Interspinous process spacers

Operation
X-STOP, INSPACE (percutaneous), WALLIS ligament and BACJAC are all types of interspinous process spacers used by Mr Chapple.

Indication
Leg pain due to spinal stenosis, lateral recess stenosis, foraminal stenosis, for augmentation of spinal decompression and facet joint back pain.

Pre-assessment
Yes

Special preparation for surgery
Stopping all blood thinning agents – aspirin, warfarin, clopidogrel as advised.

Admission to hospital
On day of surgery

General anesthetic
Yes, however can be done under local anaesthetic.

Operation position
Prone (on front) or lateral

Details of operation
Under X-ray guidance the level is marked. For some patients a midline 4 cm incision is made, others a 2cm flank incision is needed. The gap between the spinous processes is enlarged and the correct size spacer is delicately inserted.

Length of surgery
1 Hour

Urinary catheter required
No

Post-operative drain required
No

Post-operative antibiotics
No single dose given in theatre

Post-operative iv fluids (drip)
Intravenous fluids may be needed post-operatively

DVT prophylaxis
Yes , post operative aspirin where appropriate

Mobilization after surgery
Within 6 – 12 hours

Length of stay in hospital
Can be done as a day case or as in patient for up to 2 days

Post hospital recovery
2 weeks gentle increase in activities to pre-operative normal state.

Sutures removed
Dissolvable

Dressing
Dissolvable glue

Review appointment
6 weeks

Physiotherapy
Not required

Return to driving
After 2 weeks

Return to work
2-6 weeks