Lumbar spinal stenosis and spondylolisthesis are two prevalent sources of lower back pain among adults today. When pain from these conditions isn’t improved with non-surgical methods, surgery may be required for lasting pain relief.
Spinal implants are frequently used for support in surgery for spinal stenosis and spondylolisthesis. Here, we’ll discuss the role of implants in surgery for these conditions and how non-fusion implants can be used for greater outcomes.
What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis happens when the spinal canal at the lower portion of the spine narrows. As the amount of space in this portion of the spinal canal reduces, the nerves that extend through the lower back and down the legs can become compressed.
Although spinal stenosis may occur as a result of developmental abnormalities, it’s usually caused by age-related degeneration. Over time, wear and tear on the spine can provoke changes that reduce the amount of space in the spinal canal.
Age-related spinal degeneration is often referred to as spondylosis. Additionally, the term spondylosis is commonly used to describe spinal degeneration in patients with osteoarthritis. Spinal osteoarthritis occurs when the cartilage that protects the facet joints breaks down, leading to inflammation and pain.
Although osteoarthritis is a common cause of lumbar spinal stenosis, this condition can also be caused by:
- Bone spurs
Osteoarthritis causes friction between the facet joints. Bone spurs, which are smooth lumps of extra bone, can form as a result. Bone spurs can decrease space in the spinal canal, leading to spinal stenosis.
- Thickened ligaments in the lumbar spine
The ligaments that help keep the vertebrae connected can lose elasticity and become thicker over time. As a result, they may spread into the spinal canal and take up space.
- Herniated disc
Also called a slipped or bulging disc, a herniated disc is a common spinal injury. It develops when the jelly-like interior of an intervertebral disc presses through a crack in the exterior. The disc interior may then put pressure on close-by nerves.
Less common causes of lumbar spinal stenosis include tumors in the spinal cord and vertebral fractures.
Symptoms of lumbar spinal stenosis can vary. In fact, patients may experience no symptoms from spinal stenosis if no nerve compression is present.
With that said, the most prevalent symptoms of lumbar spinal stenosis include:
- Pain in the lower spine
- Pain in one or both legs, particularly while walking or standing for extended periods
- Weakness, tingling, and/or numbness in a leg or foot
What is Lumbar Spondylolisthesis?
Lumbar spondylolisthesis appears when one of the vertebrae in the lower spine slides out of position and settles on the vertebra directly under it. This condition is associated with spinal instability.
Possible causes of lumbar spondylolisthesis include:
- Genetic defects
Patients with a genetic defect in an area of the spine may be at an increased risk of developing spondylolisthesis.
- Repeated spinal trauma
If the spine undergoes repetitive trauma, such as frequent weightlifting, spondylolisthesis can result. This condition can also occur if the patient overextends the spine, which is why it’s prevalent among athletes.
- Wear and tear on the spine with age
Wear and tear on the vertebrae and spinal discs can lead to lumbar spondylolisthesis. Older adults may also develop spinal osteoarthritis, which can contribute to this spinal condition.
- An acute spinal injury
Sudden spinal injuries, like a vertebral fracture, can cause spondylolisthesis.
Some patients with lumbar spondylolisthesis don’t experience any symptoms. However, symptomatic patients usually have lower back pain as the dominant symptom. Other symptoms can include:
- Pain that extends from the lower back to the buttocks and down to the thighs
- Stiffness in the lower back
- Hamstring muscle spasms
- Pain while walking, bending over, and standing for extended periods
- Weakness, tingling, or loss of sensation in the foot
Spinal Implants For Lumbar Spinal Stenosis and Spondylolisthesis
Cases of lumbar spinal stenosis and spondylolisthesis that don’t improve after several months of non-surgical treatment may require surgery.
Surgery for Spinal Stenosis
Spinal stenosis surgery usually involves decompression and stabilization, either with spinal fusion or a non-fusion implant. Foraminotomy, laminectomy, and laminotomy are all spinal decompression procedures that are commonly used for spinal stenosis. Once the pressure on the spinal nerves has been relieved with decompression, the surgeon can stabilize the spine.
Surgery for Spondylolisthesis
Surgery for spondylolisthesis may involve realigning the damaged vertebra, decompression, and stabilization. Not all cases of spondylolisthesis require realigning the vertebra.
Decompression is often performed for patients with spondylolisthesis if the slipped vertebra is causing nerve compression. Spinal decompression surgery effectively alleviates pressure on the spinal nerves.
Spinal fusion is widely used for spondylolisthesis surgery because it stabilizes the spine by permanently fusing two vertebrae. This can prevent spinal instability and stop the vertebra from slipping forward in the future. Some spinal implants may be used in place of fusion for lumbar spondylolisthesis treatment.
How Are Implants Used in Spinal Surgery?
For both fusion and non-fusion spinal surgery, implants are commonly used in the procedure. In fusion, implants such as cages, plates, and rods may be used for support. These devices help place bone graft material in between the affected vertebrae to facilitate the fusion.
Emerging technology in recent years has also spurred spinal implants that can be used as an alternative to spinal fusion. As a result, many patients can avoid the reduced mobility, extended recovery period, and complications associated with spinal fusion.
The Premia Spine TOPS System implant is a non-fusion implant that can be used for lumbar spinal stenosis and spondylolisthesis surgery. It’s a mechanical implant device that replaces the tissues removed in decompressive laminectomy and other types of spinal decompression. As a spinal fusion alternative, the TOPS System retains the motion of the spine and provides a shorter recovery period.
Non-fusion spinal implants are an ideal option for many patients with chronic lumbar spinal stenosis and spondylolisthesis. Given that implants can preserve your ability to freely move the spine after surgery, they’re a fusion alternative that’s worth considering.