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AnonymousUserAAnonymousUser Posts: 49,671
I had a L4/L5 microdiscectomy last May, which seemed to fix the sciatica in both legs till about August when the sciatica returned. The post-surgery MRI showed some scarring but no reherniation. Since then I had some epidurals and have been taking meds to deal with the pain - the assumption by my pain management doc was that the scarring was the problem.

However, two docs I spoke with (one neuro, one ortho) commented that my post-surgery MRI showed a lot of disc still compressing the nerve and that more disc/bone could have been taken out to relieve pressure on the nerve. One of the docs was conservative and suggested living with it (I'd be miserable but safe from surgical mishaps), the other suggested doing a microdiscectomy and using an xstop spacer to keep room open for the nerve (he guessed 60% chance of improvement). He acknowledged that I'd be his youngest xstop patient ever (I'm 35).


(1) Has anyone on the board had success with xstop? Of course, I'm also curious to know if people have had bad luck with it, too.

(2) Since xstop is approved for patients over 50, has anyone younger had it suggested to them as an option? I was surprised when the doc proposed it to me.

(3) Any other thoughts people have?



  • I had an x stop put in just over two & a bit years ago when I was 37, this was along with a two level fusion. My surgeon was hesitant to do a full three level fusion due to my young age & i was advised that this would still give some flex to the upper end of the three level section they were working on. Post Op no issues things were going great & the grafts were taking. I foolishly then re-injured myself! two & a bit years on in a sh**ty state again but not due to the X stop or the fusion.
    I'm UK based & have not heard any comments on the X stop being used on older people ie over 50's, it was given as something they use. I have actually held an xstop as just before my surgery someone had dropped one during an op & of course it couldn't then be used - looks a bit scary but does the job for me!!
    Good luck with things, db
  • I was very exciting about the X-Stop when I first read about it, and thought it would be the solution to my problems. Turns out I had spondylolisthesis and therefore, was not a candidate.

    You are correct that in the U.S. it is almost always used in the older patient population -- not even the 50+ but more like the over 60 crowd. I don't have a clue why that is, but I think it has something to do with the X-Stop not being a "permanent" solution. I think they assume that the younger population is more physically active and the X-Stop was not designed to be used for really active people who are playing a lot sports, twisting, jumping, etc.

    I would suggest you get another opinion from a fellowship-trained spinal specialist. Maybe you will find a third option! Otherwise, it might be worth trying the X-Stop. It is easily removed if it doesn't work out....
  • I really have never heard of the xstop being used on older people only & certainly not being a permanent solution. But I have to admit overall we do not get as much choice or information as other countries offer!! thats the good old NHS in the UK for you!!!!
    Mind you this info would not have stopped me having the surgery done, I was far too desperate to be pain free. db
  • This is from the manufacturer's website:

    If you can answer yes to all of the following statements, you’re ready to take the next step.
    I am 50 years of age or older.
    I have been diagnosed with and suffer from the symptoms of lumbar spinal stenosis (LSS).
    My pain is relieved when I sit down or lean forward.
    I have been in treatment for LSS for at least 6 months.

    I'm not saying it is NOT for people younger than 50. I just had investigated it when it was first approved for use and knew that it was designed for "older" patients as an alternative to fusion in the older population. Maybe they are now finding that it is a long-lasting solution and are now recommending it for younger patients as well.

    Looks like we will soon have our own version of NHS. :S
  • I'm 2 days post op from having an inerspinal devise like the X-stop put in between L2 L3 My NS quit using the X-Stop due to problems with it having too much movement or comeing loose. He has since changed to another device (I can't rember the name of it right now, but when my wife gets back from the store I'll ask her.) This inerspinal devise has a better way of staying in place & the NS said he has had great success with it. Of course my surgery was on Wednesday & I can't say if it's doing the job or not because the meds are covering up my symptoms. I just got back from a 1/2 mile walk & the only pain I'm feeling is from the insision.
    You might want to do some reading here http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2226191
  • As in any procedure, the failure rate goes up when the patients are not carefully screened for the particular procedure. If you look at the title of the abstract you mentioned, it is for the use of the X-stop in patients who have spondylolisthesis as a cause of their stenosis. Having spondylolisthesis is a disqualifier for having the X-Stop implanted. It was never designed to accommodate that condition....and it states that clearly in all information pertaining to the X-Stop.

    I'm glad you're happy with the results of your procedure and hope that it will provide you years of pain-free living.
  • "Looks like we will soon have our own version of NHS."
    What is this about - I haven't heard anything about this, this side of "the pond". Trust me you really don't want it. In theory it is great, go into A&E & get treated for free as an emergency. Need an "non urgent" op & this is a different kettle of fish. Each county (state) could have several different Primary Care Trusts & depending on the size of it & the demographics of the population they can be tight on money for funding - my PCT is mainly retired people & they have a very tight budget & I have found that I have had to wait months & months for appointments to see a spinal surgeon or even to get to a pain management clinic. Last time I saw a surgeon at clinic was 13 months ago & desite my GP reporting I am having problems & have new undiagnosed back pain i am not scheduled to see anyone! Again last time I was at pain clinic was July 2nd last year & only getting to go back in two weeks time on the 17th March as i have kicked off big time - they were hoping to leave me until may time before brining me back in! I could see people next week if I could pay for it privately - which I can't afford to do an MRI scan would cost between £650-1000 a time & a private consult with my spinal surgeon £200. I know I sound very bitter & twisted about this, but after a while the waiting & lack of coomunication really gets to you. I work as best I can & pay my taxes! DB
  • before I go - i'm at work ! i've never been told that I have or might have lumber spinal stenosis!, just that I had three crumbling discs! DB
  • I really hope this is working for you & all stays well! DB
  • Thanks for all your comments. I'm going to be getting yet another opinion in a month or so, so I can ask about this then. I guess I'd be little concerned about durability of the device, but with my disc problem and the pain, I'm already living like someone over 50 in terms of physical activity unfortunately. I'll keep everyone posted if I learn anything else interesting when I see the next doc.
  • I just reviewed my medical records - part of the doc's reasoning in recommending xstop for me was to get some pressure off the disc, in addition to opening up some space for my nerve. He noted that some evidence from Europe showing xstop could be useful in treating discogenic pain (maybe that explains how you got it, Dorset Boy?).
  • dcguy, my spinal surgeon was unkeen to go for a three level fusion given that I had not long turned 37 at the time as thesucess %age rates drop severely once you go for a 3 level fusion & he always said that the xstop would give me relief & space for the nerves & some flex at this level. db
  • Did you ask your dr. about the Aspin devise made by Lanx that I posted earlier? I know it hasn't been out long. So far week#2 post op no more leg pain.
  • ME
    as i have had a laminectomy and bilateral discectomy at 3 levels .and i have just found out that i have facet joint hypertrophy at all the surgical level i also have 2 bulge but at the moment the bulges they are not in to the central spinal canal so they are not giving me any pain.however i do suffer with permanent pain from a damaged nerve root L5/S1 i think ..any one know whether i would be a suitable candidate? {seeing the consultant 18 may 09}
  • Straker only your NS or OS could answer that.
  • I didn't ask about lanx - i was just reviewing my medical records so I didn't have a chance to ask the doc any new questions (just making sure I understood what he said to me the first time around). I'm getting a second opinion in a few days so it'll be interesting to see if the other doc brings up interspinous spacers.
  • Boo hoo. I hate the thought of it!
  • The x-stop was invented in the US so I don't think that is the reason. As I believe we already discussed, it was developed for a limited group of people --

    The reason it is not used more often is that not that many surgeons have been trained to install it. Is that the fault of the manufacturer or is the product not that useful?

    from the manufacturer's website:

    If you can answer yes to all of the following statements, you’re ready to take the next step.
    I am 50 years of age or older.
    I have been diagnosed with and suffer from the symptoms of lumbar spinal stenosis (LSS).
    My pain is relieved when I sit down or lean forward.
    I have been in treatment for LSS for at least 6 months.

    Straker ~ I don't believe you would qualify. I think it is only used on people who have never had any back surgery.
  • Had X-Stop surgery 6 weeks ago. I am still having leg pain even after one injection. The nerve at L-4 must still be inflamed. Can not walk any distance at all without significant pain. Has anyone had the x-stop surgery procedure? If so, what has been the results? Did you suffer leg pain after surgery?
  • The manufacturer's European website lists a number of uses other than stenosis, for which the device is approved in the United States.
  • i just had back surgery could not walk before now im mowing my lawn. it took 30 min was walking with in 6 hour of surgery went home next morning in 2 weeks i go back to work
  • I had an X-stop inserted in L3/L4 a year ago last May.
    After 3 months I told my consultant I was still experiencing similar symptoms as before but less severe. He suggested it would take some time for the pain to subside. Last January the symptoms became severe and I m back where I started. I am having another MRI scan in 2 weeks to find out what is going on but it looks likely that apart from collapsed discs at L1/L2 and L2/L3 there is likley to be stenosis in this area. I am convinced I had stenosis in this area last year so I am not sure why my consultant felt content to just offer me the X-stop at L3/L4.
    At the time of my op I did some research and discovered that there was little known about the success rate of the X-stop as it was still relatively new but it appeared to have a similar success rate as a laminectomy. My consultant has told me that his experience is a success rate of up to 80% using a new modified X-stop.
    Of course the X-stop is less invasive than a laminectomy or fusion which is possibly why some surgeons prefer this procedure and it may be a cheaper option (being cynical). Also it is a reversable procedure. I did speak to a doctor while staying in India (I needed pain killers) and he told me that they do not advocate the X-stop procedure as they find it only gives temporary relief and that they then have to perform a laminectomy or more likely a fusion at a later stage on these same patients.

    Unless I have missed some posts I have yet to find anyone who says that the X-stop has cured their symptoms completely or maybe they just don't bother to post anymore.
    I will listen to my consultant but will need some convincing that another X-stop procedure will solve my problem.
  • maryjferekmmaryjferek Posts: 1
    edited 02/13/2013 - 12:35 PM
    Hi, this is a couple years later than these comments. I had the x-stop surgery done on 11/29/12 and had my almost 3 month with the surgeon today. I have a spondy at L4-L5 and stenosis and had been going for epidurals which always helped me. After I fell on the basement stairs I had a lot of pain. I read about the x-stop online and went to the only surgeon in my area that does it. After a new MRI I tried 2 epidurals to relieve the pain and at the second one the Dr. there told me flat out if he were me he would have the surgery, that he couldn't even do a nerve block for me as I had no space between those vertebrae.

    I thought that like other surgeries I had (thumb joint replacements, carpal tunnel) I would have immediate relief but not so. Good days and bad days and the sciatic pain travels. But I just noticed I can sneeze and cough without the intense pain I had been having. Also he said that the nerves have memory and it will take time since it was compressed for so long.

    Surgeon said I had a bad slippage and that he is happy I have gotten as much relief as I have. He is working with the 3rd variation on the spacer and uses synthetic bone to "crazy glue" it in. I haven't been able to take anti-inflammatories till today. He said that I can see relief up to a year and as the synthetic bone sets more there will be less and less slippage and I may have more relief. I can go back to my gentle yoga and no restrictions any more basically.

    I'm very happy so far. I still can't sit on anything soft but he said that there is nothing else on the MRI that should be affecting the sciatic nerve so I can wait, I can go for another epidural and now there is space for that Dr. to do it where he needs to, he gave me a script for Neurontin if I want to try that.

    Honestly, getting up and moving the first hour or so is the worst but so far I see improvement. He said it was a 25 minute surgery vs. a 4 hour one for the work I would have had to have done otherwise so to me it is worth trying.

    I should say I am 57. It was an outpatient procedure. I don't think its cheap as the hospital bill that came to me listed it at $33K ( I don't have to pay that, just my deductible).
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