Spinal Stenosis Surgery

Are Spinal Implants Right for Me?

Question: I was diagnosed with spinal stenosis a few months ago, and I've been researching different surgery options for this disease. Have there been any recent studies on the use of spinal implants (such as X-STOP) for spinal stenosis surgery?
—Boston, MA
Closeup of pencil eraser and black spinal stenosis textAnswer: The short answer is that there is no good long-term data on the use of interspinous process decompression (IPD) devices, such as X-STOP. However, there is a lot of short- and mid-term data (up to 5 years) that show these devices may offer a safe, effective, and less invasive option than traditional open spine surgery to reduce pain caused by spinal stenosis.

In fact, the most recent mid-term study on spinal stenosis surgery in September 2010 showed that after 2 years, X-STOP is effective overall at relieving pressure on your nerves1. This is encouraging news for many patients who were wary about the usefulness of spinal implants or who were intimidated about spine surgery in general.

However, another recent study showed significant complications associated with X-STOP 4 years after surgery2. One key takeaway from this study showed that it's important to remember that certain patients, such as those with severe osteoporosis, aren't good candidates for IPD. These patients' soft bone can re-model around the rigid implant, and the effect of the implant can be lost or their bone could fracture.

To understand why you may need surgery for spinal stenosis in the first place, here's a little background information on spinal stenosis: Spinal stenosis—the narrowing of the space around your spinal cord and nerve roots—can cause significant pain, including pain that radiates (travels) down your leg(s) or arm(s). It can also cause numbness, weakness, and tingling.

The most common area to get spinal stenosis is in the lumbar spine (low back). Interspinous process decompression is a minimally invasive procedure that spine surgeons use to relieve pain caused by lumbar spinal stenosis.

IPD involves an implant (called a spacer), usually made from titanium alloy. This implant is inserted between your spinous processes and helps create more space between the vertebrae. The implant reduces pressure on your spinal nerves and restores disc height—which, ultimately, can help relieve your pain.

As mentioned previously, spinal implants are generally a safe, effective option for treating spinal stenosis. However, they're not your only option.

As you already know from your research, there are several options for spinal stenosis surgery, but sometimes a more aggressive approach is taken. It's best to work with your doctor to decide what spinal stenosis surgery option is right for you.