January 9, 2007 > The X-Stop's Here
The X-Stop's Here
Minimally invasive procedure offers relief for painful spinal condition
For months, Cathy suffered pain in her back and legs. Increasingly, the 70-year-old woman found it more and more difficult to walk, progressing to the point where she could walk only short distances and needed a wheelchair to get around. Then one day she couldn't get up and walk at all. Frightened, she called her daughter, who took her to see neurosurgeon Dr. Desmond Erasmus, medical director of the Spine Program at Washington Hospital. He diagnosed her problem as spinal stenosis and recommended implanting a device called the X-Stop into her spine.
"It was scary not to be able to walk," Cathy recalls. "I was afraid I'd never be able to walk again. Dr. Erasmus explained what causes spinal stenosis and how the X-Stop works. It sounded like my best option. The day after the procedure, I was up and walking again. Now I'm walking everywhere. It's truly a miracle."
Spinal stenosis shrinks the spinal canal and pinches the nerves, causing lower back pain and shooting pains down the legs. "Spinal stenosis can be either congenital or acquired," Dr. Erasmus explains. "Acquired stenosis, which is a form of osteoarthritis, is a degenerative condition that happens as you age, and it is most common in people after age 60, although it can happen earlier. The facet joints between the vertebrae become thick and cause a narrowing of the spinal canal, impinging on the nerves."
Dr. Erasmus notes that people who have spinal stenosis generally experience pain while standing or walking, with weakness and a sensation of heaviness or even numbness in the legs. "These patients, though, are usually comfortable when they are sitting," he says. "They might also walk in a bent-over posture to relieve the pressure on their nerves. The X-Stop device effectively spreads the vertebrae apart and widens the spinal canal, maintaining the same space in the spinal column that is there when the patient is sitting."
Before the introduction of the "interspinous decompression" X-Stop device, surgery was the only effective treatment for spinal stenosis. Traditional decompressive laminectomy surgery for spinal stenosis involves the use of a long incision, moving the muscle away from the spine and removing supporting structures to free up the compressed nerves. Recovery from such surgery can take up to six months.
"That technique destabilized the spine," Dr. Erasmus says. "Interspinous decompression, on the other hand, is very minimally invasive. We make a small incision and then place the X-Stop device between the spinous processes - the bony projections at the back of the vertebrae - just underneath the skin. The implant spreads the area of the spinal column and relieves the compression on the nerves."
The X-Stop procedure is performed in about an hour, with only local anesthesia and mild sedation, as opposed to the riskier general anesthesia required for major surgery. Patients who receive an X-Stop implant generally can go home later the same day or after an overnight stay in the hospital. They can go back to their regular activities within a few days, except for heavy lifting or strenuous exercise. After about two months, most patients can resume all activities.
Visit Washington Hospital's Web site at www.whhs.com and click on "Find a Physician" or call the toll free Health Connection line at (800) 963-7070 for a list of physicians.