What is an Intralaminal Spacer?
Interlaminar spacers are spinal implants, which facilitate a minimally invasive solution to treat certain types of spinal stenosis. For the right patients, our implant surgeons can relieve pain and symptoms from nerve compression caused by stenosis. The surgically implanted spacer is inserted between spinal segments to provide necessary space for nerves to function optimally without pain.
Who will likely benefit from this procedure?
Patients diagnosed with central and foraminal spinal stenosis may benefit from placement of interlaminar spacers using a minimally invasive surgical approach. In some cases, a more invasive surgical treatment may be needed. Osteoarthritis and the aging process can lead to bone and soft tissue thickening with crowding and irritation of nerve tissue in the affected area of the spine.
A condition that causes back, arm or leg pain and/or “pins and needles” sensations, called neurogenic claudication, may decrease when the patient sits or bends the spine. This can temporarily provide the compressed nerves with more space and consequently relieves pressure. Affected individuals sometimes begin to walk in a bent-over manner. After proper treatment, patients may regain the ability to stand straighter and walk pain-free once again. In some cases, the pain may be from vascular causes, and we work hand in hand with the cardiovascular team at NYC Surgical Associates to ensure that the right treatment is done in the right way to completely and efficiently address your problem.
When would this surgery be an option?
Surgery for spinal stenosis may be considered when one or more of these findings occur:
- Your symptoms severely restrict your normal daily activities and have become unmanageable.
- More conservative treatments do not relieve pain.
- Nerve compression symptoms, like numbness or weakness, are worsening.
- Your bladder or bowel control is decreasing.
- You experience sudden changes in gait or become clumsy.
If severe osteoporosis is present or spinal anatomy prevents implantation, implant surgery will not be recommended. There are other possible contraindications which your surgeon will discuss with you. If you have cervical spinal stenosis, which affects the upper extremities and back, your doctor may recommend surgery (of another type) because this condition can cause nerve damage and paralysis. Most stenosis, however, occurs in the lower (lumbar) back.
How does interlaminar implantation surgery work?
Placement of interlaminar spacer(s) is an alternative to more invasive laminectomy or laminectomy plus fusion surgery. When preforming a laminectomy, the spine surgeon removes a portion of the lamina (the back part of the vertebra covering your spinal canal), thickened ligaments and any bone spurs in the spine. This allows the nerves to decompress.
During this alternative and minimally invasive approach, the surgeon places one or more titanium interlaminar spacers between the spinal bones and/or tissues. The spacer “props up” the bony structures, holding them in a flexed position, as if you were bending forward or sitting. The change in position takes place only in the region of the stenosis, limiting extension of the spine and maintaining a neutral or slightly flexed position.
Are there advantages to interlaminar spacer surgery?
For the right patient candidates, interlaminar spacers offer all the advantages that come with more invasive surgery, with benefits including:
- May be performed under local anesthetic and considered lower risk.
- Generally done on an outpatient basis.
- Typically, there is no bone or tissue resection and incisions are smaller.
- The spinal canal is not compromised.
- Operating room time is shortened and may be less expensive for the patient.
- Shorter recovery times and rapid symptom relief.
This treatment is not advisable for every stenosis patient. Make an appointment with one of our specialists at NYC Surgical Associates today to have a tailor made plan formulated just for you.
To learn more about this surgery or to discuss other options, contact our Neurosurgery and Spine team at NYC Surgical Associates, where we are happy to discuss this and any other options that may pertain to your care. You may contact us at 888-286-6600 or by submitting our online contact form.