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Lumbar Interspinous Process Spacer

What does “Lumbar Interspinous Process Spacers” mean?

    Here is the meaning of each word:

  1. Lumbar: area of the spine located in the low back
  2. Interspinous Process: a device located between the spinous processes of two vertebrae
  3. Spacers: a device which keeps two bones apart

Altogether, “Lumbar Interspinous Process Spacers” means placing a device between the spinous processes of two vertebrae of the low back.

What is a Lumbar Interspinous Process Spacer?

                A Lumbar Interspinous Process Spacer is a device which is placed between the spinous processes of two vertebrae for spinal stenosis (narrowing of the canal in the spine) or foraminal stenosis (narrowing around a spinal nerve). The spacer increases the distance between the spinous processes. This increase in distance can change the angle the two vertebrae have towards each other (angle is widened). When this angle is widened, the spinal foramen (opening on the side of the spine where the spinal nerve leaves) can become larger and the spinal canal can become wider. Making the foramen larger can relieve compression of the spinal nerves. Widening the canal can relieve some of the compression of the spinal nerves or spinal cord in the spinal canal.

Why are Lumbar Interspinous Process Spacers used?

                A Lumbar Interspinous Process Spacer is used to relieve the symptoms of spinal stenosis. Only a small operation is required to place them. These devices are used in hopes of avoiding a larger operation.

What are the different types of Lumbar Interspinous Process Spacers?

                Currently only one type of Lumbar Interspinous Process Spacers is FDA approved. This device is called the “X-Stop” device. Other devices are called the “Wallis” device, “Diam”, and “Coflex”. They are not approved by the FDA but are used in Clinical Trials.

How is a Lumbar Interspinous Process Spacer surgery done?

Here are some of the steps of how a X-Stop Interspinous Process Spacer is placed:

  1. An intravenous catheter (IV) is placed and antibiotics given.
  2. The patient is taken to the Operating Room and placed on the back (supine).
  3. A General Anesthetic can be given. Another option is to give the patient relaxing medication through the IV (sedation).
  4. The patient is carefully placed on the stomach (prone).
  5. The low back (lumbar spine) is cleaned with a sterile surgical solution and plastic sheets (drapes) are used around the site of the surgery.
  6. The correct spinal level is found with the help of an X-Ray machine.
  7. The surgeon makes a small cut (incision) over the spine.
  8. The tissue under the skin is opened and pushed aside.
  9. Some of the spinal muscles attachments are removed from the spinous processes.
  10. The ligament between the spinous processes (interspinous ligament) is seen and a portion removed.
  11. The X-Stop device is placed at the site where part of the ligament is removed.
  12. The device is “wedged” between the spinous processes and secured with its anchoring device.
  13. The tissue and skin are closed.
  14. A sterile bandage (dressing) is placed over the site of the surgery.
  15. The patient is turned on their back and awoken from Anesthesia.
  16. The patient is taken to the Recovery Area.

How long does it take to complete a Lumbar Interspinous Process Spacer surgery?

                This surgery often takes 30-60 minutes to complete.

What is the recovery like from a Lumbar Interspinous Process Spacer surgery?

                Here are some of the steps in the recovery process:

  1. This surgery is usually done as an outpatient.
  2. After discharge the patient is given specific activity restrictions, such as limitations on lifting, bending and twisting.
  3. The wound will typically heal within 2-4 weeks.
  4. The surgeon will usually reevaluate the patient within several weeks following the surgery. At that time X-Rays are often taken.

What kind of benefit can patients gain from a Lumbar Interspinous Process Spacer?

                Here are some potential benefits from the surgery:

  1. Relief of leg pain, numbness and tingling
  2. Relief of leg weakness
  3. Ability to walk further distances