X-Stop Update

Back in 2007, I blogged about the X-Stop, a procedure that reportedly reduces the pain associated with spinal stenosis. Spinal stenosis is usually treated with decompression surgery. The X-stop is a recent development; it was approved by the FDA in 2005. Questions about how well the X-stop works continue, and since my last post then there have been a couple of new research studies. Here's the update:

• The X-stop works best if you don't have any other musculoskeletal problems. This research study also showed that while the X-stop does make a difference for patients, there are questions as to whether it is as helpful as originally thought.
• If your stenosis is due to spondylolisthesis, the X-stop is not recommended. There are a number of reasons for this, but the most important was a very high failure rate shown in a recent study. The X-Stop may even make the spondylolisthesis worse.

Please also be aware that most insurance companies regard the X-Stop as "investigational", which means most likely they will not pay for it. The reason for this is that there have only been a few studies on the procedure, none of which looked at device durability, safety, pain relief and other factors over the long term.

_Sources:
Verhoof OJ, Bron JL, Wapstra FH, et al. High failure rate of the interspinous distraction device (X-Stop) for the treatment of lumbar spinal stenosis caused by degenerative spondylolisthesis. Eur Spine J 2008 February 17(2): 188-92.
Brussee P, Hauth J, Donk RD, Verbeek AL, Bartels RH. Self-rated evaluation of outcome of the implantation of interspinous process distraction (X-Stop) for neurogenic claudication. Eur Spine J. 2008 Feb;17(2):200-3. Epub 2007 Oct 31.