Percutaneous Interspinous Spacer Placement

What is an interspinous spacer?

An interspinous spacer is a device that is inserted into the back of the spine, between the spinous processes. The device is used to treat spinal stenosis. Spinal stenosis occurs when the passageways of the spine are narrow and compress the nerves of the spine. The spinous processes are the part of the vertebra that stick out and form small bumps in the middle of your back. The spacer is placed between the spinous processes and gently opened. By opening the spacer, it functions similar to a car jack. It separates the spinous processes and thereby opens up compressed passageways in the vertebra. This frees up the nerves of the spine from compression.

How is a percutaneous interspinous spacer placement performed?

A small skin incision is made in the middle of the back at the level to be treated. A series of small tubes is placed through the incision and a 10 mm tube is placed through a smaller tube to a final position between the spinous processes of the vertebra. The spacer is then inserted through this small tube and by twisting the handle of a delivery apparatus attached to the spacer the lobes of the spacer are opened. The skin incision is closed with one or 2 sutures.

What are the advantages of percutaneous interspinous spacer placement?

In a recently concluded trial, percutaneous interspinous spacers present effective in treating the symptoms of lumbar spinal stenosis as a spacer placed through a larger skin incision and requiring a larger surgery.

How long will the procedure take?

The procedure takes approximately one and a half to two hours to perform depending on the number of levels operated on.

What is the recovery like?

You will walk out the door and go home the same day with pain medications. For the first two to three days we advise plenty of rest with light stretching exercises. Activity should be tolerably increased over 7 days and should consist of short walks at first and a gradual return to normal daily activities. Avoid strenuous activity and heavy lifting (over 10 to 15 pounds) for the first several months. If one’s job is sedentary then work can be resumed in 7 days. At 4 weeks physical therapy can be resumed. Since the procedure is minimally invasive rehabilitation will generally be easier and faster than with traditional surgery. Recovery time will vary based on individual factors.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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