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X-Stop: A treatment for spinal stenosis

If you're living with lumbar spinal stenosis, a device called the X-Stop Spacer could be a little solution for a big problem.

Lumbar spinal stenosis occurs when there's a narrowing of the spinal canal—the space in the back that contains the spinal cord. Usually, the condition affects middle-aged and older adults.

"It's a disease of arthritis, wear and tear, and normal degenerative changes that, over a period of months or years, produces pressure on the nerves that go to the legs," explains John Ratliff, MD, spokesman for the American Association of Neurological Surgeons.

"Classically, this pressure manifests itself when someone is walking, sitting for a long period of time or standing for a long period of time. People can get discomfort in their buttocks, the posterior parts of their thighs and their calves," he says.

That discomfort can become bothersome. People may find it difficult to walk, be active and function normally. It can severely affect quality of life, says Dr. Ratliff, who is also an associate professor of neurosurgery at the Stanford University Medical Center.

Often symptoms are relieved with conservative treatments, such as physical therapy or medication.

But if those treatments aren't effective, surgery may be considered. One option is minimally invasive surgery using the X-Stop.

A pressure release

The X-Stop is a small device made of titanium alloy. It's inserted through a small incision in the back and placed between the spinous processes near where the nerves are being compressed. (Spinous processes are thin projections on the back of spinal bones. Muscles and ligaments attach to them.)

The X-Stop props open the narrowed space, taking pressure off nerves. Its winged design allows it to be positioned without being attached to bone or ligament.

"It kind of clamps down and anchors itself in place," says Dr. Ratliff.

Symptoms may be relieved right away. And patients generally can't feel the device once it's in place.

Advantages

Treating spinal stenosis with the X-Stop offers several advantages over treating it with laminectomy—surgery in which bone and soft tissues that are pinching the nerves are removed. Those advantages include:

  • The possibility of having the surgery performed with general or local anesthesia. (Laminectomy is usually performed with general anesthesia.)
  • The possibility of outpatient surgery.
  • A potentially quicker recovery.
  • An option to remove the X-Stop and pursue other treatments if the device doesn't help or if the stenosis gets worse.

Right for me?

Not everyone is a candidate for this procedure, including those who are allergic to titanium or titanium alloy. To qualify, you must be at least 50 years old and meet certain criteria.

"The X-Stop is very good for people with moderate disease affecting one or two levels in the spine and in whom appropriate conservative therapies have failed," says Dr. Ratliff.

If you have spinal stenosis, talk to your doctor to see if the X-Stop is right for you.

reviewed 5/20/2016

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