Have you heard of new "TOPS" Spine 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.

@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.

@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.

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 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.

I have severe central canal stenosis at L4-5 with cauda equina compression and severe left L5 neural foraminal stenosis with flattening of the nerve root. I'm seeing a neurosurgeon next week and expect surgery is my only option. Ill be asking about the Tops System. My spine specialist already has said it could involve a laminectomy with discectomy and spinal decompression.