Interspinous Spacers

Interspinous Spacers for Spinal Stenosis Treatment

Increasing life expectancy and the related demand for quality of life among the elderly has contributed to neurogenic claudication becoming one of the most common diagnoses of all degenerative spine diseases. Back and leg pain along with decreasing walking tolerance limit quality of life and can result in social isolation. Non-operative spinal stenosis treatment is well recognized for the treatment of early-stage disease and mild symptoms, generally yielding satisfactory results within the first 3 months. In cases of severe complaints or a failure of conservative management, surgical treatment is usually offered to the patient.

What are Interspinous Spacers?

Interspinous spacers are devices that are inserted into the spine to help treat patients who have narrowing or stenosis, of the spinal canal in the lower back (lumbar area). This condition is called lumbar canal stenosis. It causes leg pain and in some cases, back pain when standing or walking. This condition typically develops late in life, usually in people who are in their late 60's or older.

Lumbar interspinous spacers have recently become popular as an alternative spinal stenosis treatment and lumbar degenerative disease. Patients with lumbar spinal stenosis can experience intermittent neurogenic claudication, pain, and numbness in the legs.  Implantation of an interspinous spacer can increase the cross-sectional area of the spinal canal. Many interspinous spacers have been designed for clinical use and an increasing number of studies have reported their use for lumbar spinal stenosis treatment. Forward bending tends to relieve patients’ symptoms of neurogenic claudication. Interspinous spacers capitalize on this effect by inducing segmental kyphosis and limiting spine extension. Interspinous spacer devices are used in lumbar spine from L1 to L5 for spinal stenosis treatment with neurogenic claudication, foraminal stenosis, facet joint disease, and the dorsal disc unloading in extension.

Benefits of Getting Interspinous Spacers

Use of these devices significantly increases canal area and foraminal width radiographically. Implantation of an interspinous spacer is a rapid and uncomplicated procedure. Several studies have reported good short to mid-term results after spacer implantation, with less pain, claudication symptoms, and disability. The main indication for interspinous spacer implantation is the presence of discoligamentous lumbar spinal stenosis that results in tightening of the posterior longitudinal ligament and the ligamentum flavum. In cases of bony stenosis or reduced segmental flexibility, expansion of the spinal canal with the placement of an interspinous spacer is unlikely, and thus, this spinal stenosis treatment should not be selected. Evidence for the treatment of discogenic back pain with interspinous spacers is minimal.
It was reported that the biomechanical studies with all the devices showed that interspinous spacer devices have a beneficial effect on the kinematics of the degenerative spine. The Lumbar interspinous spacer devices may have a potential beneficial effect in the selected group of patients with degenerative disease of the lumbar spine.

Risks of Interspinous Spacers for Spinal Stenosis Treatment

In approximately one out of every seven cases, the spinal stenosis treatment does not adequately separate the vertebrae, so the pain is not relieved. A second surgery may need to be considered in this case.

There is also a low risk of infection. If the bones are very fragile and give way easily, it may not be possible to proceed with the operation.

Pre-Operative Advice

On the day you are scheduled for spinal stenosis treatment, it is important that you have nothing to eat. Do not eat anything after midnight on the night before your operation. Doctors and hospitals vary on how long before spinal stenosis treatment you need to stop drinking water. You will be given instructions that explain this. If you don't understand something, be sure to ask your doctor.

  • Do not smoke on the day of your spinal stenosis treatment.
  • On the morning of your surgery, take a bath or a shower and don't use any lotions or makeup. Be sure to remove any nail polish.
  • Be sure to take any scans or tests with you to the hospital.

How Interspinous Spacers are Inserted

This procedure typically does not require general anesthesia. You will be sedated and local anesthesia will be used to make sure you are comfortable. The sedative will be given to you through a vein in your arm or your hand, and you will sleep throughout the operation. The spinal stenosis treatment typically takes less than 30 minutes.

A small incision is made over the part of the spine that is affected. The tissues are then moved so the surgeon can see to insert the spacer between the vertebrae. This removes pressure from the nerves. The incision is then closed and bandaged.

Post-Operative Advice

Following the procedure, you will stay in the recovery room for a short time. Then you will be transferred back to the outpatient surgery area or your room and be given something to eat and drink. You will stay at the hospital for a few hours to make sure your condition is stable.

After you have been sedated or given a light anesthetic, you will not be able to drive, so you will need someone to pick you up and take you home. It is also recommended that someone stay with you during the first 24 hours following your procedure. Be sure to drink plenty of liquids and eat lightly.

Other instructions after a spinal stenosis treatment:

  • Do not drive or operate heavy equipment
  • Do not drink any alcohol
  • Avoid making any significant decisions. Your thinking and logic skills may continue to be affected by the sedative you were given for 24 hours.
  • Do not take any sleeping pills or medicine that makes you sleepy. For example, Benadryl.

The nurses at the hospital will provide you with instructions related to the care of your incision. If you have any questions or concerns about this, contact your surgeon.

It is normal to have discomfort and pain around your incision for one to two weeks after spinal stenosis treatment. If your surgeon doesn't provide you with a prescription for pain medication, ask what over-the-counter analgesics you can use.

 

 

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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

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Temed Holdings
4 answers
Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

Read more
Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers