I'm scheduled to have an implant put between the two bumps along my low back (L45, I think). What should I expect after surgery? Like how long will I be out of commission. Will I need someone to come take care of me? (I live alone). What else can you tell me?

It sounds like you might be getting the X-STOP®, a metal implant made of titanium. The procedure to put this device in place is minimally invasive. Minimally invasive in this case means the implant is inserted through a small incision in the skin of the low back. This type of treatment is recommended for mild lumbar spinal stenosis (LSS). It is designed to fit between the spinous processes of the vertebrae in the lower back. It stays in place permanently without attaching to the bone or ligaments in the back. Spinal stenosis describes a clinical syndrome of buttock or leg pain. These symptoms may occur with or without back pain. It is a condition in which the nerves in the spinal canal are closed in, or compressed. The spinous process is the piece of bone that sticks out behind the vertebra. It is the bump you feel down the back of your spine. The spinal canal is the hollow tube formed by the bones of the spinal column. Anything that causes this bony tube to shrink can squeeze the nerves inside. As a result of many years of wear and tear on the parts of the spine, the tissues nearest the spinal canal sometimes press against the nerves. This helps explain why lumbar spinal stenosis (LSS) is a common cause of back problems in adults over 55 years old. What should you expect after surgery? This may depend somewhat on your surgeon and his or her preferences. We can give you a general idea but it would be best to ask your surgeon for his or her recommendations. You will likely be up and walking with a physical therapist in the first 24 hours. Studies show that patients who are mobilized (move, usually by walking) have fewer problems, especially with blood clots. Some surgeons still have their patients wear a back brace but many others do not. Motion past neutral spine alignment into an extended position is not recommended or allowed. You will be able to bend sideways and rotate or twist but not past an easy amount of range of motion. Lifting is limited to nothing more than eight to 10 pounds (approximately the weight of one-gallon of milk). These restrictions are in place for 10 to 14 days. You will be allowed to gradually increase motion and lifting limits. A physical therapist can help you begin learning how to move safely with the least strain on your healing back. As the rehabilitation program evolves, you will be asked to do more challenging exercises. The goal is to safely advance strength and function. As the therapy sessions come to an end, therapists help patients get back to the activities they enjoy. Ideally, patients are able to resume normal activities. Patients may need guidance on which activities are safe or how to change the way they go about certain activities. When treatment is well under way, regular visits to the therapist's office will end. The therapist will continue to be a resource. But patients are in charge of doing their exercises as part of an ongoing home program.

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