The XStop Procedure usually takes place on an outpatient basis, and patients can often return home just a few hours after the procedure. For some patients, particularly those who have had the operation whilst under general anaesthetic, the surgeon will recommend an overnight hospital stay for monitoring purposes. In all but the rarest cases, patients will be encouraged to get out of bed and resume gentle walking on the same day of the surgery. This can help prevent stiffness and muscle weakness, and aids the healing process by encouraging healthy blood flow. The risk of thrombophlebitis (blood clots in the deep veins) and subsequent stroke are reduced for patients who become mobile quickly after surgery.
Pain medication may be prescribed but is not usually necessary after X-Stop implantation. The patient can expect to be a little sore from the procedure but they will usually feel some degree of relief from their spinal stenosis symptoms in addition to the tenderness of the incision site. A follow-up appointment is typically set with the surgeon for six weeks after the operation although patients should report any concerns that they have prior to this time as appropriate. Some redness of the wound and a little tenderness is to be expected but any seepage, extension of the redness beyond 1cm or so, or extreme heat or swelling in the area of the incision should be investigated immediately as this suggests the presence of infection. If the patient develops a fever then they should also consult their doctor.
Infection and other surgical issues
There is little risk of deep infection with the X-Stop procedure unless the surgeon had call to remove significant bony material or tissue. As the operation does not impinge upon the deeper parts of the spinal canal there is almost no risk of dural tear or spinal nerve trauma.
Any new symptoms that suggest these having occurred should be reported immediately, such as:
- acute pain
- loss of continence
There is a very small possibility that fracture of the spinous process can occur either during or following surgery to position the X-Stop. This will usually be observed at the time, although it may develop after the patient has been discharged, particularly if they experience some kind of trauma or jolting to the spine soon after surgery.
Restrictions after Surgery
Some restrictions on activity are imposed following the X-Stop device being placed in the lumbar spine. Patients should not bend backward, or engage in vigorous physical activity that may result in the lower back being twisted, jolted, or stretched (such as swimming, running, golf, or certain kinds of sexual activity). Climbing stairs is usually discouraged as is the lifting of anything heavy (over 20lbs). Gentle activity is advisable, such as short walks on even ground, building up to longer walks and then normal activity after two to six weeks. Patients should discuss their progress with their doctor in order to be cleared for a return to normal daily life. Most patients undergoing any back surgery will be given a series of physical therapy sessions after their operation in order to facilitate an optimal recovery and reduce the risk of stiffness, injury, and complication. Stretching and strengthening back and neck exercises can help prevent further spinal degeneration but should not be carried out without endorsement from a professional who knows the patients’ medical history.
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