Spinal stenosis and spondylolisthesis are both prevalent spinal conditions, especially among the aging population. These conditions can cause debilitating back pain, along with neurological symptoms. Ultimately, spinal stenosis and spondylolisthesis may diminish patients’ comfort during day-to-day activities.
Surgery for these conditions typically involves spinal fusion to stabilize the spine. However, many patients are now seeking non-fusion alternatives for spinal stenosis and spondylolisthesis to avoid the risks of fusion.
In this article, we’ll discuss spinal stenosis, spondylolisthesis, and how non-fusion spinal implants can support the surgical treatment of these conditions.
What is Spinal Stenosis?
Spinal stenosis is a condition that develops when the space in the spinal canal, which houses the spinal cord, becomes narrower. This gradual narrowing may also occur within the foramina, which are the bony arches of the spine.
The key symptoms of spinal stenosis include:
- Back pain
- Numbness, cramping, weakness, or tingling in the extremities (for cervical spinal stenosis, this occurs in the arms; for lumbar spinal stenosis, it occurs in the legs)
- Sciatica
- Cramping and/or heaviness in the legs
Patients with severe forms of spinal stenosis may also experience a loss of bowel or bladder control.
What Causes Spinal Stenosis?
There are numerous potential causes of spinal stenosis. Some of the most common include:
- Bulging or herniated disc
An injured intervertebral disc can lead to spinal stenosis. A bulging disc occurs when the disc exterior weakens, typically due to aging. The disc may then bulge out into the spinal canal.
A herniated disc is a step beyond a bulging disc. When a disc is herniated, it means that the soft disc interior has protruded out from a crack in the exterior.
- Thickening ligaments
The ligaments that connect the spinal bones can become thicker over time, typically because of aging and/or arthritis. When the ligaments become thicker, they take up more space in the spinal canal.
- Bone spurs from osteoarthritis
Osteoarthritis is the degeneration of the cartilage that protects joints throughout the body. This form of arthritis can affect the facet joints of the spine. With time, increased friction in the facet joints can lead to bone spurs.
Bone spurs are lumps of excess bone. If they form in the spinal canal, they may lead to spinal stenosis.
What is Spondylolisthesis?
Spondylolisthesis is a condition that develops when a vertebra slips out of place and rests on the vertebra beneath it. Although this condition most often affects the lumbar spine, it can occur in the cervical or thoracic spine.
The symptoms of spondylolisthesis can include:
- Back pain (which is generally exacerbated by standing or physical activity)
- Sciatica
- Stiffness in the back
- Muscle spasms and/or stiffness in the hamstrings
What Causes Spondylolisthesis?
Spondylolisthesis can develop at younger and older ages. In young individuals, the condition is generally caused by overstretching the spine during physical activity. The sports that are the most likely to cause spondylolisthesis include soccer, football, gymnastics, and weightlifting.
In older individuals, spondylolisthesis is typically caused by age-related spinal degeneration.
Additionally, key risk factors for spondylolisthesis include:
- Degenerative arthritis
- Excess body weight
- Short height
When is Surgery Required For Spinal Stenosis and Spondylolisthesis?
Spinal stenosis and spondylolisthesis are usually successfully treated with non-invasive methods, such as physical therapy, medication, lifestyle adjustments, and steroid injections. However, if patients don’t improve after six months or more of conservative treatment, spinal specialists may recommend surgery.
For spinal stenosis, surgery typically involves spinal decompression with spinal fusion. Spinal fusion is generally also done for spondylolisthesis.
What is Spinal Decompression Surgery?
Spinal decompression surgery refers to procedures that relieve nerve compression in the spine. Commonly performed for spinal stenosis, herniated discs, degenerative disc disease, and spinal injuries, decompression surgery is an effective cure for spinal nerve impingement.
The main types of spinal decompression surgery are:
- Laminectomy, which involves removing all or part of the lamina of the affected vertebra
- Discectomy, which involves removing all or part of a damaged disc
- Foraminotomy, which involves creating more space around one of the spinal bones
The Risks of Spinal Fusion
The purpose of spinal fusion is to stabilize the spine, help alleviate pain, and prevent future injury. Unfortunately, spinal fusion also comes along with multiple risks and downsides.
- Limited mobility
The predominant downside of spinal fusion is that it limits the patient’s mobility in the back. Patients lose the ability to bend and twist at the fused segment, which limits their day-to-day activities. In some cases, patients can no longer bend over to pick up items off of the floor after spinal fusion.
- Risk of adjacent segment disease
Adjacent segment disease, or ASD, is a possible complication of spinal fusion surgery. ASD occurs when the segments located above and below the fused vertebrae undergo degenerative changes. This happens because the adjacent segments must undergo added strain as a result of the fusion.
- Prolonged recovery period
Spinal fusion involves an extensive recovery period. Patients may need to remain in the hospital for up to five days after fusion. Additionally, it can take up to a year to fully recover from spinal fusion.
Are Non-Fusion Alternatives Available For Spinal Stenosis and Spondylolisthesis?
Advancements in medical technology have led to non-fusion alternatives that can effectively treat spinal stenosis and spondylolisthesis. By avoiding spinal fusion, patients can maintain the flexibility of the spine while achieving long-lasting pain relief.
Non-fusion spinal implants are considered the gold standard of spinal fusion alternatives available today. A spine device like the TOPS System protects the patient’s range of motion while supporting and stabilizing the spine. After spinal decompression procedures such as laminectomy, the TOPS device can significantly decrease back surgery recovery time.
Non-fusion implants like the TOPS System work by replacing the soft and bony tissues that are removed during spinal decompression. The TOPS System also provides motion in all directions, including extension, flexion, lateral bending, and axial rotation.
If you or a loved one suffers from chronic back pain, don’t hesitate to contact a spine specialist and learn about the non-fusion solutions available today.