Interspinous devices are implants placed between the vertebrae of your spinal cord to limit the extension between spinal levels. This relieves pressure on the nerves passing through the spinal canal. For patients experiencing severe leg and back pain from lumbar spinal stenosis, placing interspinous devices is a safe and effective way to relieve the symptoms.

After thoroughly examining and diagnosing lumbar spinal stenosis, your doctor will recommend a suitable treatment. If your case is less severe, you may use anti-inflammatory medications or physical therapy to deal with your symptoms. However, you may need interspinous device placement surgery for extreme spinal canal narrowing and severe symptoms.

Your spine surgeon will use a small tube to place the device into your spinal cord, preventing excessive bleeding and muscle damage during the surgery. The interspinous devices have arms that open up to cover the spinous. This allows more room for the nerves. Most people experience instant relief after this procedure. For a desired outcome in your spine surgery in Los Angeles, CA, you will need the top-notch spine surgery services we offer at Dr. George Rappard’s Clinic.

An Overview of Lumbar Spinal Stenosis

The spinal cord is a bundle of nerves that passes through a tunnel formed by the vertebrae. Lumbar spinal stenosis is caused by the narrowing of the spinal canal in the lower back. Stenosis causes pressure on the nerves that move from your spinal cord to the muscles. While spinal stenosis can happen anywhere, it is most common on the lower side.

Lumbar stenosis can result from natural wear and tear, which happens to your joints as you age. This condition is common among individuals over fifty years old. In addition to osteoarthritis, the following factors could contribute to the development of spinal stenosis:

  • Traumatic injury to your spine.
  • A naturally narrow spinal canal.
  • Spinal tumors.
  • Past surgical procedures on your spine.
  • Bone diseases.
  • Rheumatoid arthritis.

You may not experience any symptoms in the early stages of lumbar stenosis. However, as the condition progresses, you could experience these symptoms:

  • Lower back pain.
  • Burning that moves from your back to the buttocks and legs.
  • Tingling, numbness, and cramping in the legs.
  • Loss of sensation in your feet.
  • Loss of sexual ability.
  • Severe pain and weakness in the legs.
  • Loss of bladder and bowel control.

Treatment of Spinal Stenosis with Interspinous Devices

When non-surgical procedures are ineffective in treating your lumbar spinal stenosis, your doctor will recommend placing interspinous devices. The purpose of these devices is to distract adjacent spinous processes and limit the extension of the spine. Placing interspinous devices is not the first option for treating lumbar spinal stenosis. However, your doctor can recommend treating first- and second-level spinal canal narrowings.

Your medical history determines your spinal stenosis level, your physical assessment, and the severity of the symptoms you experience from the condition. Your doctor will use magnetic resonance and other computer technologies to examine and determine the compression level there.

You may not be a good candidate for this procedure if you experience these symptoms:

  • You have multiple levels of spinal stenosis. If you exhibit symptoms of different levels of moderate stenosis, your doctor could recommend an alternative surgical procedure to ease your symptoms.
  • You have severe spinal stenosis. An interspinous device may not effectively relieve your symptoms if you have severe spinal stenosis in the lumbar vertebrae. Common symptoms of severe spinal stenosis include severe pain that radiates to the legs and loss of bowel or bladder control.
  • You have a deformity in the expected implantation space. After assessing your condition to determine the severity of your stenosis, your surgeon will identify an area for implantation of the interspinous device. In most cases, this location will help ensure the spinal canal is wide enough to accommodate the nerves. If the expected area of device implantation is damaged or has a deformity, the procedure will not proceed. Implanting the device in a deformed area will increase the risk of dislodging it.
  • You have undergone decompression surgery at the suggested implantation area. Sometimes, you may need an interspinous device since another surgical procedure to treat your condition failed. If decompressive surgery was done at the recommended site of implant placement, the treatment may not be suitable for you.
  • You have metal allergies. You must disclose your medical history to your surgeon before you undergo this procedure. If you are allergic to metals, you will need an alternative treatment for your condition.

Procedure for Placement of Interspinous Devices

The symptoms associated with spinal stenosis cause discomfort and pain and can impact your ability to perform daily tasks. Although interspinous devices have been proven to relieve these symptoms, they must be appropriately placed for maximum benefit. The surgeon who performs your interspinous device placement surgery must correctly understand your anatomy to determine how these devices will perform after implantation.

The lumbar spine consists of five vertebrae. Between the vertebrae are discs that cushion the bones and provide shock absorption. This allows the spine to rotate and bend without damage to the bones. Lumbar stenosis is the narrowing of the spaces in the spine where the nerves pass through. Excessive pressure on these nerves can cause pain and severe damage.

Lumbar stenosis accompanies many painful symptoms, which can be relieved when interspinous devices are placed. Placing interspinous devices is a simple outpatient procedure that uses a minimally invasive surgical technique. The following are the steps involved in the placement of these devices:

  • The surgeon makes an incision on your lower back. Depending on the devices that need implanted, your body may be placed laterally or pronely. The surgeon will then use biplanar fluoroscopy to visualize your anatomy.
  • Placement of the interspinous device. Interspinous devices are implants placed between the vertebrae for a short time. This helps reduce blood loss and tissue damage during the procedure. When the device is placed incorrectly, it could cause an explosion and damage the bones of the spinal cord. Therefore, you must seek the services of an experienced spine surgeon.

The interspinous device has projections that open and surround the spinous process. This helps protect the implant from dislodging. After implant placement, you will enjoy a fast recovery and relief from the painful symptoms of spinal stenosis. After completion of the procedure, your surgeon will give you some post-operative tips for quick recovery and minimizing complications.

Aftercare Interspinous Device Placement

You can explore the following aftercare tips for your interspinous device placement to speed up your healing:

  • Rest. Interspinous device placement is an outpatient procedure that takes a short while. Therefore, you will be able to go home immediately after the procedure. You could rest for the remainder of the day to give your body time to heal.
  • Physical activity. While you can return to work after your procedure, you should avoid lifting weights and engaging in vigorous physical exercise. Returning to physical exercise should be gradual. This helps you avoid overstraining your body.
  • You should avoid sitting in the same posture long after the procedure.
  • Keep your body active while you heal from the procedure to avoid blood clotting.
  • Wash your surgical wound with saline water to avoid infection.

Benefits of Interspinous Devices

Compared to other surgical procedures for your spinal stenosis, you will enjoy the following benefits from interspinous device placement:

  • Minimally invasive procedure. Placing an interspinous device is a minimally invasive procedure, meaning the incision on your body is smaller than in traditional surgery. This minimizes the risk of muscle damage and excessive bleeding.
  • Decreased risk of infection. Minor incision marks reduce the risk of bacteria entering your body through the surgical site. For this reason, individuals who have undergone this procedure report lower infection rates.
  • Shorter stay in the hospital. The interspinous device placement procedure is short. This means you will not need to spend the night in the hospital. You can go home, rest, and continue your routine the following day. However, when you go home, you must follow the care instructions given by your surgeon.

Complications of Interspinous Spinal Device Placement Surgery

Placing an interspinous device for spinal stenosis is a minimally invasive procedure. This means that instead of cutting your back open and moving your muscles to place the device, your surgeon will use a small tube guided by a fluoroscope to access the vertebrae and place the device. This will minimize the risk. However, the following are likely complications of the procedure:

  • Cosmetically problematic scar. Scarring is reduced when a minimally invasive technique is used. However, some people may not appreciate the scar left by this procedure. A scar could lower your self-esteem and cause you to be conscious when exposing your lower back.
  • Spinous process fracture. The interspinous devices are placed between your vertebrae to distract the spinous process and create space in the spinal canal. You could suffer a fracture if you already have an injured vertebra or the canal is too narrow.
  • Dislodging the device. While this is a rare complication, the interspinous device could dislodge if placed incorrectly. This will result in a failed procedure, and the symptoms you experienced could return.
  • Wound infection. The incisions made during the placement of interspinous devices are minor. However, a person with compromised immunity could suffer an infection at the surgical site or deep into the muscles.
  • Excessive bleeding. Bleeding is a common aftermath of a surgical procedure, even minimally invasive. However, the expected bleeding from this procedure should be minimal. If you have blood complications or are on blood-thinning medication, you could experience excessive bleeding.

Alternatives to Interspinous Devices

Not all patients with lumbar spinal stenosis are good candidates for interspinous devices. If your condition is severe and the narrowing of your spinal canal is minimal, your doctors could recommend non-surgical treatments, including:

  • Medication. Your doctor could recommend anti-inflammatory medications to help relieve swelling and pain caused by spinal stenosis. Sometimes, you may need steroid injections.
  • Physical therapy. This treatment could include exercises that strengthen your leg and back muscles. You may also need braces to support your back.

For more serious spinal stenosis, your doctor can recommend you undergo alternative surgical procedures to create space in the spinal canal, including:

  • Laminectomy. A lumbar laminectomy is a surgical procedure that removes the back part of a problematic spinal bone. This helps to ease the pressure on the nerves that pass through the spinal canal to your muscles. Depending on the severity of the damage to your spine, the bone may be linked to the nearby bones through a graft.
  • Lumbar Interbody Fusion. Sometimes, a degenerative spinal disc is the root cause of spinal canal compression. In this case, your spine surgeon will address the problem and its cause by removing the problematic disc to create more space for the nerves. After removing a damaged disc, the surgeon will replace it with bone material, metal, and carbon devices for normal spinal function.

Before you settle on interspinous fusion devices, your doctor will assess your situation and discuss your options. This ensures that you are informed of the procedure and the potential outcome of the treatment.

Find a Competent Neurointerventional Surgeon Near Me

The symptoms of lumbar spinal stenosis, including leg pain, numbness, and discomfort, can take a toll on your life. Some of these symptoms make it hard for you to perform your normal activities or go to work. When you seek medical attention with these symptoms, you may undergo multiple tests to confirm the condition's existence.

Your doctor can recommend different forms of treatment, including therapy and medication. However, if these alternatives are unsuccessful in treating your symptoms, placing interspinous devices may be the only way to relieve the pain and discomfort associated with the procedures. The interspinous devices are implanted between your vertebrae to relieve pressure from the narrowing spinal canal. This is done by preventing extension between vertebral layers.

This procedure is a less invasive alternative to laminectomy. The placement of these devices is a non-invasive outpatient procedure. Using minimally invasive techniques helps prevent complications like infection, bleeding, and muscle damage. At George Rappard’s Practice, we offer safe and reliable spine surgery services to our clients in Los Angeles, CA. Call us at 424-777-7463 today to book an appointment.