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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:

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:

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:

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

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:

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.
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