Familiar with "TOPS" spine surgery?

Posted by libertyusa @libertyusa, Apr 18, 2025

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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ou14mejc | @ou14mejc | Jun 12 12:59pm

In reply to @planatlaw "@ou14mejc - This is not a healthcare system - this is a crap shoot where the..." + (show)

@planatlaw Exactly! Finding out that you owe thousands of dollars AFTER the surgery has been performed could financially ruin a lot of people. I was told, "we can't give you a number beforehand because we have to wait and submit to your insurance to see what it pays after the surgery."

cori | @ccchang | Jul 3 1:40pm

In reply to @johnfm "I had the TOPS procedure last year to resolve severe bilateral leg pain due to stenosis..." + (show)

@johnfm

I had the TOPS procedure last year to resolve severe bilateral leg pain due to stenosis AND spondilolithesis at the L4-5 level. I opted for the TOPS procedure, since in theory, it allows a little motion at the vertebra and would thus hopefully reduce the risk of developing spine issues at either end of a fusion where the spinal segment is locked up. Your surgeon is the one to determine if you qualify for the procedure.
My surgery went extremely well. The SEVERE pain issues were resolved immediately, and I was very happy with the outcome. However, I did develop some significant burning pain in both buttocks and upper thighs 2 months after the surgery with the new MRI showing a severe stenosis at the L3-4 level (which had only showed a moderate stenosis on the previous MRI before the surgery). This burning pain is only experienced when sitting on soft surfaces such as the bed, recliner, and car seat. I could walk, and sit on hard surfaces without any discomfort. That is slowly resolving after 12 months, but still is an issue.
*The recovery time with the TOPS is much shorter (slightly less than 3 months to complete recovery in my case, and resumption of all activities; vs. a fusion which might take up to a year to fully heal (as I was told by two surgeons).

One issue to consider is that Medicare (and therefore most insurances) did deny the cost of the spine prosthesis put in, due to still being considered experimental. The denial was appealed twice, with the denial being upheld. However, after going through an ALJ (administrative law judge hearing); the denial was overturned and I was refunded the money I had paid to the surgeon's office).

Last thing to consider is that at the time of the surgery, I was told by the surgeon that the long term studies/outcomes of the TOPS procedure were still ongoing. So who knows what the future might bring. But overall, I am very happy with the results.

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@johnfm Who was your surgeon and which hospital? Also, how many hours was the surgery? and how many nights spent in hospital? Did the TOPS survery relieve your pain and numbness?

johnfm | @johnfm | Jul 6 7:30am

cori, My surgery was at the Orthopedic Hospital of Wisconsin, in Glendale, WI. I believe I was in the hospital for two nights. I think the surgery was a couple hours. The surgeon was Stephen Robbins. The severe pain I had been experiencing in the distal posterior thighs was immediately relieved, and has been absent since the surgery over a year ago. However, the nerve pain in the buttocks started two months later, related to an issue at a higher vertebral level. This has improved with a lot of PT, and daily exercises, but is still an ongoing issue. If you want to discuss further I would be happy to discuss it with you.