Have you heard of new "TOPS" Spine surgery?
It focuses on Stenosis and Spondylolesthesis which I have. I also have Scoliosis. I have a new Dr., well educated, who I do not think has
much surgery experience. But I am anxious to get going to fix
my problems. Have spent over a year on working on fixing my spine.
I am in the highest age category they will do (80). Am in good shape and basically very healthy.
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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.
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1 Reaction@sallylang Thanks, I appreciate it. Look forward to your update! I know Mayo Clinic was one of the very first health systems in the US to get training on it and be able to do the surgery. So that's promising for you!! I looked into flying to Germany for it before it was in the US but decided it was too much work (& money) so I'd just wait until it was approved by the FDA.
@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.
I do strongly agree with the theory of the TOPS procedure in that it does allow some (very little but some ) range of motion within the segment involved; so theoretically is will reduce the increased stress on the vertebra at either ends outside where a fusion would be done. I was told by two surgeons that my only options for my spinal condition was either the TOPS or a fusion. I was told by both surgeons that a fusion would take a full year to heal.
*I was informed by the surgeons office that Medicare may not pay for the hardware; but with only a 3 month full healing time with the TOPS procedure, I felt getting 9 months back in my life was worth paying for the non covered portion of the surgery. Note, because the procedure is relatively new, the long term results are not published yet.
@johnfm Thank you for sharing your experience with me. I did not realize Medicare would not pay for the hardware. Insurance coverage would have been my next step had I been a candidate. Now I need to learn more about fusion.