Mr Ben Okafor FRCS (Orth.)

Consultant Orthopaedic and Spinal Surgeon

What is the X-Stop procedure?

This is a surgical procedure in which a titanium implant is placed between two bones - called spinous processes - in the back of your spine. The implant is designed to remain safely and permanently in place without attaching to the bone or ligaments in your back. No bones or soft tissue are removed during this procedure. 

What sort of patients are suitble for this procedure? 

The X-STOP procedure is suitable for patients aged 50 or older who have been diagnosed with lumbar spinal stenosis. The typical patient will have a moderately impaired ability to function, and may experience relief from their pain symptoms when bending forward.

The X-STOP device is not suitable for people who have:

  • an allergy to titanium or titanium alloy
  • spinal anatomy that would prevent implantation of the device or cause the device to be unstable in your body
  • cauda equina syndrome, which is a spinal nerve compression that causes bowel or bladder dysfunction
  • bone fractures or a diagnosis of severe osteoporosis
  • an infection in your blood or anywhere near your lower back where the surgery is planned.

What happens during the operation?

The procedure may be performed usually under general anaesthesic. With the help of X-ray guidance, the X-STOP Implant is inserted through a small incision in the skin of your back. Occasionally it can be inserted using local anaesthesic with sedation. It normally takes around 45 minutes to insert the implant.

Once in place, the implant is designed to keep the space between your spinous processes open, so that when you stand upright, the nerves in your back will not be pinched or cause pain. As a result, you shouldn't need to bend forward anymore to relieve your symptoms.

What are the benefits of X-STOP?

The procedure offers several benefits compared to traditional surgery for lumbar spinal stenosis, including:

  • a shorter operation time
  • usually no removal of bone or tissue, which allows for a quicker recovery
  • it's a fully reversible procedure that doesn't limit any further surgical or non-surgical treatment options that may be needed in the future

Preparing for Surgery

If you elect to go ahead with the X-STOP Procedure, there are several things you can do to help yourself achieve the best possible outcome for your surgery. Most importantly, you can eat well-balanced nutritional meals as far in advance of your procedure as possible. Poor nutrition can reduce the body’s ability to heal itself.

Possible complications

Spinal surgery is not without risks. Although they are uncommon, the following complications are associated with the X-STOP procedure:

  • implant dislodgement (movement out of place)
  • implant not positioned correctly
  • fracture of the spinous process
  • alergic reaction to foreign body
  • additional surgery, which could include the removal of the implant
  • mechanical failure of the implant

Other uncommon complications related to spine surgery in general may include:

  • infection, which could require medication or an operation
  • blood vessel damage/bleeding
  • bruising (haematoma)
  • blood clots
  • wound closure problems
  • nerve damage
  • pain or discomfort

Postoperative care

You may feel immediate relief from pain following this procedure, and may even be able to walk the following day. You may require pain control until some of the postoperative pain settles. Your likely hospital stay is 2-3 nights.

Following your discharge, physical therapy may be recommended. You will be reviewed after six weeks. You should be able to travel and engage in light activity usually after 2-3 weeks, or when able to.

Physical activity limitations may include:

  • no heavy lifting
  • no stair climbing
  • no sports such as swimming, golf, tennis, racquetball, running or jogging

Walking is usually acceptable as long as it's comfortable and does not exceed one hour in duration. Normal activity can usually be resumed within 2-6weeks after the procedure.           

Return to treatments and operations.  



Diagram of Xstop device


Xray showing Xstop in place

Lateral xray of Xstop device

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