The procedure for implanting an XStop interspinous process decompression device is fairly straightforward and is usually conducted on an outpatient basis in an operating room or other special facility. In the majority of cases the patient will be given a mild sedative and a local anaesthetic in the area where the device is to be inserted. Some patients will have the procedure under general anaesthetic, usually given as a gas rather than intravenously due to the shorter nature of the surgery.
In the OR
Patients will either be rolled onto their front (if under general anesthetic), or asked to lie face-down or on their side on the operating table. An incision of 2-3 inches will be made along the back over the vertebral level diagnosed as stenotic. The surgeon will use a fluoroscope (X-ray) to guide the X-Stop spacer into the correct position between the spinous processes. This involves placing the X-Stop beneath the ligament at the back of the spine and some tissue or bone may need removing to fit the device. Trauma is minimal, however, and the device does not impinge upon the nerves, spinal cord, or other spinal structures but sits, rather, at the back of the spinal canal itself.
In the Recovery
Once the X-Stop has been inserted the surgeon will close the incision and apply a surgical dressing. The patient will be encouraged to become mobile as soon as possible to prevent any stiffness and lower the risk of thrombophlebitis. Patients under local anaesthetic are usually up and ambulatory within minutes of the end of the procedure, whereas those having the surgery under a general anaesthetic will be taken to recovery for monitoring as they wake. The procedure usually takes from half and hour to an hour, in contrast to other minimally invasive surgeries such as TLIF which can take three and a half hours, and open traditional back surgery with even longer operating times.
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