The reduction of the space between the vertebrae related to degenerative processes and / or osteoporosis may lead to the mutual friction of the spinous processes and the generation of local pain in the spine. The excessive approach of the vertebrae to each other also increases the risk of narrowing of the intervertebral holes and the compression of the nerve roots running in them. Conflict results in pain radiating to the lower limb (sciatica).
Placing implants between the spinous processes of the lumbar spine increases the space between the vertebrae, preventing the painful rubbing of the spinous processes and irritation of the nerve roots in the intervertebral openings. The aim of the surgery is to alleviate pain in a situation where the methods of conservative treatment remain ineffective.
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Indications for surgery
Symptomatic contact of the spinous processes of the vertebrae in the lumbar region, confirmed by X-rays (Baastrup's disease),
Degeneration of the intervertebral disc in the lumbar spine causing:
reducing the distance between the vertebrae,
narrowing of the intervertebral openings,
possible bulging of the fibrous ring towards the spinal canal and the intervertebral holes.
The course of the implantation procedure between the spinous processes
The surgical procedure requires the use of general anesthesia. The patient is placed on the stomach or in the knee-elbow position. The technique of the procedure may differ depending on the type of implant used. The surgeon makes a longitudinal incision several centimeters long over the selected spinous processes. Then it cuts the subcutaneous tissue and partially delaminates the muscles attached to the spinous processes. The implant is placed firmly between the spinous processes. Control x-rays are performed during the procedure to confirm that the implants are properly seated. The wound is closed with stitches.
Implant materials (plastic or titanium):
do not cause allergies (or very rarely),
do not corrode in the body,
they are not a contraindication to MRI examinations.
Procedure after surgery
The patient may stand up and start walking with the surgeon's approval - this is usually a few hours after the operation. Discharge from hospital usually takes place on the second day after surgery.
For a few days of wound healing, physical activity should be avoided, which would aggravate the pain in the operated area. You may need to take painkillers during this time. The implanted implant changes the position of the vertebrae in relation to each other, which may cause discomfort requiring the use of rehabilitation (e.g. soft tissue mobilization techniques, safe spine exercises). It is advisable to limit or permanently resign from certain forms of activity related to lifting, bending or twisting the lumbar spine.
After inserting the implant, the pain experienced before the surgery can only be partially reduced - the effect of the surgery depends on the severity of the deformation, the presence of other pathological changes in the spine and the patient's compliance with postoperative recommendations. It should be emphasized that the inserted implant does not remove the hernia of the intervertebral disc. In the future, it may be necessary to perform surgical decompression of the nerve root (e.g. by discectomy).
Important information
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Duration of the procedure (depending on the method) |
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Tests required for surgery |
morphology, coagulation, electrolytes, blood group |
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Anesthesia |
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Hospital stay |
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A period of significant dysfunction |
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A period of limited dysfunction |
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Removal of stitches - first visit |
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Change of dressings |
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Contraindications to the procedure |
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Frequently asked questions about inserting an implant between the spinous processes:
If rehabilitation and painkillers do not alleviate the pain, it may be necessary to insert an implant between the spinous processes. The implant increases the distance between the spinous processes, reducing pain resulting from mechanical tissue irritation. Qualification for surgery is performed by a surgeon on the basis of a clinical examination and assessment of X-rays and other imaging tests. Sometimes the pain may result from multiple pathologies present in the course of degenerative disease of the spine, therefore it is very important to carefully diagnose and plan the appropriate treatment.
After the procedure, the mobility of the lumbar spine is limited. It is contraindicated to perform bends, sudden rotations and lifting heavy objects. The recommended form of activity is swimming and exercises to strengthen the muscles in a lying or supported kneeling position. Following the doctor's recommendations after the procedure reduces discomfort in the spine and extends the life of the implants. Individual activity limitations are discussed with the patient during a medical visit.
