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What is the Vertiflex Procedure?



VERTIFLEX PROCEDURE


Vertiflex Procedure is a surgical treatment for moderate cases of Lumbar Spinal Stenosis. It is a minimally invasive and stand-alone implant that is placed inside the spine to help prevent reduction of the space when standing or walking. This type of treatment is also known as an interspinous process decompression. It provides relief by lifting pressure off the nerves to alleviate leg and back pain symptoms that often accompany the condition.


The spacer is a device that gives a durable, long-term relief of complaints of intermittent neurogenic claudication for individuals having moderate issue of lumbar spinal stenosis. The device or spacer is typically made of titanium alloy.


Developed with patient safety and comfort in mind, this FDA-approved, outpatient treatment aims to give those with lumbar spinal stenosis the freedom to get on with their daily lives, as it offers a significant reduction in symptoms and improves physical function.


Why Someone May Need to Get This Treatment


Patients suffering from neurogenic claudication typically need this surgical treatment. Neurogenic claudication is a symptom of lumbar spinal stenosis. It refers to leg symptoms present in the buttocks, anterior thigh, and groin which radiate down along the lower part of the thigh to the feet.


Patients suffering from lumbar spinal stenosis are also common patients for this procedure. Lumbar spinal stenosis is a gradual space narrowing in the spine where nerves pass through. The narrowing of the space can cause pinching on the nerves in the lower back. This can result in an aching, dull back pain spreading down the buttocks and into the legs.


If you are experiencing any of these symptoms and/or your doctor has diagnosed you with lumbar spinal stenosis, you may be a good candidate for the Vertiflex Procedure.


What the Procedure Entails


For the Vertiflex Procedure, a patient is positioned face down on his/her stomach, and a local anaesthetic and/or general anaesthesia is administered. With the use of real-time imaging (fluoroscopic guidance), the surgeon makes one small incision in your lower back and implants the IPD spacer between two spinous processes (e.g., Lumber 4-Lumber 5). The surgical incision is then closed.


Generally, the procedure takes 15 to 45 minutes to perform depending on whether one or two spacers are implanted.


Treatment Duration and Recovery


Once the device is implanted, it provides extra space for the patient’s nerves and spinal cord in the vertebral column without eliminating any bone, thus resulting in less pain to the ligaments and muscles.


Other added advantages include the preservation of some spinal motion (unlike spinal fusion that permanently limits movement), the minimization of blood loss, and the reduction of risk for infection.


Results of a study published in the Journal of Pain Research in November 2018 show long-term maintained clinical improvements, a decline in neurogenic claudication symptoms, a decline in need for revision surgery in these subjects, and minimized opioid use post-operation. The Vertiflex Procedure is a simple and safe, minimally invasive treatment clinically proven for effective, long-term relief from the pain associated with lumbar spinal stenosis.


After the procedure, you can expect some soreness, and your incision site will have a few stitches or staples that should be kept clean and dry until the first follow-up visit, usually 7 to 14 days after having the procedure. For 6 weeks following your procedure, limit all lifting, bending, twisting, and strenuous activity including lifting anything over 10 pounds, swimming, golf, tennis, racquetball, running, jogging, or sexual activity. Light activity, such as walking, is allowed.


Possible Risks and Side Effects


The risks associated with the Vertiflex Procedure include:


1. The implant can become dislodged or moved out of place.

2. A bone may settle around the implant, which is a common risk in people with osteoporosis.

3. The spinous process can fracture when the IPD spacer is implanted.

4. After implantation, the spacer may not provide adequate relief from pain and symptoms.

5. The patient may need additional surgery to relieve pain and other symptoms.

6. If lumbar spinal stenosis is left untreated, it can worsen over time, leading to excessive narrowing of the spinal canal. This can cause constriction of the nerves that run down the back and into the legs, resulting in pain, discomfort, and limited mobility.

Before moving forward with treatment such as the vertiflex procedure, you should always consult a professional to discuss other options, possible risks and side effects, long-term effects, and any other questions you may have. The team at Northern Arizona Spine and Pain are highly qualified professionals and can be a helpful resource when considering any type of pain-reducing treatments. Please visit our website to learn more about procedures or to book an appointment: www.NAZspineandpain.com.


References:

Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. Kim DY, Lee SH, Chung S, Lee HY. Spine. 2005;30:123–129.

Cost-effectiveness of three treatment strategies for lumbar spinal stenosis: conservative care, laminectomy, and the Superion interspinous spacer. Parker SL, Anderson LH, Nelson T, Patel VV. Int J Spine Surg. 2015;9:28.

Influence of diabetes mellitus on patients with lumbar spinal stenosis: A nationwide population-based study. [Mar;2019 ];Lee CK, Choi SK, Shin DA, Yi S, Ha Y, Kim KN, Kim I. PLoS One. 2019 14:0.

Interspinous implants to treat spinal stenosis. Gala RJ, Russo GS, Whang PG. Curr Rev Musculoskelet Med. 2017;10:182–188.

Minimally invasive versus open laminectomy/discectomy, transforaminal lumbar, and posterior lumbar interbody fusions: a systematic review. Imada A, Huynh T, Drazin D. Cureus. 2017;9:0.

Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the national surgical quality improvement program. Schoenfeld AJ, Ochoa LM, Bader JO, Belmont PJ Jr. J Bone Joint Surg. 2011;93:1577–1582.

Segmental spinal canal volume in patients with degenerative spondylolisthesis. Miao J, Wang S, Park WM, et al. Spine J. 2013;13:706–712.

Superion interspinous process spacer for intermittent neurogenic claudication secondary to moderate lumbar spinal stenosis: two-year results from a randomized controlled FDA-IDE pivotal trial. Patel V, Whang P, Haley T, et al. Spine. 2015;40:275–282.

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