Dr. Daniel Roshan, a Pacific Pain Physician, performed a successful Vertiflex interspinous Spacer at L2-3. The patient was suffering from the narrowing of the spinal and nerve canal at the L2-3 level causing him right side dominant low back and leg pain. His pain was worsened by walking and relieved by sitting and resting which is typical of spinal stenosis and neurogenic claudication symptoms. He had obtained good relief of his symptoms in the past from lumbar epidural steroid injections but as time progressed the benefits wore off quicker. The patient wanted to avoid back surgery and was hoping for a longer lasting solution so the decision was made to proceed with implanting a vertiflex spacer at L2-3. The procedure was completed in less than an hour and the patient went home the same day. To date he has had 75% of his relief of his right leg and low back pain!
What is Lumbar stenosis?
This is the narrowing of the spinal canal that can result from degeneration of the discs of the spine and growth of arthritic joints as we age. This can put pressure of the spinal cord which a patient will experience as leg pain, cramps, and even weakness. Typically this is worsened by standing or walking and improved with sitting, laying down, or bending forward slightly. The reason that walking and standing makes the pain worse is that it actually causes the spinal canal to become more narrowed relative to when you are bending forward or sitting. Often patients with stenosis can only walk half a block or less before having to sit down due to the pain.
How is Lumbar stenosis treated?
In the pain management world we typically try a series of epidural steroid injections which can help reduce the pain and improve functionality. However generally you should only do several of these a year and sometimes they don't last long enough or start to wear off quicker as the stenosis worsens with time. At this point patient's would be considered for surgery with a Spine surgeon to decompress the level of the spine. However, some patients are not good candidates for surgery due to advanced age and multiple medical conditions. Some patients also prefer not to have a surgery if possible.
What is the vertiflex spacer?
It is a small metallic device (MRI compatible) which is implanted between 2 adjacent bone segments of the spine where there is stenosis.
How does it help the stenosis?
It essentially works by acting as a door stop to prevent further narrowing of the canal as you walk and stand which the patient experiences as reduced pain and increased ability to stand and walk.
How is the vertiflex spacer placed?
It is done through an incision less than 1 inch in your back with a set of tools to obtain access to the space, measure the patient's specific space at that level, and then implant the device between the adjacent vertebral bones.
Who is a good candidate for vertiflex?
A patient that has low back and leg pain stemming from 1-2 level lumbar stenosis who has failed conservative management/epidural steroid injections and who is not a surgical candidate or does not want to undergo surgery.
Is my anatomy changed with the procedure?
No bone is cut or removed during the placement of the vertiflex. In fact, should you need to undergo surgery it is quite simple for your spine surgeon to remove.
if you have any further questions please make an appointment with one of our four double board certified Pain physicians Drs. Hullander, Mozingo, Pires, and Roshan!