A Minimally Invasive Spine Surgery Option for Spinal Stenosis

Peer Reviewed

Image of Lumbar SpineX STOP® is a nonfusion surgical implant for use in treating lumbar spinal stenosis. Lumbar spinal stenosis can cause pain and may limit physical function. X STOP® is a titanium alloy device implanted between the spinous processes to relieve symptoms from low back spinal stenosis. The spinous processes are small stubby finger-like bones that slightly protrude off the back of each vertebral body.

X STOP received approval in 2005 from the United States Food and Drug Administration. Since then, many spine surgeons in the US have performed the procedure. More than 11,000 X STOP implants have been inserted worldwide.

In July 2006, results from a four-year follow-up study were published in the Journal of Spinal Disorders & Techniques about X STOP. Findings from this clinical trial showed patients with lumbar spinal stenosis, treated using X STOP, experienced sustained relief from symptoms.

X STOP Procedure
The X STOP device is used in a procedure called the X STOP Interspinous Process Decompression System (IPD®). IPD is a surgical procedure. During the procedure, the X STOP device is implanted between the spinous processes using fluoroscopic guidance (a type of x-ray). The X STOP device may be implanted at one or two levels of the lumbar spine.

The procedure is performed under local anesthesia with the patient positioned on their side. The surgery takes between 45 minutes to an hour-and-a-half.

Patient Considerations
Most patients with lumbar spinal stenosis are successfully treated nonoperatively. Any type of surgery carries certain risks. A careful and thorough discussion between patient and surgeon is necessary. Possible complications include movement of the implant, spinous process fracture, allergic reactions, mechanical implant failure, and the need for another spine surgery.

Some patients should not receive X STOP®. Included are patients allergic to titanium or titanium alloy, who have cauda equina syndrome, bowel or bladder dysfunction, severe osteoporosis, or active infection.

Postoperative Care
Some patients reported immediate pain relief following the procedure and walk the same day. Although hospital discharge is usually within 24-hours, the surgeon may recommend a short stay.

Physical limitations may include no heavy lifting, bending backward, stair climbing, jogging, tennis, golf, or swimming. A physical therapy program and light activity may be recommended soon after surgery. Many patients are able to resume near normal activities within two to six weeks postop.

Want to Know More?
Patients diagnosed with lumbar spinal stenosis, who want to know if they are an X STOP® candidate, are encouraged to talk to their spine specialist.

Updated on: 03/22/16
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What Is Spinal Instrumentation and Spinal Fusion?
Christopher P. Silveri, MD, FAAOS
The X STOP has been implanted in a variety of patients for a wide range of severities of spinal stenosis. There are limited, conclusive prospective long-term randomized studies to ascertain its efficacy and long-term success. To this day it remains a technique with unclear indications and has not been proven to improve outcomes as compared to the gold standard decompressive techniques.
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What Is Spinal Instrumentation and Spinal Fusion?

Spinal instrumentation and fusion may be performed to stabilize the spine following disc removal (discectomy) and spinal decompression surgery (laminectomy).
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