@readinglamb- I saw Dr. Shaleen Vira today. He said I am not eligible for the TOPS surgery because my bones are to thin. I am 76 years young and do have Osteopenia. Looks like I am a candidate for fusion for my spine problems.

I had the L4-5 TOPS procedure done last March 31, 2025; here in Milwaukee. I woke up from the surgery pain free. It was very successful. Completely off Gabapentin immediately after weaning off of it. No rehab needed. 3 months to full recovery. I think it might be FDA approved since it is done with the clinical trials stage in the US.
****HOWEVER; it is not covered by Medicare at this time so I had to pay out of pocket for the hardware that was installed. Most private insurances follow Medicare guidelines, so I assume most other insurances are not covering it. The denial by Medicare has been appealed many times without success.
The only problem following surgery was that I developed significant burning pain in the buttocks, bilaterally 2 months post surgery. The burning pain only occurs when sitting on softer surfaces such as the recliner, car seat, and reading in bed. MRI showed a severe stenosis at the level above the surgery. The surgeon has offered to do a laminectomy but I prefer to not go under the knife again so soon. There has been little improvement after 2 injections; 2 rounds of PT, acupressure, and using a low dosage of Gabapentin. I am scheduled to see a different spine pain specialist next week for any ideas and discussion on any further approaches to resolve this issue, without surgery, if possible.