Lumbar Liberation

Spacer implant ends agony triggered by spinal stenosis.

Florida snowbird Scott* spent a career as a neuropsychologist, but in retirement became a certified flight instructor of amphibious floatplanes near his summer home of Bar Harbor, Maine. After one flight nine years ago, Scott experienced intense lower back pain. He learned later the cause was spinal stenosis.

“As I got off the plane, I felt excruciating pain in my lower back, and I couldn’t walk across the ramp without bending over,” Scott describes. “I eventually had to get into a wheelchair and my wife took me to the emergency room, where they gave me an epidural injection. That provided minor relief, but my condition continued to deteriorate.

“Over the years, I went to numerous physicians who recommended conservative treatments such as medications, mainly strong doses of nonsteroidal anti-inflammatory drugs. I got some relief from regular strengthening exercises and physical therapy, but my problem only got worse and really culminated two years ago.

“I love to take long walks on the beach, but at that point I wasn’t able to walk 500 yards without bending over and cringing in excruciating pain. I couldn’t find any position to sleep comfortably, so I wasn’t sleeping well. At times, the pain was a 10 on a scale of one to 10.”

Scott visited several orthopedic surgeons. More than one told him he needed a laminectomy, an invasive surgical procedure in which the lamina, a portion of the vertebra, is removed. Scott hoped to avoid surgery, so his family physician recommended pain management specialist Harold J. Cordner, MD, of Florida Pain Management Associates in Sebastian and Vero Beach.

“Scott came to us with complaints of pain in his low back going down both legs, as well as some weakness,” Dr. Cordner reports. “He experienced pain while walking that was relieved with bending forward or leaning on something such as a shopping cart. That’s a classic symptom of spinal stenosis, which was confirmed on MRI.”

The MRI showed Scott had compression of the discs in his lower lumbar spine.

“Dr. Cordner said I had an uneven spine from scoliosis, a degenerative disc disease called spondylosis and arthritis,” Scott says. “All these conditions contributed to the spinal stenosis.”
To treat the stenosis and relieve pain, Dr. Cordner recommended spinal decompression using the Vertiflex® Superion® InterSpinous Spacer System.

The Superion spacer is an H-shaped implant made of a titanium alloy that fits between two adjacent bones in the lower back. It’s designed to help flex the spine when the patient stands and walks, relieving painful symptoms.

“The Superion spacer decompresses the spine,” Dr. Cordner informs. “Once the spacer is implanted during a minimally invasive procedure, it opens up and enlarges the neuroforamen, the holes where the spinal nerves exit the spine. The spacer opens up the central canal as well.

“Scott had severe stenosis at two levels of the spine, so we implanted spacers at those two levels. The Superion spacer procedure is limited to two levels, so patients with more than two levels of stenosis are not ideal candidates for the procedure.”

Surgery Alternative

Traditionally, treatment for spinal stenosis begins with nonsurgical steps, such as physical therapy, anti-inflammatory medications, chiropractic manipulation and steroid injections. When all nonsurgical efforts have failed, surgery is generally the next step.

“The treatment for spinal stenosis often included epidural steroid injections,” Dr. Cordner notes. “If those did not help, patients would undergo a decompressive laminectomy. However, there are patients who are elderly or have diseases or complicated medical illnesses and cannot get cleared for or are too sick to have surgery.”

And some people, like Scott, simply choose to avoid surgery.

During a laminectomy, the surgeon removes some bone and any bone spurs and/or ligaments that are compressing the nerves. Doing this opens up the space for the nerves and relieves pain. However, it requires one large incision or multiple smaller incisions, and a lengthy recovery period. Serious complications are possible, and there is no guarantee it will succeed.

The Superion spacer is an excellent alternative to surgery. The device is implanted during a brief, 20- to 30-minute, outpatient procedure using local anesthetic and sedation. Dr. Cordner works through a small, half-inch incision.

“During the implant procedure, I make the incision in the back and clear out some tissue between the spinous processes on the vertebrae,” Dr. Cordner explains. “Then, I insert the device through a small tube about the size of a dime. As I engage the device and screw it open, two arms emerge that push the spinous process bones apart. This creates more room inside the spinal canal and neuroforamen.”

According to Dr. Cordner, laminectomy works best at treating stenosis of the central spinal canal but has limitations in treating stenosis of the neuroforamen.

“It’s typically very difficult for surgeons to correct narrowing of the neuroforamen,” Dr. Cordner stresses. “When surgeons perform a laminectomy, they can decompress the central canal, but opening up the narrowing on the sides of the spine is technically very challenging.

“However, the Superion spacer excels at opening up the neuroforamen, so it was the ideal procedure for treating Scott’s spinal stenosis.”

“Absolutely Spectacular”

Dr. Cordner performed the spacer procedure on Scott in May 2018, and it was highly effective.

“After it was done, Dr. Cordner showed me an x-ray, and I could see how the procedure straightened my spine,” says Scott, who has resumed his favorite activities and says the results have been “absolutely spectacular.”

“Now, I’m taking the longest beach walks I’ve ever taken – without pain,” he adds. “I’m also cycling 20 miles sometimes, and I’m hiking up mountains in Arizona and California when we visit grandkids. I’m sleeping very well at night, and I can sit comfortably at work. My pain used to be a 10, and now it’s zero. I have my life back.

“My Superion spacer procedure was an absolute success. It’s truly amazing because now I feel terrific, and there were times I wondered if I would be crippled for the rest of my life. Now, I’m active, and my health is restored. I recommend this procedure without a doubt.”

Scott says he also recommends Florida Pain Management Associates to others suffering with low back pain. He has high praise for the physician and his staff.

“I’ve never had such good care, and I’ve seen many physicians,” he states. “I’m impressed by their level of compassion and understanding, and how they take time to figure out each individual’s unique issue. Then, there’s the surgical skill of Dr. Cordner. He’s truly remarkable.

“I feel extremely fortunate to have encountered Florida Pain Management Associates and Dr. Cordner. They’re the best I’ve seen.”

*Patient’s name changed at his request.
Print This Article