Dr. Anekstein is the director of the spinal surgery unit at Assaf Harofeh Hospital. He specializes in degenerative diseases of the spine, which aren’t typical forms of back pain. These ailments, including spinal stenosis and spondylolisthesis, occur when the spine degenerates gradually with age.

Facet joint degeneration, in particular, often causes pain and neurological symptoms in patients’ 50s and 60s. Intervertebral disc degeneration typically begins earlier in life.

Some patients can manage degenerative spinal conditions with physical therapy, lifestyle changes, and other non-surgical treatments. However, surgery is required to stem the degeneration and cure conditions like spinal stenosis.

Laminectomy, a procedure to open up the spinal canal, is the standard surgical treatment for spinal stenosis. In cases of severe degeneration, this procedure can cause spinal instability, and the symptoms may eventually return. Spinal fusion surgery can be implemented to prevent this instability, but it can lead to degeneration in the neighboring segments.

The TOPS™ System is an implant that replaces the degenerated facet joint. Dr. Anekstein uses this device to facilitate movement between the vertebrae while relieving nerve compression. The average recovery time is one month before returning to full function.