New Vertiflex Procedure Offers Hope for Patients with LSS

“Imagine simply walking through the grocery store and suffering pain in your legs and back that requires you to stop to rest or sit down to relieve it before finishing your shopping,” said Dr. Ashish Malik.

Dr. Malik, who is trained in pain medicine and serves as director of the Pain Medicine Fellowship at Baystate Medical Center, notes the pain - worse when standing or walking and relieved when leaning forward or sitting - is often consistent with a condition called lumbar spinal stenosis (LSS).

As many as six million people in the United States just like Richard Leger of Westfield suffer from LSS, the narrowing of the spinal canal, which can cause compression of nearby nerves and result in significant back and leg pain, disability, functional impairment and diminished quality of life.

Diagnosed with LSS

“For me it started in the winter of 2019. I would go to the gym and something just didn’t feel right….pain in my back and legs. Then it was all of the time, not just when I was trying to exercise, but even while lying in bed. The pain was terrible and just never went away,” said Leger, 71.

He was eventually diagnosed with LSS and given an injection of cortisone into his back, but the relief was only temporary.

“I was at the Cape (Cod) several months later when the pain was unbearable once again, so much so that I could hardly walk. I went to the emergency room and when I left it was with a walker. Back home we were having a birthday party for my grandson and a good friend of mine saw me hobbling around and suggested I see Dr. Malik at Baystate’s Pain Management Center,” said Leger, who would soon learn about the Vertiflex Procedure.

A clinically proven procedure

Typical treatments include medications, physical therapy, steroid injections, and surgery. But, now a new procedure - available in Western Mass. only by Dr. Malik - from Boston Scientific called Vertiflex offers patients with a clinically proven procedure designed to deliver long-term relief from leg and back pain associated with LSS.

Procedures similar to Vertiflex have been around for years, but this is a one-of-a-kind, minimally invasive, percutaneous (any medical procedure or method where access to inner organs or other tissue is done via needle-puncture of the skin) treatment.

“The procedure is very-well tolerated and patients are expected to go home the same day. It is approved for those with moderate levels of spinal stenosis unlike surgery, which is usually reserved for severe stenosis. It can either serve as a bridge to surgery or possibly as a replacement to surgery,” said Dr. Malik, who traveled to Dallas, TX, to train to become certified in the procedure.

Less than one hour

Approved by the U.S. Food and Drug Administration (FDA), The Vertiflex Procedure is designed to provide the same relief you experience when leaning forward or sitting down. It uses a small, titanium alloy spacer which serves as an extension blocker designed to relieve pressure on the affected nerves. The treatment helps minimize the effects of spinal degeneration while preserving the patient’s anatomy.

The procedure - primarily performed by physicians who treat chronic pain patients with therapies including spinal cord stimulation and radiofrequency ablation - is performed in under one hour. The physician makes a small, ½ inch incision where the spacer is to be inserted, then guided through the surrounding tissue (without the need to dissect lots of muscle or bone) by using a dilator and real time X-ray to implant the device. Once inserted, the spacer’s arms open around the spinous processes (the bumps you can feel in your spine) to help make proper space for the affected nerves.

“I’ve started to play golf for the season and am feeling fine. I underwent the procedure in December of 2019 after meeting with Dr. Malik, who ordered an MRI to see if I was a candidate for the Vertiflex implant. Since then I have spoken with several patients considering the procedure that Dr. Malik asked I share my experience with, and I’ve told them, ‘Do it,’” said Leger.

90% satisfaction rating

The level-one evidence-based procedure is supported by data from patients who reported successful outcomes up to five years. In the randomized controlled trial, 66% noted improved back pain, while 75% had improved leg pain. In addition, the procedure contributed to an 85% reduction in the use of opioids for pain. Altogether patients reported a 90% degree of satisfaction after undergoing the Vertiflex Procedure.

“The only restrictions after the surgery is that patients cannot do any heavy lifting, participate in sports activities, or engage in any strenuous twisting or bending for six weeks to allow the implant to be set into place permanently,” said Dr. Malik.

“Lumbar spinal stenosis, while it may affect younger patients, is a degenerative condition that typically affects those who are age 60 and older,” said Dr. Malik.

Symptoms of LSS

Symptoms of LSS often include:

• Pain while walking or standing
• Weakness in legs
• Loss of balance
• Decreased physical endurance
• Numbness or tingling in the legs, buttocks or back
• Aching, dull back pain spreading to legs
• Tendency to sit or lean over to relieve pain.

If you are experiencing any of the above symptoms, you may be a candidate for the Vertiflex Procedure.

“We can determine through X-rays or MRI if you are a candidate for the procedure. If you are eligible, then we might need to try other conservative methods first such as an epidural steroid injections, and based on your response to the injection determine if implanting the Vertiflex may be a good option for you,” said Dr. Malik.

“The Vertiflex Procedure is also an excellent option for those patients with chronic diseases such as diabetes, whose blood sugars could not tolerate the effects of a steroid or for those of whom the cortisone injections are no longer providing prolonged relief,” he added.

The Baystate Pain Management Center is the only comprehensive, interdisciplinary centers for the care and treatment of patients with persistent pain in western Massachusetts.

Make an appointment today

To make an appointment, please call 413-794-4681.