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Lali Sekhon, MD, PhD, FACS

Dynamic Stabilization

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Dynamic stabilization is an exciting part of spine surgery which is somewhere between a fusion and a decompression. Some refer to it as a "soft stabilization". The most widely used dynamic stabilization device is the X'Stop device shown in the figure above and below:

dynami1

 

The device acts as a buffer and is placed between the spinous processes of affected levels. It has 2 effects:

  1. It opens up the space for the nerves
  2. It reduces motion slightly by limiting flexion


Below is a the anatomy of a patient who gets leg symptoms when they stand but no symptoms when sitting:

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This patient has pinching of the nerves due to disc bulging and facet and ligament enlargement.

An X'Stop device is placed between the spinous processes in the operating room:

dynami3

 

This is the appearance after placement where there is more room for the nerves:

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Aside from pinched nerves, the X'Stop device is also being used above fusions to try and buffer normal levels and hopefully stop them wearing out prematurely. Below are xrays of a patient with a fusion with an X'Stop at the level above:

CIMG5955     CIMG5956

 

At the moment this technology is new and still being evaluated. There are a multitude of dynamic stabilization devices appearing, some good, some not so good.  Not all patients are suitable for this surgery but for those that are suitable relief whilst keeping motion may occur.

For a Video on the first X'Stop case in the Reno/Northern Nevada area click here.