About X-Stop, Symptoms of Spinal Stenosis
If you suffer from lumbar spinal stenosis you may feel various symptoms, including:
- dull or aching back pain spreading to your legs
- numbness and “pins and needles” in your legs, calves or buttocks
- weakness, or a loss of balance, and
- a decreased endurance for physical activities
Symptoms increase after walking a certain distance or standing for a time. Symptoms can improve when you:
- sit
- bend or lean forward (see Figure below)
- lie down, or
- put your foot on a raised rest
What is Spinal Stenosis ?
Spinal stenosis is a narrowing of the spinal canal. Some patients are born with this narrowing, but most often spinal stenosis is the result of a degenerative condition that develops in people over the age of 50. Spinal stenosis is the gradual result of aging and “wear and tear” on the spine from everyday activities.
Degenerative or age-related changes in our bodies can lead to compression of nerves (pressure on the nerves that may cause pain and/or damage).
As we age:
- the ligaments of the spine can thicken and calcify (harden from deposits of calcium)
- bones and joints may also enlarge
- bone spurs, called osteophytes, may form
- discs may collapse and bulge (or herniate)
- one vertebra may slip over another (called spondylolisthesis)
Treatment Options
Once a diagnosis of spinal stenosis is confirmed, the process of treating the condition usually begins with a regimen of non-invasive, “conservative” therapy.
Non-surgical Treatment of Stenosis
There are a number of ways a doctor can treat stenosis without surgery, including:
- Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain, and analgesics to relieve pain.
- Corticosteroid injections (epidural steroids) to reduce swelling and treat acute pain that radiates to the hips or down the leg. Pain relief from an epidural injection may be temporary and patients are usually advised to get no more than 3 injections per 6-month period.
- Rest or restricted activity.
- Physical therapy and/or exercises to help stabilize the spine, build endurance and increase flexibility.
While some patients obtain relief from symptoms with these treatments, others do not.
Surgical Treatment of Stenosis
Decompression
Non-surgical treatments may temporarily relieve pain. More severe cases of stenosis may require surgery.
The most common surgical procedure for stenosis is a decompressive laminectomy sometimes accompanied by fusion. Often referred to as “unroofing” the spine, this procedure involves the removal of various parts of the vertebrae, including:
- the lamina, as well as the attached ligaments, that cause compression of the spinal cord and nerve roots, and/or
- enlarged facets, osteophytes and bulging disc material
The goal of the surgery is to relieve pressure on the spinal cord and nerves by increasing the area of the spinal canal and neural foramen.
Other types of surgery to treat stenosis include:
- Laminotomy - only a small portion of the lamina is removed to relieve local pressure on the spinal cord and nerve roots.
- Foraminotomy - the foramen (the opening through which the nerve roots exit the spinal canal) is enlarged to increase space for the nerves. This surgery can be done alone or with a laminotomy.
- Facetectomy - part of the facet joint is removed to increase space for the nerves.
The X STOP® Procedure
The procedure may be performed in either the operating room or special procedures room at the hospital. Using local anesthesia and with the help of X-ray guidance, the X STOP implant is inserted through a small incision in the skin of your back. Alternatively, your surgeon may elect to use general anesthesia.
You will be placed on your side during the procedure so that you can bend your spine when the X STOP is inserted. The surgery to implant the X STOP typically lasts 45 minutes to an hour-and-a-half. During this time you may be awake and able to communicate with your doctor.
Why May X STOP® IPD Work?
The X STOP implant is designed to keep the space between your spinous processes open, so that when you stand upright the nerves in your back will not be pinched or cause pain. With the X STOP implant in place, you should not need to bend forward to relive your symptoms.
IPD offers several benefits compared to traditional surgery for lumbar spinal stenosis, including:
- the option of local anesthesia
- the potential to be an outpatient procedure
- usually no removal of bone or soft tissue allowing for potentially quicker recovery
- fully reversible procedure that does not limit any future non-surgical and surgical treatment options
What is IPD®?
Interspinous Process Decompression (IPD)
IPD is a surgical procedure in which an implant, called the X STOP®, is placed between two bones called spinous processes in the back of your spine.
With IPD surgery there is no removal of bone or soft tissue. The X STOP implant is not positioned close to nerves or the spinal cord, but rather behind the spinal cord between the bony spinous process.
