New England Spine Care

Spinal Stenosis

Stenosis means narrowing. When the spinal tunnel is narrowed, the condition is called spinal stenosis. This can happen in the cervical spine, thoracic spine or lumbar spine. The reason behind spinal stenosis can be a herniated disc, degenerated facet joints, short pedicle, spinal ligament thickening, misaligned vertebrae (spondylolisthesis), synovial cyst and/or bone spurring. Spinal stenosis often is an aging disease and can present in an acute or chronic format. Lumbar spinal stenosis often limits one’s ability to walk. Patients with lumbar spinal stenosis complain of leg pain or heaviness with walking, and feel less pain when they sit or lean on a shopping cart. This condition is often associated with numbness, tingling, balance issues, and possibly weakness. The presentation of symptoms could be acute or chronic and could involve one or both legs. In rare cases, genital numbness, and incontinence of urine or stool may develop and should alarm the patient to be evaluated urgently.   Spinal stenosis can be treated in multiple ways.  Conservative care includes physical therapy NSAID treatment and spinal injections including epidural injections.  If 3-6 months of conservative care fails to improve neurogenic claudication symptoms  (Leg pain, Numbness, tingling when walking and standing which resolves with sitting), patients with moderate spinal stenosis can be considered for Vertiflex implant. Contraindications include grade 2 spondylolisthesis, Pars fracture, Severe spinal stenosis, Significant osteoporosis, and Previous laminectomy in that segment.

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Vertiflex procedure

Patients with spinal stenosis often feel better when they are sitting down or stooping forward such as leaning on a shopping cart.  Sitting or stooping causes slight flexion of the spine and as a result, less internal pressure on the nerves and blood vessels within your spinal tunnel.     Vertiflex procedure Is designed to help with leg pain of spinal stenosis particularly when a patient walks or stands.   It is also indicated for patients who have foraminal stenosis in addition to spinal stenosis.  Although patients may experience improved back pain, this particular procedure is designed to improve leg pain related to spinal stenosis

 

Vertiflex procedure is performed in an outpatient setting and does not require hospitalization.  It would take less than 1 hour to perform and you will be in our center for less than 3 hours. Using X-ray guidance, your doctor will place a small implant in between the vertebrae.  This is done with conscious sedation and does not require general anesthesia. The incision is approximately 1.5 cm and requires 3-4 stitches.  This small Implant limits the extension of the spine and allows for gentle flexion of the spine, resulting in indirect decompression. Patients experience leg pain relief, Improved walking and standing tolerance over 6 to 12 weeks after the procedure.  Following the procedure, for 6 weeks, your doctor would limit you from activities such as lifting weights over 10 pounds, any significant bending of the spine especially with twisting, and performing any strenuous activity such as swimming, golfing, tennis, racquetball, running, jogging and sexual activities.  This is to allow for the implant to settle in.  Once this period of time is passed, you may start a course of physical therapy and return to normal activities.  

 

This procedure is FDA-approved and is covered by Medicare. 

 

Clinical Data from Boston Scientific

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