Familiar with "TOPS" spine surgery?

Play recently saw a well-known surgeon who is one of the few in the country who puts in the TOPS device instead of fusion. I have osteoporosis, not severe in most places but at any rate I read that that device is not advised for people with osteoporosis but the surgeon is recommending it saying it would be better for me than fusion. Has anyone had the device put in who also has osteoporosis and it worked out? I have many gifts that are degenerating, one reason cited by the majority of surgeons who do fusion that tops wouldn't work for me.

As an old spine patient I had stainless steel plates and screws implanted in 1990, then considered state of the art. They now know that placing stationary plates causes vertebrae above the fusion to deteriorate. It appears the TOPS device permits spinal movement where mine does not. The long term pain issues and activity limiting I have encountered is partially due to my fusion. I was offered in 2016 to replace my steel with titanium but I’m not sufficiently debilitated to want unneeded spine surgery again. If I was in your shoes I’d go for the TOPS but research your surgeon and make sure they’ve done plenty of these before you dive in. I’m a Jefferson patient too. Which doc suggested the TOPS?
https://www.google.com/search

@jenatsky
The tops was suggested by the head of the Cleveland clinic. I'm not sure if I'm allowed to say his name but anyway he's well known obviously. I do have foraminal stenosis also which I don't know if the tops would help with that. Have a lot of degeneration through my whole spine but the worst is l34 where I have spondylolisthesis. Recently another doctor in Boston told me my cervical spine needs attention that I would be in danger of spinal cord compression if I don't deal with that. It's very complicated trying to figure this out. But I'm not sure which is Jefferson what is Jefferson?

Play recently saw a well-known surgeon who is one of the few in the country who puts in the TOPS device instead of fusion. I have osteoporosis, not severe in most places but at any rate I read that that device is not advised for people with osteoporosis but the surgeon is recommending it saying it would be better for me than fusion. Has anyone had the device put in who also has osteoporosis and it worked out? I have many gifts that are degenerating, one reason cited by the majority of surgeons who do fusion that tops wouldn't work for me.

@annie1 our spines sound similar. I have a grade II spondylo and disc bulging also. Had L4-S1 fused in 1990. Now experiencing cervical spine issues with arm and hand symptoms. MRI on 3/3/26.

Play recently saw a well-known surgeon who is one of the few in the country who puts in the TOPS device instead of fusion. I have osteoporosis, not severe in most places but at any rate I read that that device is not advised for people with osteoporosis but the surgeon is recommending it saying it would be better for me than fusion. Has anyone had the device put in who also has osteoporosis and it worked out? I have many gifts that are degenerating, one reason cited by the majority of surgeons who do fusion that tops wouldn't work for me.

Recent MRI states: L1-L2: Minimal symmetric disc bulge, which along with facet arthropathy, prominence of ligamentum flavum, prominence of the dorsal epidural fat contributes to mild thecal sac stenosis, increased from prior. Adequate neural foraminaL2-L3: Disc bulge is asymmetric to the right, which along with facet arthropathy, prominence of ligamentum flavum, and prominence of the dorsal epidural fat contributes to mild thecal sac stenosis, increased from prior. Adequate neural foraminaL3-L4: Symmetric disc bulge, which along with facet arthropathy, prominence of ligamentum flavum, and prominence of the dorsal epidural fat contributes to severe thecal sac stenosis, slightly increased from prior. Associated crowding of the cauda equina nerve roots (series 5 image 22). Adequate neural foraminaL4-L5: Anterolisthesis L4 on L5 with uncovering of disc material. Superimposed symmetric disc bulge, which along with facet arthropathy, prominence of ligamentum flavum, prominence of the dorsal epidural fat contributes to severe thecal sac stenosis, increased from prior. Subarticular recesses are completely effaced and there is crowding of the cauda equina nerve roots. Moderate left and mild right neural foraminal narrowingL5-S1: Adequate thecal sac. Bilateral facet arthropathy with adequate neural foramina. Tiny (0.2 cm) right-sided facet synovial cyst directed toward the spinal canal and neural foramen, but does not contribute to any significant spinal canal or neural foraminal stenosisIMPRESSION:1. Interval increase in multilevel degenerative changes of the lumbar spine with superimposed epidural lipomatosis, now with severe thecal sac stenosis at L3-L4 and L4-L5, mild thecal sac stenosis at L1-L2 and L2-L3, and multilevel mild or moderate neural foraminal narrowing, as detailed. Wondering if anyone had TOPS instead of fusion, and how has the back been since the surgery?

Recent MRI states: L1-L2: Minimal symmetric disc bulge, which along with facet arthropathy, prominence of ligamentum flavum, prominence of the dorsal epidural fat contributes to mild thecal sac stenosis, increased from prior. Adequate neural foraminaL2-L3: Disc bulge is asymmetric to the right, which along with facet arthropathy, prominence of ligamentum flavum, and prominence of the dorsal epidural fat contributes to mild thecal sac stenosis, increased from prior. Adequate neural foraminaL3-L4: Symmetric disc bulge, which along with facet arthropathy, prominence of ligamentum flavum, and prominence of the dorsal epidural fat contributes to severe thecal sac stenosis, slightly increased from prior. Associated crowding of the cauda equina nerve roots (series 5 image 22). Adequate neural foraminaL4-L5: Anterolisthesis L4 on L5 with uncovering of disc material. Superimposed symmetric disc bulge, which along with facet arthropathy, prominence of ligamentum flavum, prominence of the dorsal epidural fat contributes to severe thecal sac stenosis, increased from prior. Subarticular recesses are completely effaced and there is crowding of the cauda equina nerve roots. Moderate left and mild right neural foraminal narrowingL5-S1: Adequate thecal sac. Bilateral facet arthropathy with adequate neural foramina. Tiny (0.2 cm) right-sided facet synovial cyst directed toward the spinal canal and neural foramen, but does not contribute to any significant spinal canal or neural foraminal stenosisIMPRESSION:1. Interval increase in multilevel degenerative changes of the lumbar spine with superimposed epidural lipomatosis, now with severe thecal sac stenosis at L3-L4 and L4-L5, mild thecal sac stenosis at L1-L2 and L2-L3, and multilevel mild or moderate neural foraminal narrowing, as detailed. Wondering if anyone had TOPS instead of fusion, and how has the back been since the surgery?

I have an appointment with Dr. Shaleen Vira on 3/17. He is trained in TOPS. He did a video talk for Premia Spine yesterday. I don't know if I qualify, but I will find out. I will update you after I see him.