symptoms, and treatments available for this prevalent condition. 

    Understanding Spinal Stenosis

    “Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal. The spinal canal is the space at the center of the vertebrae that houses the spinal nerves. 

    This restriction of the spinal canal places pressure on the spinal nerves. It can also impact nerves that emanate from the affected vertebrae to other parts of the body. The area that’s the most commonly affected by stenosis is the lower, or lumbar, region of the spine. 

    What Causes Spinal Stenosis?

    Spinal stenosis can be caused by a variety of factors, including:

    • Chronic inflammatory, arthritic, and spinal conditions conditions

    Osteoarthritis, rheumatoid arthritis, scoliosis, and herniated disc are among the medical conditions that may lead to spinal stenosis.  

    • The normal aging process

    The spine naturally changes with age. For one, the intervertebral discs dry out, become thinner, and may begin to bulge. An injured intervertebral disc takes up additional space in the spinal canal, potentially leading to spinal stenosis. 

    Additionally, the aging process can cause the ligaments and/or bone in the spine to thicken or expand. When this occurs, the open space in the spinal canal becomes more limited.

    Spinal stenosis is most often seen in adults above the age of 40 years, and women are affected by spinal stenosis more frequently than men.

    • Heredity factors

    Clinical studies have confirmed that lumbar spinal stenosis is highly genetic. This is despite the fact that spinal degeneration is widely considered to be the key contributing factor to the development of stenosis. In a 2014 study, lumbar spinal stenosis cases yielded heritability estimates of 66.9%

    Spinal Stenosis Symptoms

    Symptoms of spinal stenosis can include intense back and leg pain, as well as numbness or cramping in various regions of the body. In spinal stenosis patients, loss of sensation can be extreme. 

    Severe Spinal Stenosis Symptoms

    Lumbar spinal stenosis symptoms in severe cases may include difficulty controlling urine or bowel movements and difficulty balancing while walking. While these symptoms can sound alarming, especially if you were just diagnosed with spinal stenosis, they only occur in a small portion of spinal stenosis patients.

    To illustrate this fact, let’s consider a survey conducted in 564 U.S. hospitals and general practice clinics. Out of 3,647 patients diagnosed with lumbar spinal stenosis in this survey, only 135 patients experienced bowel and bladder dysfunction. 

    Bowel and bladder dysfunction mainly occur in spinal stenosis patients with cauda equina lesions. The cauda equina is the collection of nerve roots located in the lower spinal cord. It facilitates movement and sensation in the legs and bladder. 

    Spinal stenosis can trigger cauda equina syndrome, which requires immediate diagnosis and treatment to prevent severe neurological complications. 

    Spinal Stenosis and Walking Problems

    As we mentioned above, severe spinal stenosis can lead to walking and balance problems. However, even in its earlier stages, spinal stenosis can cause difficulty walking for extended distances.

    Walking problems with lumbar spinal stenosis may include:

    • Cramping, tingling, and/or numbness in the legs while walking
    • Pressure in the lower back while standing upright
    • Muscle weakness in the legs
    • Pain in the buttocks, legs, and/or back while walking
    • A foot that slaps the ground when you take a step due to weakness

    Leaning forward alleviates pressure on the spinal nerves. So, spinal stenosis patients experiencing walking problems often experience relief when they sit down, crouch, lean forward, or even push a grocery cart.

    If you’ve been diagnosed with spinal stenosis and are experiencing severe pain and weakness while standing or walking, reach out to your doctor immediately. You may be experiencing cauda equina syndrome.   

    What is Considered Severe Spinal Stenosis?

    Patients may have what’s considered a severe case of lumbar spinal stenosis if they experience a loss of physical function or are disabled as a result of the stenosis. Additionally, physicians may classify a case of spinal stenosis as severe if the patient doesn’t respond to several months of non-surgical treatment. 

    Severe spinal stenosis typically requires surgery for symptom relief. After spinal stenosis surgery, patients generally experience restored function and improved quality of life. 

    Can Spinal Stenosis Be Treated At Home?

    Patients experiencing symptoms of spinal stenosis need to receive a medical evaluation and diagnosis. This ensures that any troubling symptoms are promptly addressed before causing lasting complications.

    With that said, after receiving a diagnosis, many patients with early spinal stenosis can manage their symptoms with at-home care. Paired with physical therapy and physician-recommended lifestyle changes, at-home treatment can significantly improve spinal stenosis symptoms. 

    Along with heat/cold therapy, exercises for spinal stenosis are among the most widely-recommended at-home treatment for this condition. Spinal stenosis exercises can be done at home to strengthen the spine’s stabilizing muscles and improve range of motion. Your physical therapist may give you a specific exercise regimen to complete at home based on your personal needs. 

    What Is The Best Treatment For Spinal Stenosis?

    Many treatments for spinal stenosis are available, including medications, physical therapy, and, as we mentioned above, exercises for stretching the spine. 

    Physical therapy is often highly successful in treating spinal stenosis. Your physical therapist may implement a combination of therapies including massage, stabilization methods, heat/cold therapy, exercises, and acupuncture to help you overcome your symptoms. 

    Spinal Stenosis Surgery

    For patients with moderate to severe spinal stenosis who don’t respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option.

    In spinal decompression surgery, the back surgeon reestablishes the proper diameter of the spinal canal at the affected area. To accomplish this, the surgeon will remove bony elements that have grown towards the spinal canal and are impinging on the nerves.

    There are a few different spinal decompression procedures. The most common of these procedures for spinal stenosis is laminectomy, which involves removing some or all of the lamina. The lamina is the section of bone that covers the back of the spinal canal.

    Am I a Candidate For Spinal Decompression?

    You may not be a candidate for spinal decompression surgery as a treatment for spinal stenosis if:

    • You’re currently pregnant
    • You have already had spinal fusion
    • You have vertebral fractures
    • You’re experiencing pain from a previous failed spinal surgery
    • You’ve already had an artificial disc or spinal implant placed
    • You’ve already undergone more than one spinal surgery and haven’t recovered properly 

    Spinal Fusion

    Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves turning two or more adjacent vertebrae into one bone. This is done by placing bone graft material in between the vertebrae, then securing them with screws and rigid rods.

    Fusion restores stability but eliminates the natural mobility between the vertebrae. The fusion of the vertebrae is permanent and typically diminishes patients’ ability to move, stretch, and rotate the torso. 

    The Risk of Reoperation After Spinal Fusion

    Clinical research has shown that spinal fusion has a higher reoperation rate than spinal decompression alone. With this in mind, patients must carefully consider the risk of reoperation before undergoing decompression with fusion. 

    One reason why spinal fusion may lead to reoperation is the risk of adjacent segment disease. This complication of spinal fusion occurs when the vertebrae above and below the fused segment undergo added pressure. This leads to a faster rate of degeneration in these vertebrae. 

    Patients with adjacent segment disease may start to experience back pain, reduced range of motion, and neurological symptoms. These uncomfortable and potentially debilitating symptoms can create the need for corrective spinal surgery. 

    What Is The Latest Treatment For Spinal Stenosis?

    Many modern spinal stenosis patients are concerned over the risks of decompression surgery with spinal fusion. This has led to an increased interest in alternative treatments that alleviate spinal stenosis symptoms without the risks associated with fusion. 

    Patients who haven’t responded to conservative treatments can now consider non-fusion spinal implants as a spinal stenosis treatment option. These implants are designed to alleviate nerve compression while stabilizing the spine. As a result, patients can experience relief from spinal stenosis without reduced mobility from fusion. 

    The TOPS™ System For Spinal Stenosis

    Today, a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine.

    How Does TOPS™ Work For Spinal Stenosis?

    The TOPS™ System works for spinal stenosis by replacing the tissues removed during spinal decompression. The implant is designed to be placed at a single level between L2 and L5 in the lower spine. These segments are the most commonly affected by spinal stenosis. 

    Once positioned, the TOPS™ System allows movement in all directions. It simultaneously blocks sheer forces on the lower spine, which helps prevent injury after spinal stenosis surgery. 

    TOPS™ System Results

    Clinical studies show the TOPS™ System provides better outcomes than spinal fusion. In a seven-year study for TOPS™ in the management of lumbar spinal stenosis, the device maintained clinical improvement and radiologic stability, preserved spinal motion, and prevented degeneration. 

    Physician and patient testimonials demonstrate that the TOPS™ System provides excellent outcomes for spinal stenosis patients and allows patients to retain mobility at the operative segment. Additionally, patients experience symptom relief long after the TOPS™ System procedure. 

    We encourage patients with persistent back pain to consult with a spinal specialist and learn more about all of the available treatment options.

    “What is spinal stenosis?” is one of the most frequently asked questions in any spinal physician’s office. Spinal stenosis is a common back problem, but many affected patients have never heard of it before they are given the diagnosis. Symptoms of spinal stenosis can include intense pain inside the back of the legs and numbing or cramping in various regions of the body. The loss of sensation that spinal stenosis patients experience can be extreme.

    Here at Premia Spine we focus on advanced surgical treatments for spinal stenosis and related spinal disorders, including bone spurs, or facet arthrosis, and slipped disc, or spondylolisthesis. We’re excited to share information about these conditions – conditions that affect up to 70 percent of all people at some point in their lives – through our blog. An explanation of spinal stenosis is a good place to start.

    “Stenosis” means “narrowing,” and spinal stenosis signifies an unnatural narrowing of the spinal canal, the space at the center of the vertebrae that houses the spinal nerves. This narrowing puts pressure on the nerves, and on nerves that emanate from the affected vertebrae to other parts of the body. The most commonly affected area is the lower, or lumbar, region of the spine. The neck, or cervical region of the spine, can also exhibit a narrowing; these conditions are called lumbar spinal stenosis and cervical spinal stenosis respectively.

    Spinal stenosis can be caused by a variety of factors, including heredity, chronic inflammatory and arthritic conditions, and the normal aging process. In fact, it is most often seen in adults above the ages of 45 years; women are affected by spinal stenosis more frequently than men. The severity is related to the extent of the narrowing and of any attendant spinal problems, such as bone spurs, slipped discs, pinched nerves, spondylolisthesis, or sciatica. A neurosurgeon, orthopedic surgeon or any physician specializing in spinal disorders can diagnose spinal stenosis based on radiographs and X-rays.

    Many treatments for spinal stenosis are available, including medications and physical therapy, including exercises for stretching the spine. For patients with moderate to severe spinal stenosis who do not respond to conservative spinal stenosis therapy, spinal decompression surgery may be an option. In spinal decompression procedures, the back surgeon reestablishes the proper diameter of the spinal canal at the affected area by removing bony elements that have grown towards the spinal canal and are impinging on the nerves. Typically, spinal fusion back surgery is performed in conjunction with the decompression procedure. Spinal fusion involves connecting two or more adjacent vertebrae with screws and rigid rods. Fusion restores stability but eliminates the natural mobility between the vertebrae.

    Today a new implantable device allows the surgeon to decompress and stabilize the spine while preserving the spine’s range of motion: the TOPS™ System, developed here at Premia Spine. Clinical studies show the TOPS System provides better outcomes than spinal fusion. We encourage patients to consult with a physician who specializes in spinal medicine and to educate themselves about treatment options.

    Advantages of Medical Tourism

    by admin

    Can you really travel to a foreign destination for a vacation and receive high-quality medical care at the same time? That’s the question many people raise when the subject of medical tourism comes up.

    Many people are skeptical of medical tourism, and understandably so. When you receive medical care in your home country, you’ll naturally feel more comfortable with the treatment process. However, there are many advantages that medical tourism can offer. 

    For some patients, traveling to a different country for medical care is a worthwhile task. Keep reading to learn more. 

    What is Medical Tourism?

    Medical tourism is a term used to describe the action of traveling internationally for medical care. 

    What Are The Benefits of Medical Tourism?

    The following benefits are attributed to the popularity of medical tourism for USA patients:

    • Affordable care

    This is the key benefit of medical tourism. Many people can attain high-quality medical care at a fraction of the cost by traveling overseas. This particularly applies to patients in the U.S., which lacks a public healthcare system. 

    • High-quality care

    The quality of care should always be the primary consideration in medical tourism. There are first-rate medical facilities and health care professionals in many areas across the globe. Some of these areas, which are widely considered to be the best countries for medical tourism, include Germany, the United Kingdom, Turkey, Israel, India, Thailand, Singapore, Latin America, Eastern Europe, and Cyprus.

    • Advanced treatments

    Different areas of the world have different medical regulatory bodies. Here in the United States, the FDA (Food and Drug Administration) protects Americans’ health by regulating drugs, biological products, medical devices, food, cosmetics, and even certain electric products. 

    In many instances, medical innovations have been developed, proven to be successful, and used for many years in other areas of the world. But, with the FDA’s regulatory processes, it can take a long time for those proven medical solutions to become available in the United States. This can also apply to residents of other countries who don’t have access to many of the advanced medical treatments in the United States. 

    Medical tourism can give patients access to the latest medical technology and, as a result, a higher quality of care. 

    Why is Medical Tourism Popular?

    The United States has the most expensive healthcare in the world. So, while few people would consider medical tourism to the U.S., many Americans contemplate international travel to lower their medical expenses.

    Medical Tourism Statistics

    When considering traveling internationally for a procedure, it’s wise to consider medical tourism examples and statistics. 

    • In 2017, over 1.4 million Americans sought out medical care from various medical tourism countries around the globe. 
    • According to the World Health Organization, an estimated 12 to 14 million people travel abroad annually for medical care. 
    • Many countries offer certain medical procedures at 30% to 65% of the cost of care in the U.S. 
    • The worldwide medical tourism market is expected to grow at a compound annual growth rate of 32.51% between 2022 and 2030. 

    Which Choice Factors Are The Most Important To Medical Tourism Consumers?

    Consumers who are interested in medical tourism value a variety of factors. The most prominent of these factors include:

    • Finances

    Finances are arguably the most important factor to medical tourism consumers. In fact, in a study from the Medical Tourism Association, 85% of surveyed patients who traveled overseas to a hospital reported that the cost of medical care was a very important deciding factor.

    The healthcare system in the United States leaves an estimated 9.6% of residents without health insurance, as of 2021. Even among individuals who do have health insurance coverage, high co-pays and deductibles can make it difficult to afford medical care. 

    With these facts in mind, it’s unsurprising that cost is a crucial factor for medical tourism consumers. Above all, these consumers want to secure an affordable price for medical care by traveling overseas.

    • Quality of care

    Quality of care is paramount for many medical tourism consumers. By traveling to other countries, patients can attain a higher quality of care (at a lower cost) when compared to the medical treatment available in their home countries.

    However, without the assurances that Americans are accustomed to under the FDA, consumers must consider the laws and regulations surrounding medical care in the country that they’re traveling to, as well as the foreign practice’s certifications. 

    • Treatment availability

    While discussing the benefits of medical tourism, we mentioned that it can grant patients access to advanced treatments that aren’t available in their home country. With this in mind, the treatments available in other countries are a key consideration for medical tourism consumers. 

    • Waiting lists

    Waiting lists for health care services are another consideration among medical tourism consumers. As of 2022, in the United States, 28% of patients sometimes, rarely, or never receive a response from their primary physician on the same day. This is a high percentage when compared to many other areas of the globe. However, 27% of patients in the U.S. wait one month or more for a specialist appointment, which is a lower percentage than in many other countries, including Norway and Canada.

    With that said, long wait lists are primarily a concern for medical tourism consumers in nations with public healthcare systems.

    What Are The Risks of Medical Tourism?

    Although medical tourism can provide several benefits, it also presents certain risks and safety concerns, including:

    • Infectious disease

    Some countries have a risk of complications including HIV, hepatitis B, hepatitis C, blood infections, wound infections, and infections from donor tissue or blood. 

    • Communication difficulties

    If patients travel to a facility using a language that they don’t speak fluently, doctor-patient communication can be difficult. Given that doctors provide crucial pre-op and post-op information, as well as procedure specifics, this may lead to confusion and errors. 

    • Quality of care

    Certain areas may not have comparable requirements for medical licensing and accreditation. This creates the risk of low quality of care. 

    • Flying after a procedure

    Doctors typically advise against air travel immediately after surgery. This is because flying raises the risk of developing a blood clot. Depending on the type of surgical procedure, patients should wait between seven and 10 days before flying. 

    To avoid these risks, medical tourism consumers should ensure that:

    • The medical facility has been accredited by the Joint Commission International
    • The medical facility utilizes the World Health Organization Checklist
    • The staff at the facility follows stringent sanitation, disinfection, and hygiene measures
    • The provider is board-certified and internationally-recognized

    What Is The Best Country For Medical Tourism If You Need a Spine Surgery?

    As we’ve already mentioned, a significant benefit of medical tourism is that you can gain access to treatments that have not yet or have only recently been, approved for use in your country. Procedures that have been proven effective and are widely used in certain areas of the world can often benefit international patients.

    The TOPS™ (Total Posterior Solution) procedure, performed in association with spinal decompression surgery, is an example of a procedure that has been used extensively in Europe but not yet in the United States. TOPS is an alternative to spinal fusion back surgery.

    Spinal fusion is widely used with spinal decompression procedures for conditions like spinal stenosis, spondylolisthesis, bone spurs, and more. Unfortunately, fusion can severely limit patients’ range of motion in the back. Additionally, the complete recovery process for spinal fusion may last for six months to a year. 

    The TOPS System preserves the full range of motion between the individual vertebral segments, unlike spinal fusion. It involves a minimally-invasive surgical procedure, which greatly shortens the spinal surgery recovery period. In fact, patients may start moving around the day after TOPS surgery with few, if any, restrictions. 

    For certain patients with specific medical conditions, medical tourism could be the ticket to high-quality, low-cost healthcare. If you think you may benefit from medical tourism, make sure to conduct thorough research, find an accredited facility, and evaluate all of the risks before scheduling your appointment abroad. 

    Caring for Your Spinal Surgery Incision

    by admin

    All patients undergoing back surgery should actively ensure that the healing process goes as smoothly as possible. In doing so, you can attain the best possible results from the procedure while avoiding complications that could compromise your health. 

    Proper incision care is a key step in the process of adopting healthy habits and positive lifestyle choices to promote healing. As an aspect of your spinal surgery recovery, incision care will benefit your overall health. 

    Here, we’ll discuss how to care for a spinal incision to ensure a successful surgical recovery and back pain relief. Additionally, we’ll explore innovations in the field of spine surgery that allow for smaller incisions and, as a result, a lower risk of complications. 

    How Are Incisions Closed After Spinal Surgery?

    After spinal surgery, the incision may be closed with Steri-Strips, staples, or sutures, including dissolvable sutures. Most often, spinal surgeons use a combination of these closure methods.

    Since spinal surgery is performed beneath the layers of skin and muscle in the back, the incision must be closed at various layers. Your surgeon will suture the muscle layer together before closing the skin. 

    • Sutures are also commonly referred to as stitches. This wound closure method involves using sterile surgical threads, which are stronger than the threads most people are familiar with. The surgeon uses these threads with a needle to suture the incision closed, and certain types of sutures will dissolve within a few weeks of the procedure. 
    • Staples are metal clips. They allow for fast wound closure but don’t dissolve. So, you’ll need to return to your surgeon to have them removed after the procedure (typically seven to 14 days post-op). 
    • Steri-Strips are adhesive bandages that may be used to help close an incision after spinal surgery. They may be applied over dissolvable stitches to help keep the skin closed or to help the wound heal after the sutures are removed. 

    Preparing and Recovering From Back Surgery

    In preparing for back surgery, patients should begin on a path of improving their diet and physical activity. These practices will improve your overall health to ensure that the spinal surgery goes off without a hitch. 

    With that said, implementing healthy habits is not only essential for the surgery itself but also for the recovery process following the operation. While continuing the positive lifestyle changes that you applied before the procedure, make sure to rigorously follow your doctor’s orders, including those about what medications to avoid. Certain medications can interfere with the healing process, namely including NSAIDs. NSAIDs, like aspirin, ibuprofen, and naproxen, are blood thinners and can impair the body’s repair processes.

    How Do You Treat an Incision After Back Surgery?

    Proper care for the surgical incision is one of the most important aspects of post-operative home recuperation following back surgery. 

    Immediately After The Procedure

    You won’t be permitted to apply any ointments or lotions to the incision while it’s healing. You also shouldn’t bathe in a tub, swim, or use a hot tub until your incision is healed. Immersing the incision in water before your surgeon clears you to do so may increase your risk of infection and inhibit the healing process. 

    Additionally, you’ll need to keep the incision clean after spinal surgery. You can clean the incision site with soap and water, then gently dry it with a clean cloth. This helps prevent infection as the incision heals. 

    Two Weeks After The Procedure

    In most cases, non-dissolvable sutures and staples are removed 14 days following the spinal surgery. At this point, the incision is usually fully healed. 

    Six Weeks After The Procedure

    Many spinal surgery patients are eager to reduce scarring by applying scar treatments and vitamin creams to the incision. However, you must wait to get the go-ahead from your surgeon before doing so. Typically, surgeons allow patients to start applying scar creams six weeks after the procedure. 

    How Long Does It Take For a Spinal Incision To Heal?

    It generally takes about two weeks for a spinal incision, including a spinal stenosis incision, to completely heal. At this point, your surgeon will remove sutures and staples, as well as clear you to take baths and swim. However, this timeline can vary from patient to patient. 

    Spinal incision infections typically appear two to four weeks after the procedure. Your surgeon will advise you to be aware of infection symptoms, which include fever, worsening redness at the incision, and changes in the infection drainage. If any of these symptoms occur, make sure to reach out to your surgeon immediately.

    Additionally, if the surgeon places any hardware or devices during the procedure and an infection develops, they may need to be removed. This also applies to patients with an implantation spinal cord stimulator incision or spinal fusion incision. 

    How Long Does It Take For Spinal Nerves to Heal After Surgery?

    Immediately after the spinal nerves are decompressed in surgery, the healing process can begin. But, nerve tissue heals far slower than other types of tissue in the body, namely muscle tissue. So, while some patients will experience an immediate improvement in nerve pain after spinal surgery, other patients may need more time to notice a difference. 

    In the weeks and months after spinal surgery, patients should notice a gradual improvement in neurological symptoms such as numbness, tingling, and weakness. By adopting healthy lifestyle habits, such as engaging in low-impact exercise, eating healthily, and refraining from smoking, you can ensure that the spinal nerves heal as quickly as possible. 

    Spinal Surgery Advances For Smaller Incisions

    Surgeons always aim to create as small an incision as possible while successfully carrying out the procedure. This is because a smaller incision leads to less blood loss, less scarring, and a lower risk of infection. 

    Fortunately, the last several years have seen a revolution in back surgery procedures and outcomes. Now, more minimally-invasive procedures are available to patients that require spinal surgery. These procedures allow for much smaller incisions, among other advantages over traditional open back surgery.

    Spinal Fusion Alternatives

    One procedure that can now be replaced with minimally-invasive alternatives is spinal fusion back surgery. This procedure was traditionally performed in conjunction with spinal decompression surgery for spinal stenosis, spondylolisthesis, and related conditions. 

    Regain your mobility with Premia Spine! Contact us now

    Spinal fusion involves positioning an implant containing bone graft material in between the affected vertebrae. Over the course of several weeks after the procedure, the bone graft will trigger the fusing of the vertebrae, turning them into a single bone. As a result, the patient can avoid spinal instability after decompression surgery. 

    Unfortunately, spinal fusion requires a long recovery period and eliminates the natural movement of the individual vertebrae. It also creates the risk of adjacent segment disorder, or ASD, which occurs when the vertebrae surrounding the fused segment degenerate more rapidly than they otherwise would. 

    The TOPS System From Premia Spine

    Thankfully, a spinal fusion alternative has emerged to improve outcomes and preserve patients’ range of motion: the TOPS (Total Posterior Solution) System. The TOPS System is an implant that facilitates a minimally-invasive spinal surgery. It’s been shown in clinical trials around the globe to provide superior outcomes for patients who undergo treatments such as lumbar laminectomy or other spinal decompression procedures for various causes of lower back pain. 

    As the example of the TOPS System indicates, these advances in minimally-invasive back surgery allow for not only fewer complications in surgical incision healing, but also improved outcomes overall.

    Don’t hesitate to discuss concerns surrounding post-op incision care with your surgeon, and make sure to explore all of your spine surgery options.

    Spinal Surgery for a Slipped Disc

    by admin

    Each year, for every 1,000 adults, there are approximately 5 to 20 cases of disc herniation. Also known as a slipped disc, a herniated disc is a prevalent spinal disorder that develops when the interior core of an intervertebral disc burst out through the damaged disc exterior. 

    Although a slipped disc can typically be managed with non-invasive methods, there are cases that require surgery. Here, we’ll discuss slipped disc surgery, when it’s needed, and what it entails.

    Understanding Disc Herniation

    The spinal discs act as cushions in the spine. Located in between each vertebra, the discs absorb impact and reduce the stress imparted on the spinal bones. 

    Unfortunately, age-related degeneration, repetitive movements, and sudden trauma to the spine can damage the spinal discs. A disc is considered herniated when the tough disc exterior becomes cracked and the soft disc interior extends outward. 

    When this injury occurs, fluid from within the disc can leak into the spinal canal. Here, it can disrupt the spinal nerve function.

    A slipped disc in the spine is often the final stage in the process of disc degeneration. This process typically begins with a bulging disc, which occurs when the disc exterior weakens and the disc bulges out to one side. This may progress to a protruding disc before the disc finally ruptures. Although the name may be misleading, a “slipped disc” has not actually shifted position.

    Slipped Disc Symptoms

    Symptoms of a slipped disc can vary depending on the location of the damaged disc and the severity of the rupture. If a slipped disc doesn’t impart pressure on a nerve, it may be entirely unnoticeable to the patient. However, if a slipped disc does press on adjacent nerves, it may cause pain, numbness, weakness, and tingling.

    A slipped disc in the neck, which is known as a slipped cervical disc, may trigger symptoms in the shoulders, arms, or chest. A slipped disc in the lower back, which is known as a slipped lumbar disc, may cause sciatica. This refers to pain that radiates downward from the lower back, causing nerve pain in the buttocks, legs, and feet.

    What Can Cause a Slipped Disc?

    The most prevalent causes of slipped discs are:

    • Spinal degeneration from the natural aging process

    As people age, the spinal discs naturally become drier and weaker. This, along with accumulated wear and tear on the spine over the course of many years, can lead to a slipped disc. Disc herniated most commonly occurs in patients between the ages of 35 and 50

    • Injuries caused by excessive stress on the spinal column

    Improperly lifting heavy objects and exercising with improper bodily mechanics are examples of activities that may cause a slipped disc. Athletes in sports that place significant stress on the spine, including football and weightlifting, are often at a heightened risk of disc herniation. 

    Smoking, excess body weight and a sedentary lifestyle also increase the risk of developing a slipped disc. Sudden trauma to the spine, (which may occur during an automobile accident, for example) may cause a slipped disc, although it’s rare. 

    Slipped Disc Treatments

    Treatments for slipped disc include:

    • Physical therapy

    Slipped disc treatment without surgery typically involves physical therapy. Targeted slipped disc exercises and PT can alleviate tension, improve your posture, and strengthen the muscles that support the spine.

    Additionally, physical therapy can help reduce the pressure of the damaged disc on your spinal nerves. Your physical therapist may recommend alternative therapies such as massage, acupuncture, and electrostimulation to further enhance your recovery process. 

    • Medication to relieve pain and inflammation

    Certain medications can be used to manage pain and inflammation from a slipped disc. Over-the-counter options are available, as well as prescription medications from your doctor. Always consult your doctor before starting a new medication. 

    • Surgery

    In some cases, surgery for slipped discs is required for the patient to make a full recovery.

    When Does a Slipped Disc Require Surgery?

    As we’ve already mentioned, slipped discs rarely require surgery and heal with non-invasive methods. However, a slipped disc may require surgery if:

    • Non-invasive methods have failed after several months
    • The patient is experiencing radiating back pain, (known as sciatica), which isn’t responding to conservative methods
    • The patient has constant pain that’s diminishing their quality of life
    • The patient’s basic mobility is compromised (i.e. trouble standing and walking)
    • The patient has neurological symptoms that are noticeably worsening 

    Before undergoing an invasive procedure, patients must talk to their doctors and learn about the slipped disc surgery risks. 

    What Kind of Surgery is Done For a Slipped Disc?

    Decompression surgery is most commonly performed for a slipped disc. This surgical method involves alleviating pressure on the spinal nerves by removing spinal tissue. There are different types of spinal decompression surgery, including discectomy, laminectomy, corpectomy, and foraminotomy. 

    Spinal fusion back surgery is often performed in conjunction with surgery for a slipped disc. The fusion stabilizes the spine but eliminates the natural independent motion of the newly-fused vertebrae.

    Today, many patients are choosing the TOPS™ (Total Posterior Spine) System as an alternative to spinal fusion surgery. The TOPS™ solution provides better clinical outcomes and preserves the independent motion of the vertebrae. This is just one of the medical advancements bringing new, improved therapies to patients worldwide.

    How Long Does it Take to Recover From a Slipped Disc Surgery?

    Spinal fusion surgery for a slipped disc involves an extensive recovery period. The procedure itself generally takes 4 to 6 hours to complete, and patients typically remain in the hospital for 2 to 4 days. The complete slipped disc surgery recovery time with spinal fusion may take anywhere from 6 months to a year. 

    With the TOPS™ system, the slipped disc surgery recovery period is much less involved than that of spinal fusion. The procedure is considered minimally invasive and typically only lasts for 60 to 120 minutes. 

    Patients can generally walk and move around just one day after TOPS™ surgery. After 4 to 6 weeks, patients reach their expected level of mobility. This recovery time for slipped disc surgery can be further aided by physical therapy and a nutrient-dense diet. 

    What Is The Success Rate of Slip Disc Operation?

    Surgery for slipped discs involving spinal fusion can improve back pain and symptoms at a rate of anywhere from 60% to 90%, depending on the study. For TLIF surgery with spinal fusion, studies have shown that the procedure improves patients’ pain by 60% to 70%, with an 80% satisfaction rate among patients. 

    With that said, it’s difficult to determine the success rate of slipped disc surgery with fusion without considering the risks. Patients may lose a significant degree of mobility in this procedure, which can diminish their quality of life.

    Additionally, the risk of increased degeneration around the fused segment, which is known as adjacent segment disease, must be taken into account. The prevalence of adjacent segment disease in patients who undergo lumbar spinal fusion ranges from 2% to 14%.

    To evaluate the success rate of the TOPS™ System for slipped disc surgery, we can consider the results of a 7-year follow-up study. The study evaluated 10 patients suffering from spinal stenosis with degenerative spondylolisthesis who underwent spinal decompression with TOPS™. 

    • The visual analog scale score for back and leg pain dropped from 56.2 before surgery to 19 7-year post-op mark. 
    • The Oswestry disability questionnaire, which is often used to measure back pain, fell from 83.5 before the procedure to 8.8 at the 7-year post-op mark. 
    • An MRI examination 7 years after the procedure didn’t show spinal stenosis adjacent to the stabilized segment. 

    Although spinal surgery for a slipped disc is widely considered to be a last resort, it can help patients achieve pain relief, improved mobility, and a higher quality of life. If you’re experiencing symptoms of disc herniation, schedule an appointment with your doctor for an evaluation.

    What is Lumbar Spinal Decompression?

    by admin

    Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.

    There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve. 

    This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure. 

    Why is Lower Back Pain So Common?

    Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.

    This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.  

    The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.

    Lumbar Spine Disorders

    The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.

    • Bulging disc

    A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal. 

    • Herniated disc

    A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior. 

    • Spinal stenosis

    Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.

    Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress. 

    • Spondylolisthesis

    Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it. 

    These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.

    What is a Lumbar Decompression Surgery?

    Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.

    The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.

    How is Lumbar Decompression Surgery Performed?

    There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:

    Laminectomy and Laminotomy

    Laminectomy and laminotomy are two surgical methods of lumbar decompression that involve the lamina. The lamina acts like the roof of the spinal canal and protects the spinal cord. 

    • In a laminectomy, the surgeon removes the majority of the lamina at the affected spinal segment. 
    • In laminotomy, the surgeon only removes a small portion of the lamina. 


    Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina. 


    In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery. 

    By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves. 


    Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.

    Lumbar Decompression Surgery With Spinal Fusion

    Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. 

    In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.  

    Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:

    • Reduced range of motion

    The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery. 

    • Damage to adjacent vertebrae

    The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms. 

    Are Alternatives To Spinal Fusion Available?

    Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world. 

    The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.

    How Long Does It Take to Recover From Lumbar Decompression Surgery?

    The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work. 

    Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.

    Is Lumbar Decompression Surgery Serious?

    Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.

    With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications. 

    If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you. 

    Can Spinal Stenosis Surgery Be Minimally-Invasive?

    by User_01 Sortino Marketing

    Especially in people over the age of 50, spinal stenosis is a prominent cause of chronic back pain and neurological symptoms. When this condition isn’t improved with several months of non-invasive treatment, your doctor may recommend spine surgery. 

    Patients who are concerned about the complications associated with traditional spine procedures may be interested in minimally-invasive spinal surgery. Also called MIS, minimally-invasive surgery can reduce your risk of complications, shorten your recovery, and cause less pain after the procedure. 

    With the benefits of MIS in mind, can spinal stenosis surgery be minimally-invasive? Here, we’ll discuss this question and discover spinal fusion alternatives for spinal stenosis patients. 

    What is Spinal Stenosis?

    Spinal stenosis is a common condition that develops when the spaces in the spinal canal become narrower. With less space in the spinal canal, the nerve roots and spinal cord may become compressed. This can result in a variety of symptoms, including:

    • Back pain and stiffness
    • Sciatica, which is nerve pain that extends from the lower back to the buttocks and down the legs
    • Cramping and/or numbness in the legs
    • Lost sensation and/or a sensation of weakness in the feet
    • In severe cases, lost bladder or bowel control

    What Causes Spinal Stenosis?

    Most often, spinal stenosis is triggered by osteoarthritis-related spinal degeneration. Osteoarthritis is a condition that occurs when the cartilage that cushions the joints (including the joints in the spine) breaks down over time. This results in pain, stiffness, and inflammation. 

    Other spinal conditions including herniated discs, spinal fractures, and bone spurs can also lead to spinal stenosis. Less commonly, patients are born with a narrow spinal canal or scoliosis (an irregular curve of the spine), leading to congenital spinal stenosis

    Surgery For Spinal Stenosis

    Surgery for spinal stenosis typically entails spinal decompression. The goal of spinal decompression surgery is to alleviate pressure on the spinal cord and/or spinal nerves to relieve back pain, stiffness, and neurological symptoms. 

    There are multiple possible approaches to decompressive spinal stenosis surgery. These include:

    • Laminectomy

    Laminectomy is the most frequently performed procedure for spinal stenosis. It involves removing some or all of the lamina, which covers the back of the vertebra. By getting rid of some or all of the bony arch at the back of the affected vertebra, your surgeon creates more room in the spinal canal. 

    • Laminotomy

    Laminotomy is similar to laminectomy. However, while laminectomy involves the total removal of the lamina, laminotomy involves only partial removal of the lamina. Laminectomy and laminotomy are both performed to alleviate nerve compression. 

    To determine which procedure you need, your surgeon will consider the specifics of your case. However, both types of spine surgery are conventionally performed with a posterior method. 

    • Foraminotomy 

    Foraminotomy is another type of spine procedure. It’s done to expand the path where the spinal nerve roots leave the spinal canal. The name of this procedure is taken from the word “foramen”, which is defined as a passage in medical terminology. The end of the word, “otomy”, is a term meaning “to open”. 

    While performing a foraminotomy, your surgeon will cut out any bone and soft tissue that’s blocking the passageway. By removing these tissues, your surgeon will effectively relieve pressure on the spinal nerve roots. 

    • Facetectomy

    The facet joints are small joints that connect the vertebrae from the back of the spine. Each vertebra has two facet joints. 

    In facetectomy, the surgeon fully or partially removes the facet joints of the affected vertebrae. The goal of this procedure is to assuage nerve compression on the nerve roots that run near the facet joints of the lower spine. 

    • Discectomy

    Patients who experience spinal stenosis caused by a herniated (bulging) disc may need a discectomy. In this spinal procedure, the surgeon removes damaged disc tissue to eliminate strain on the spinal nerves. 

    In a discectomy, your surgeon will aim to leave as much of the intervertebral disc untouched as possible. 

    The Benefits of Minimally-Invasive Spinal Treatment

    Minimally invasive spinal stenosis surgery presents several benefits over conventional spinal surgery. These include:

    Less Postoperative Pain

    During surgery, the body goes through a degree of trauma. But, minimally-invasive spine surgery limits or entirely avoids cutting through the muscles.

    By reducing the trauma to your muscles and soft tissues, MIS leads to less pain after spinal procedures. This can also lessen the need for pain medication after surgery. 

    Less Time in The Hospital

    After undergoing spinal surgery, patients are eager to return home as fast as possible. After all, you’re bound to feel more comfortable in your own home than in a hospital bed. So, one of the most attractive benefits of minimally-invasive surgery is that it can reduce the length of your hospital stay. 

    Faster Recovery

    After struggling with chronic back pain, a lengthy recovery period from spine surgery can be daunting. Additionally, a lengthy recovery period can require patients to take time away from work and their favorite activities.  

    Local Anesthesia

    Many minimally-invasive procedures can be done with local anesthesia, rather than general anesthesia. This makes MIS safer, as the risk of severe complications is much lower with local anesthesia when compared to general anesthesia. 

    Less Scarring

    Though arguably a less crucial benefit than reduced pain and a faster recovery, less scarring is a perk of minimally-invasive surgery. Due to a smaller incision, MIS limits scarring after surgery. 

    Lower Risk of Complications

    Medical complications are a major concern among surgery patients. Minimally-invasive surgery can limit the risk of medical complications, including the risk of infection and an adverse reaction to general anesthesia. Additionally, MIS avoids excess blood loss and the problems that it can cause. 

    Minimally-Invasive Spinal Stenosis Surgery

    Minimally invasive surgery (MIS) is available for spinal stenosis. Methods that can be used to achieve minimally invasive spine surgery include:

    • Using small incisions to limit bleeding and scarring
    • Using specialized instruments and/or a microscopic camera to guide the surgeon
    • Moving the muscles away from the spine with a tubular retractor
    • Accessing the spine from the patient’s side, rather than the back, to avoid the large back muscles
    • Using a percutaneous placement of rods, screws, and other spinal implants for implant placement without disturbing the spinal muscle
      • A percutaneous placement involves using x-ray imaging to position guidewires into the vertebrae on the same path as the screws will take. The screws can then take the route of the guidewires and help guide the rod placement. The rods can be connected to the screws and the screws can be secured into place using screw extenders that reach outside of the skin.  

    Spinal Fusion and Minimally-Invasive Spinal Stenosis Surgery 

    Spinal fusion is commonly performed for spinal stenosis surgery. By fusing two or more of the injured vertebrae together, fusion provides stability and pain relief. However, spinal fusion isn’t conventionally a minimally-invasive procedure. 

    The Downsides of Spinal Fusion Surgery

    Along with the risks of a non-MIS procedure, traditional fusion also presents risks of its own. For one, fusion significantly lengthens the amount of time that the patient must remain in the hospital after spine surgery. Additionally, the complete recovery period after spinal fusion can last as long as a year. 

    One of the most prominent downsides of spinal fusion is the fact that it can limit patients’ mobility. In the area of the fused vertebrae, patients often lose the ability to bend, rotate, and flex the back. This can prevent patients from taking part in their favorite activities after fusion surgery.

    Thankfully, minimally-invasive spinal fusion surgery is possible with the help of innovative spinal implant systems. 

    Spinal Implants For Minimally-Invasive Spinal Stenosis Surgery

    Some implant systems can facilitate minimally-invasive spinal stenosis surgery and serve as spinal fusion alternatives. By stabilizing the spine without preventing motion, an implant can help resolve spinal stenosis without the need for fusion. 

    The TOPS spinal implant is one of the available alternatives to spinal fusion that can allow for a minimally-invasive procedure. It’s a mechanical device that replaces the tissues removed in spinal decompression surgery. The implant works by instituting a controlled range of motion in the spine.  

    Minimally-Invasive Spinal Fusion Surgery Recovery Time

    The minimally-invasive spinal stenosis surgery recovery time is much shorter than that of conventional spine surgery. With the TOPS System, patients can regain a complete range of motion immediately after the procedure. Additionally, in comparison to fusion, TOPS patients are subject to far fewer restrictions during the recovery period. 

    Non-Surgical Alternatives to Spinal Stenosis Surgery

    Patients looking to entirely avoid spinal surgery may achieve symptom improvement from ongoing non-surgical treatment. Treatment options include:

    • Physical therapy
    • Chiropractic care
    • Massage therapy
    • Acupuncture
    • Anti-inflammatory medication
    • Epidural steroid injections
    • Lifestyle and activity modifications

    Your doctor can advise you on the best approach for surgical or non-surgical treatment to resolve symptoms of spinal stenosis, including proven and less invasive solutions like the TOPS spinal implant

    What Is XLIF?

    by admin

    Thanks to breakthroughs in spinal medicine, patients today can benefit from treatment regimens and procedures tailored to their individual needs and specific conditions. Among these recent advances on the surgical front is eXtreme Lateral Interbody Fusion, or XLIF.

    What is XLIF Spine Surgery?

    XLIF refers to a type of spine fusion surgery. In this procedure, the surgeon reaches the spinal disc from the side of the body, which is known as a lateral approach. This is unlike other methods, which access the spine anteriorly (from the front of the body) or posteriorly (from the back of the spine)

    For patients suffering from symptoms of spinal conditions, XLIF spine surgery is to assuage nerve root compression in the spine, correct spinal deformities, and resolve spinal instability. 

    XLIF Procedure Process

    XLIF is among the endoscopic spine surgery procedures performed with microsurgery tools and techniques. It’s generally performed with general anesthesia, so the patient is asleep through the procedure. Additionally, XLIF takes about an hour to complete. 

    Electromyography in XLIF

    Nerves extending from the backbone are positioned near the psoas, which can be compromised during surgery. To avert nerve damage, the XLIF procedure utilizes electromyography (EMG), a type of neuromonitoring. This enables the surgeon to examine the nerves that emerge out of the spine throughout the procedure, making sure that they’re not inflamed or damaged.


    XLIF falls into the category of back surgery involving the removal of the disc in the front of the spine. Then, an implant that holds a bone graft is used to replace the disc. The graft enables the two vertebrae to fuse between the disc area in a process known as spinal fusion.

    For patients with chronic back pain, XLIF provides a method of spinal fusion for the treatment of several different lower back disorders.

    Steps of XLIF

    1. The first step of XLIF surgery is to put the patient under general anesthesia. 
    2. Next, with the patient positioned on one side of the body, the surgeon will take x-rays. Using the information gathered from these x-rays, the surgeon can define the exact position of the intervertebral disc that will be extracted. 
    3. With the position of the disc marked on the patient’s skin, the surgeon will create an incision in the patient’s flank. The flank is located in between the hips and lower ribs. 
    4. Next, the surgeon will adjust the peritoneum aside from the abdominal wall. The peritoneum protects and encompasses the organs of the abdomen. 
    5. The surgeon will then make a second incision in the side of the body. A dilator will be placed into the incision, and the position of the dilator is checked with an x-ray. The dilator should be positioned precisely above the intervertebral disc. 
    6. To gain access to the spine, the surgeon will use a probe to separate the psoas. Then, a retractor can be used to allow spinal access. 
    7. With a path to the spine, the surgeon will remove the nucleus (interior) of the affected intervertebral disc. This step, which is referred to as discectomy, preps the area for fusion. 
    8. A spacer containing bone graft material will then be placed into the disc area. The spacer maintains the position of the vertebrae and helps with the fusion process. 
    9. In some cases, the surgeon may opt to complete posterior fixation with rods and facet/pedicle screws. This step can provide spinal stability after XLIF surgery. 

    How Does XLIF Differ From Conventional Spine Procedures?

    XLIF differs from the traditional posterior approach for spine surgery, which is called posterior interbody fusion (PLIF). Since PLIF involves reaching the spine from the back, the procedure requires the surgeon to disturb the large back muscles. Doing so triggers a lengthy recovery process, along with significant pain in the post-op period. 

    Additionally, XLIF is a minimally-invasive form of spine surgery, unlike PLIF. Along with a shorter recovery period and less postoperative discomfort, minimally-invasive procedures offer the benefit of a lower risk for medical conditions.  

    What Are The Benefits of XLIF?

    • Requiring only small incisions, XLIF surgery minimizes tissue damage, blood loss. and scarring. 
    • XLIF has a relatively quick recovery time, especially when compared to conventional spine surgery.
    • Taking as little as an hour to complete, XLIF minimizes the amount of time that the patient spends under anesthesia. 
    • Since the back muscles, ligaments, and bones are left undisturbed with the lateral approach of XLIF, patients experience less pain. 
    • After XLIF, patients can return to their regular activities faster than through conventional spine surgery. 
    • Patients can often walk on the day of the XLIF procedure. 
    • Although some XLIF cases may require the patient to stay for one night at the hospital, it typically results in a quicker hospital stay than other spinal procedures. After conventional spinal fusion, patients must remain in the hospital for multiple days after the procedure. 
    • XLIF surgery reviews are positive and indicate that the procedure can successfully reconstruct spinal deformities. 

    What Are The Drawbacks of XLIF?

    A drawback of the XLIF procedure is that it involves fusing vertebrae. Spinal fusion eliminates independent movement between adjacent levels.

    Spinal fusion significantly lengthens the recovery period of any spinal fusion procedure. Unfortunately, even after making a full recovery, patients won’t regain a full range of motion in the spine. With each vertebra that’s fused, patients lose a degree of spinal flexibility. 

    After XLIF with spinal fusion, patients may no longer be able to bend, flex, stretch, and twist the back like they once could. This can diminish patients’ ability to partake in various physical activities. 

    Additionally, when two or more vertebrae are fused, they force the rest of the spine to compensate for their lack of motion. Specifically, the vertebrae on top of and below the fused spinal bone undergo increased impact. This can result in adjacent segment disease, or ADA.

    With ADA, the vertebrae that are adjacent to the fused portion of the spine degenerate more rapidly. This can result in chronic back pain and neurological symptoms in the legs and feet. 

    Fusion Alternatives

    Non-Surgical Treatment Methods

    Spinal fusion typically isn’t recommended until patients have undergone several months of conservative treatments. Nonetheless, patients looking to avoid the complications of fusion may consider continuing with non-surgical therapies, such as:

    • Physical therapy

    Physical therapy can help patients improve their posture, strengthen the spine’s supporting muscles, and alleviate muscle tension. 

    • Chiropractic care

    Chiropractic care can help relieve tension in the spine by enhancing spinal alignment. 

    • Lifestyle modifications and rest

    Rest and lifestyle modifications can reduce the strain on the spine. Lifestyle factors including smoking, having a sedentary lifestyle, and having a high body weight can exacerbate spinal conditions.  

    • Anti-inflammatory medications

    Anti-inflammatory medications can help patients manage chronic pain from spine conditions. NSAIDs, muscle relaxants, and acetaminophen are examples of medications that may benefit patients with chronic spinal pain. 

    • Epidural steroid injections

    Epidural steroid injections can only be used a few times per year. However, this condition can help alleviate pain and swelling from spinal disorders. 

    Spinal Implants

    Today, thanks to another advance in spinal medicine – the TOPS™ System –  some patients may be able to avoid the risks and complications associated with spinal fusion. In select cases, a TOPS implant can be used in place of traditional spine fusion surgery to resolve conditions such as spinal stenosis, spondylolisthesis, and herniated discs. 

    Unlike fusion, the TOPS System preserves the full range of motion of individual vertebrae. Additionally, the TOPS System has been proven to provide better outcomes than spinal fusion in clinical studies conducted around the world. This adds up to two breakthroughs in the treatment of spinal conditions, promising effective relief for many patients with back problems that require a surgical solution.

    With the TOPS System, patients can avoid:

    • The lengthy recovery period associated with fusion
    • The post-operative pain that patients experience with fusion
    • The prolonged hospital stay required after fusion
    • The reduced spinal mobility caused by fusion
    • The risk of adjacent segment disease and related conditions

    If you’re struggling with symptoms of a spinal disorder, talk to your doctor about the available treatment options, such as XLIF surgery and the TOPS System. 

    Degenerative Joint Disorders That May Require a Surgery

    by User_01 Sortino Marketing

    Degenerative joint disease is also referred to as osteoarthritis or OA. Osteoarthritis is the most widespread form of arthritis, and it’s mainly caused by age-related joint degeneration. 

    Many different disorders fall under the umbrella of degenerative joint disease. If these disorders don’t respond to conservative treatments, surgery may be required for symptom relief. 

    Let’s discuss the degenerative joint disorders that may require surgery, as well as available treatment options. 

    Which Degenerative Joint Disorders May Require Surgery?

    Degenerative joint disorders can gradually progress, become severe, and fail to respond to non-surgical treatment options.

    Examples of degenerative joint disorders with the potential to require surgery include: 


    Osteoarthritis can severely diminish various joints in the body, including the knees, hips, and fingers, as well as the facet joints in the spine. If the condition becomes severe, it can cause chronic, debilitating pain and a loss of function of the affected joint. 

    If non-surgical treatment options don’t resolve joint pain from osteoarthritis, the joint may need to be surgically removed and replaced with an artificial joint. 


    Spondylosis is a term that refers to spinal degeneration. It occurs when the spinal bones, called vertebrae, wear down and change with age. Oftentimes, spondylosis is called osteoarthritis of the spine or degenerative disc disease. 

    Oftentimes, spondylosis can be effectively treated without surgery. Physical therapy, pain medications, chiropractic care, rest, and spinal injections have a high rate of success in spondylosis patients. 

    However, if this degenerative condition doesn’t respond to non-surgical treatments and causes severe symptoms such as spinal instability and weakness, tingling, or numbness in the extremities, surgery may be required. 

    Surgery For Spondylosis

    Examples of surgical procedures that may be done for spondylosis include:

    • Laminectomy, which involves removing some of all of the lamina, the bony layer of the vertebra that encloses the spinal canal
    • Facetectomy, which involves removing one of the spine’s facet joints. Facet joints connect the vertebrae to allow for spinal motion and stability. 
    • Laminotomy, which involves creating a larger opening in the spinal canal by removing some of the lamina
    • Foraminotomy, which also involves creating a larger opening in the spinal canal, but by enlarging the space around the intervertebral foramen

    These procedures are all forms of spinal decompression surgery, which we’ll discuss in greater detail below. 

    Spinal Stenosis

    Spinal stenosis is a condition that occurs when the space inside of the spinal canal narrows. It most often occurs as a result of spinal degeneration from the aging process. 

    As the spinal canal becomes narrower with spinal stenosis, it can irritate and compress the spinal nerves. This may lead to back pain, along with numbness, tingling, and weakness in the extremities.  


    Spondylolisthesis is a condition that occurs as a result of spinal instability. With this condition, one of the vertebrae slips out of place and settles on the vertebra beneath it. Spinal disc degeneration is a common cause of spondylolisthesis in older adults. 

    When one of the vertebrae are out of alignment with spondylolisthesis, it can lead to back pain, stiffness, trouble walking and/or standing, and muscle spasms, along with numbness, tingling, and weakness in the foot. 

    Spine Surgery For Degenerative Joint Disorders

    Spine surgery for degenerative joint disorders may involve the following procedures:

    Facet Joint Replacement

    Facet joint replacement is a type of spine surgery that involves replacing a degenerated facet joint with a spinal implant, like the Premia Spine TOPS System. In this procedure, the surgeon will remove the affected facet joint and secure the implant in its place to stabilize the spine while relieving pain from spinal degeneration.  

    Spinal Decompression

    Spine surgery for spinal degeneration usually involves spinal decompression and fusion. Decompression surgery involves removing the spinal tissue that’s causing the patient’s symptoms, typically because it’s pressing on nearby spinal nerves.  

    What’s Involved in Spinal Decompression?

    During spinal decompression, the patient is first put under general anesthesia. Next, the surgeon creates an incision (often in the abdomen). The organs and other tissues then must be moved aside to create access to the spine. 

    Once the surgeon has achieved access to the spine, he or she will remove the spinal tissues that are causing nerve compression. The type and amount of tissue that’s removed during spinal decompression can vary from patient to patient. 

    With the spinal tissue removed, the surgeon typically then performs spinal fusion (or, as an alternative, places a spinal implant) to stabilize the spine. 

    Spinal Fusion

    After decompression is complete, spinal fusion is often performed to stabilize the spine. This procedure involves positioning bone graft material in between the affected vertebrae. The bone graft stimulates the fusion of the vertebrae in the months after the procedure. 

    Downsides of Spinal Fusion

    • Reduced spinal mobility

    Spinal fusion prevents spinal instability. However, it also inhibits the motion of the spine. Patients largely lose the ability to twist, bend, and flex the spine after spinal fusion. 

    Reduced spinal mobility can limit the patient’s activities and everyday movements after the spinal fusion. For example, some patients may no longer be able to bend over after fusion and may require tools to pick up items off of the ground. 

    • Prolonged recovery process

    Since fusion involves operating directly on spinal bone tissue, it also prolongs the recovery process for degenerative joint disease surgery. Patients require more downtime after spinal fusion, and the recovery process tends to be more painful than non-fusion procedures. 

    • Risk of adjacent segment degeneration

    Adjacent segment degeneration (ASD) can occur in patients who undergo spinal fusion. It’s a condition that occurs when the spinal bones around the fused vertebrae are placed under added stress. As a result, these portions of the spine degenerate more rapidly. 

    Fusion Alternatives For Degenerative Joint Disease Treatment

    Spinal implants like the TOPS System are alternatives to spinal fusion in surgery for degenerative joint disorders. In facet joint replacement and spinal decompression, an implant can stabilize the spine without compromising the patient’s mobility. 

    The TOPS spinal implant moves with the spine, allowing the patient to twist and bend quickly after the procedure. As a result, patients experience relief from symptoms of spinal degeneration without compromising the normal motion of the spine. 

    For more information about the TOPS System in degenerative joint disease treatment, contact Premia Spine today.  

    What is Neural Claudication?

    by admin

    Neurologic Claudication

    Recently, we addressed the topic of claudication. Claudication refers to pain typically felt in the legs as a result of vascular (blood vessel) problems or back problems (such as spinal stenosis) that can cause pinched nerves in the lower back.

    Neurogenic claudication is a common symptom of lumbar spinal stenosis, which is the abnormal narrowing of the spinal canal in the lumbar (lower) spine. Neurogenic refers to the condition’s genesis in the nerves, while claudication (Latin for limp) refers to painful weakness or cramping in the legs.

    The Basics of Neurogenic Claudication

    Also called pseudoclaudication, neurogenic claudication occurs as a result of compression of the nerves in the lumbar spine. Neurogenic claudication is widely considered a syndrome, meaning that it involves a group of symptoms that usually develop collectively. 


    As aforementioned, most cases of neurogenic claudication are triggered by spinal stenosis, which occurs when the space around the spinal cord diminishes.

    Understanding Spinal Stenosis

    Spinal stenosis is estimated to affect 8% to 11% of adults in the United States, according to the American Academy of Orthopedic Surgeons. It’s the most prevalent in adults over the age of 50.  

    Common causes of spinal stenosis include bone spurs, bulging discs, and the thickening of ligaments in the spine.  

    • Bone spurs are solid lumps of extra bone that can develop as a result of wear and tear on the spine, such as osteoarthritis. 
    • Bulging discs, which may also be called herniated discs or slipped discs, occur when there’s a tear in the firm exterior of a spinal disc. The soft interior of the disc may push out through this crack and place stress on spinal nerves.  
    • The ligaments that support the spine and keep the vertebrae connected can stiffen with age. As a result, the ligaments may thicken and begin to take up extra space in the spinal canal. 

    These spinal conditions can trigger the impingement of spinal nerves, which leads to the symptoms associated with neurogenic claudication. 

    Bilateral vs. Unilateral

    This syndrome may be bilateral (in both legs) or unilateral (in one leg). However, most cases of neural claudication are bilateral. 


    Symptoms of neural claudication typically include pain, cramping, weakness, and tingling. These symptoms most often appear in one or both legs, the lumbar spine, and the buttocks. 

    Pain from neural claudication may be triggered by walking or prolonged standing and is generally alleviated by changing position or bending the waist. Unlike vascular claudication, neural claudication can’t be alleviated simply by resting.

    In severe cases, pain from this syndrome may be persistent. Without treatment, spinal stenosis and neural claudication can become a source of chronic pain. 

    Treating Neural Claudication


    First, your physician will need to run tests to provide a diagnosis. An x-ray, MRI, and CT scan are all often used to diagnose neural claudication and can identify stenosis, bone spurs, and slipped discs.

    • X-rays use electromagnetic beams of energy to create images of the patient’s bones. Although the spinal cord, spinal nerves, and other soft tissues generally can’t be viewed using an x-ray, this test allows for a general examination of the bone tissue in the spine. 
    • MRIs (magnetic resonance imaging) use radiofrequency energy, magnets, and computers to develop bone and soft tissue images. Unlike an x-ray, an MRI can help physicians evaluate soft tissue injuries in the spine, like a slipped disc. 
    • CT (computed tomography) scans combine x-rays and a computer to form images of soft tissues and bones.

    These tests can evaluate the general condition of the spinal bones and soft tissues to determine if neural claudication is present. This, along with a physical exam and patient interview, will help your physician diagnose your spinal symptoms. 

    Conservative Treatments

    Conservative treatments may be sufficient to relieve neurogenic claudication. Physicians generally start patients out with a conservative treatment plan before considering surgery. 

    Some of the most common non-surgical treatments for neurogenic claudication include:

    • Physical therapy

    Physical therapy for neural claudication usually involves exercises for spinal flexion, abdominal exercises to improve stability, and lifestyle recommendations. Massage and heat/ice therapy may also be implemented for pain relief. 

    • Medications

    Anti-inflammatory medications can help relieve pain and inflammation caused by neurogenic claudication. These medications may be found over-the-counter or prescribed, depending on the severity of the case. 

    • Injections 

    Epidural steroid injections can be used to relieve pain from irritated nerves in the spine. When injected into the affected area, the steroid medication works to reduce pain signals from the injured nerves, leading to less pain and discomfort. 

    Keep in mind that epidural steroid injections should generally only be applied three to six times annually. If you get too many injections, there’s a risk of decreasing the strength of the vertebrae and adjacent muscle tissue. 

    spinal decompression surgery

    In moderate to severe cases of neurogenic claudication that don’t respond to conservative protocols, surgery may be recommended. Spinal decompression surgery can improve your comfort and quality of life if neurogenic claudication is interfering with your daily activities. 

    Spinal decompression surgery is typically performed to remove portions of the vertebrae that are impinging on a nerve. This pinched nerve is the source of pain, weakness, and cramping in cases of neurogenic claudication. 

    Any procedure that relieves pressure on spinal nerves to resolve symptoms of spinal compression, including neurogenic claudication, is referred to as spinal decompression surgery. There are a few different approaches to spinal decompression, including discectomy, laminotomy, laminectomy, foraminotomy, foraminectomy, corpectomy, and osteophyte removal. 

    Your surgeon will determine the best method of spinal decompression to suit your circumstances. 

    Spinal Fusion

    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.

    Spinal fusion involves connecting neighboring two vertebrae so that they eventually form one bone. To do this, the surgeon will position bone graft material in between the vertebrae.

    To keep the vertebrae in position during the bone graft’s healing process, your surgeon may also perform posterior fixation. This involves using screws and rods to reinforce the alignment of the spine. 


    Although spinal fusion can prevent further damage from spinal instability, it has several downsides. For one, patients commonly need to stay in the hospital for up to four days after spinal fusion. After the patient returns home, it can take many months for the vertebrae to fuse together and for the spine to heal. 

    Spine fusion surgery eliminates the natural independent motion of the fused vertebrae. It can contribute to the deterioration of adjacent vertebrae, potentially leading to further complications.  

    Additionally, spinal fusion compromises the mobility of the spine. Patients may require special tools to pick up items off of the floor because they can no longer bend over after spinal fusion. 

    Alternative Solutions

    The TOPS (Total Posterior Solution) System provides an alternative to spinal fusion that preserves the full range of natural motion of each vertebra. It’s a mechanical device that supplants the tissues removed during spinal decompression. 

    With the TOPS spinal implant, it’s possible to reinforce the stability of the spine after spinal decompression surgery without compromising the patient’s range of movement. This device moves with the spine so that the patient can resume their normal activities soon after surgery. 

    The TOPS device also provides a faster, more comfortable recovery process after spinal decompression. This spinal implant reduces the trauma on the spinal tissues after decompression. 

    If you experience pain that interferes with your quality of life, seek qualified medical help and get the facts about all of your treatment options. Today’s advanced procedures provide excellent outcomes for spinal conditions including neural claudications. 

    How soon can you return to athletics after spinal surgery?

    by admin

    Near the top of the list of questions from almost every spinal surgery, the patients indicate how long they will have to wait for the following surgery before resuming their everyday activities. When it includes 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 patients can get back in the game include their physical condition and health. Just because one engages in strenuous physical activity doesn’t mean they are in good physical condition or health. Recovery times are faster for surgery patients in good physical shape because their bodies heal more quickly. Of course, the operation itself will play a significant role in deciding when you’ll be back on the tennis courts, golf course, taking a job, or engaging in a simple walk. The postoperative physical therapy program also plays a significant role. But the type of back surgery is the primary factor affecting the time required to get back into sports activities.

    How to recover from surgery if you are an athlete or cannot live without daily activity – read further in this article.

    Table of contents

    1. What does it mean to be in recovery?
    2. Exercises after surgery
    3. Conclusion

    What does it mean to be in recovery?

    While many people consider back surgery as the end of a promising sports career, Olympic, amateur, or professional athletes have returned to their competition after many common types of operations. General physical condition, professionalism during surgery, and spine rehabilitation affect how quickly you return to the game. Here are some tips for athletes planning to return to sport after a minimally invasive intervention. 

    Follow your doctor’s recommendations

    In most cases, surgeons consult about postoperative care. They depend not only on the patient’s health and medical history but also on the desire to return to sports. We previously discussed lower back surgery recovery: diet, exercise, physical therapy, massages, proper wound care, and medication support are vital aspects of recovery. Of course, you shouldn’t neglect motivation and grit to achieve success. And if your competition is right around the corner, and you’re still in the hospital ward, this is not a reason to be upset. Your orthopedic surgeon will take this into account when planning your postoperative period. Of course, everyone wants to leave and start an everyday life immediately. Still, following the recommendations, you’ll be able to return to sports faster than causing implicit harm to your body during self-rehabilitation. Returning too early cancels not only the healing but the operation’s effectiveness. 

    So, a doctor’s advice may include:

    • doing certain exercises
    • wearing compression bandages, insoles, and stockings to avoid the risk of complications
    • A diet that includes vitamin and mineral complexes
    • A set of particular activities after back surgery.

    Define your limits

    You’d also talk to your coach about your career prospects or options (if you’re an amateur athlete) when getting approval from your PCP to return to athletics. It’s essential to be careful and aware of the limitations.

    The postoperative stage depends on the patient, understanding the symptoms of complications, and a quick reaction if something goes wrong. E.g., accurately characterizing the level of pain and discomfort, reporting aches, numbness of the limbs, dizziness, suppuration in the wound area doesn’t mean a step back in the rehabilitation progress, but on the contrary, the ability to accelerate after a slight slowdown. Try to protect the spine, especially in the early stages of recovery. Respect your body and its healing times. 

    Don’t forget about the course of drugs

    Infections at the site of the surgical incision most often occur 2–4 weeks after the intervention. Most often, the following symptoms appear:

    • redness and suppuration at the incision site;
    • back pain that gets worse;
    • fever and fever;
    • change in consistency, odor, and color of drainage.

    It’s essential to treat any of these and some other signs as they arise. If ignored, unavoidable consequences may occur. 

    For patients with deep infection, a course of intravenous antibiotics is often given for about two months. Chronic contamination leads to the removal of the implant. 

    Keep the wound clean: it must be washed with water and soap at least once a day. Remember to keep the wound dry for healing and crusting. It’s undesirable to utilize ointments, lotions, body creams on the operated areas. After two weeks, when the staples or stitches are removed, you may return to bathing or swimming. 

    For opioid pain relievers, discontinuation usually occurs within the first few weeks, at most a month. There are other pain management options, such as using acetaminophen or non-steroidal anti-inflammatory drugs. But, as in the first case, they have their pros and cons and depend on the medical history. By combining medicines with physical therapy, you can achieve impressive results. 

    It’s no secret that athletes’ dedication to the postoperative rehabilitation program greatly influences their subsequent success. Depending on overall progress in physical therapy, you may get consent to exercise, but return to activity must be gradual and gentle to avoid unnecessary risks.

    Exercises after surgery

    Patients, who have undergone minimally invasive TOPS™ procedures, can usually regain a full and painless range of motion. They have the greatest likelihood of returning to sport at pre-injury levels. Conversely, most exercises after spinal fusion aren’t available to athletes, and the possibility of injury increases – they’re less likely to return to athletics. Any collisions and falls will negatively affect health.

    In any case, physiotherapy is a panacea for healing – movement combined with other aspects of rehabilitation can give you a chance for a better life. Let’s consider the leading practices that are useful for patients in the postoperative period.


    It’s worth moving daily to improve blood circulation and speed up the healing of muscles and spine tissues. E.g., an essential therapy is walking, which can support the normal functioning of the heart and lungs. An upright position of the body is the best activity for the spine after surgery – this way, you can protect the discs from unnecessary stress. So, start with simple walks, and then work with your coach to develop your exercise program.

    Bench press

    That’s one of the simplest and effective therapies utilized in various types of operations. For instance, laminectomy recovery exercises are invaluable as they help protect discs and strengthen your back muscles.

    This exercise is valuable because the discs hold the lower back during flexion and extension of the lumbar spine. So, to perform the training, you need to do the following steps:

    1. Lie face down with your arms parallel to your body.
    2. The back and hips should be relaxed. Gently lift your upper body while leaning on your stomach. Feel light pressure in your lumbar region.
    3. Hold this position for about two seconds and slowly lower yourself to the floor. Do ten hikes.

    Straight leg raise (SLR) 

    To strengthen the muscles of the lower back, it’s worth doing the SLR exercise. To do this, while lying on your stomach, slowly and alternately lift each leg up. In doing so, try to tighten your abdominal muscles. Do an exercise with a delay of two seconds at the highest point of the limb position. As before, do ten reps per set. Such a physiotherapy approach is appropriate for laminectomy, fusion, microdiscectomy, decompression, and of course, implantation.

    Regain your mobility with Premia Spine! Contact us now

    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 stenosis, spondylolisthesis, and other degenerative changes or as a result of spinal cord trauma. Spinal fusion back surgery has been the primary stabilization procedure. But the fused vertebrae lose their independent motion following stabilization. Often, patients are restricted from physical activity for up to 6 months while waiting for the biological fusion process to complete. 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 the 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.


    As you improve your range of motion in your spine, it’s time to start doing more challenging activities that will help you get back to working condition. To do this, discuss a possible change in activity with a PCP and trainer and adjust the training schedule. After implantation, you don’t have to worry that you can’t perform some exercises. The TOPS™ System is an alternative to spinal fusion and allows you to perform any range of movements required for warm-up, training, and cool-down.