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The Promise of Posterior Dynamic Non-Fusion Devices

Dr. Anand Blog

April 9th, 2018

Low back pain is one of the most talked about health conditions in the world. So it stands to reason that as far as surgical treatment goes, spine surgery ranks fairly high as one of those topics that just about everyone has an opinion on – whether you’re a medical provider, a patient, or someone who has heard about the surgical experience from their Aunt Jane. As a spine surgeon however, someone who daily sees and treats patients suffering from debilitating back pain conditions, spine surgery absolutely has claim to a solid place on the list of treatments that can help a patient regain the capacity for daily living as well as a solid quality of life. The question is how?

Historically, as a treatment for a wide variety of spinal disorders, rigid spinal instrumentation is the surgical technique that has been preferred and used to stabilize and fuse segments of the spine. While the systems that provide this type of treatment have been the gold standard for many years, they aren’t without their drawbacks and we spine surgeons know it. For one, rigid fixation of the spine inevitably puts significant stress on the spinal segments above and below the one that was operated on. This often leads to degeneration of those segments and can become a vicious cycle which frequently leads to the need for additional fusion surgery.

To combat the phenomenon of fusion-associated spinal degeneration after rigid instrumentation, spine and research experts began exploring the notion of dynamic stabilization systems. These systems were designed with the intent to preserve the stability and natural range-of-motion in the spinal segments – with the additional goal of eliminating or reducing the effects of degeneration on adjacent segments of the spine. With this in mind, dynamic stabilization systems can be seen as one alternative to rigid fusion surgery for some patients.

There are a number devices now available to achieve these goals for patients. In fact, The Anand Spine Group is currently enrolling patients in a new FDA/IDE trial at Cedars-Sinai Medical Center which compares lumbar fusion surgery to the TOPS System – a motion-preservation system. The purpose of this study is to determine whether the TOPS System is more effective than transforaminal lumbar interbody fusion, also known as TLIF. The TOPS System is a motion-preserving posterior spine implant that was designed to be an alternative to fusion surgery by providing dynamic stabilization to a single lumbar spine segment after decompression surgery. There are a number of eligibility criteria for those interested to be eligible for this study. Some criteria include: those who experience radiating leg pain, greater leg or buttock pain than back pain, severe pain after walking as little as 100 yards or 2 minutes and/or pain that reduces when sitting, bending forward, or leaning over a shopping cart. As with any study, choosing to participate is a extremely personal decision and one that should be honestly discussed with your doctor and your loved ones.

We know that back pain as a health concern isn’t going away any time soon. But we must also recognized that research and advances in treatment designed to help patients recover well from their spine conditions is a worthy endeavor. If you know someone who you think may benefit from enrollment in this study, please contact us.

Sources:

http://www.infospine.net/research-trials-spinal-surgery-dr-neel-anand-los-angeles-ca.html

https://clinicaltrials.gov/ct2/show/NCT03012776

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626386/

https://www.spine-health.com/treatment/back-surgery/posterior-dynamic-stabilization-systems

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