Selected Podcast
Vertiflex®: Treatment for Lumbar Spinal Stenosis
Lumbar spinal stenosis (LSS) is quite literally a ‘pain’ in the rear – as well as the back and legs. This degenerative spine condition occurs when nerves in the lower spine become pinched, typically caused by normal wear and tear of the spine. It most commonly affects those age 60 and older. Franciscan Health doctors now offer a new treatment option that benefits many patients – Vertiflex®, which acts as a spacer to reduce or eliminate pressure on the nerves. This device essentially acts as a doorstop in the spine preventing the canal from becoming fully narrow and reducing the crowding around the spinal nerves.
Featuring:
John Kihlken, M.D.
Dr. John Kihlken is a pain management physician with Franciscan Physician Network Neuroscience Specialists. He is board certified in anesthesia and pain medicine. Dr. Kihlken received his medical degree from Indiana University School of Medicine. While he was there, he served his anesthesia residency. Dr. Kihlken completed his pain management fellowship at the University of Louisville School of Medicine. Dr. Kihlken offers treatment such as, but not limited to, a number of different injections and nerve blocks. Transcription:
Scott Webb (Host): Lumbar spinal stenosis or LSS is quite literally a pain in the rear, as well as the back and legs. This degenerative spine condition occurs when nerves in the lower spine become pinched, typically caused by normal wear and tear of the spine. It most commonly affects those aged 60 and older. Franciscan Health doctors now offer a new treatment option that benefits many patients called Vertiflex, which acts as a spacer to reduce or eliminate pressure on the nerves.
This device essentially acts as a doorstop in the spine, preventing the canal from becoming fully narrow and reducing the crowding around the spinal nerves. And joining me today is Dr. John Kihlken. He's the Franciscan Health Spine Center Medical Director, and he's Board Certified in Anesthesia and Pain Medicine. This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, thanks so much for your time today. We were just talking off the air here a little bit. I'm 53. I probably have spinal stenosis, I'm sure many listeners may have, or may suspect that they have it. So, before we get rolling here and talk about this amazing Vertiflex system, let's just have you kind of set the scene a little bit. What is lumbar spinal stenosis?
John Kihlken, M.D (Guest): Well, what stenosis means, the word itself, just means that you've got a hole that is too small. And so in your spine, what is in your spinal canal or the hole in your spine is your nerves. And so if you've got a hole that's too small and your nerves are passing through that, that can cause nerve irritation.
And so you can have nerve pain. We call that neuropathic pain. So, spinal stenosis usually presents with people who have low back pain and not always, but a lot of the time they'll have pain that runs down their leg in the distribution of a nerve. That's the kind of behind the scenes or the definition, I guess, of spinal stenosis.
Typically it affects older folks, because most of the time, this is kind of a chronic degenerative, change in the spine that causes the narrowing or causes the stenosis. And so a lot of times, as we age, our spinal canals get smaller and people in that demographic end up with spinal stenosis and symptomatic spinal stenosis.
Host: Yeah, that's great to kind of lay the foundation there and, you know, I've suspected and heard from other guests that I've had, that it's not really an acute thing, that this is a chronic degenerative condition. One in which a number of treatment options, interventions may be tried, but I really want to talk about this Vertiflex system. I was reading about this. I watched a video on this, this sounds and seems really amazing, but I want to have you explain to folks what it is, how it's used, when it's indicated. And so on.
Dr. Kihlken: Sure. So Vertiflex is a super exciting new treatment that we're using here at St. Francis. I've been using it for over a year now and I've seen some really good results with it. Basically what it is, is essentially, it's kind of like a wedge. So, what it does is it opens the spinal canal. And so the people who are gonna benefit the most from this device, or from this procedure are going to be people who have pain in certain positions.
So, there's a positional component to spinal stenosis. And usually what that classically, I guess, presents as, is people when they stand up straight or when they extend their lumbar spine, that can tighten the spinal canal. And when you either sit forward or lean forward on something, you can open your spinal canal just a little bit. And so Vertiflex tries to address this problem. It's a small implant. It's placed by making about a one inch incision in the skin. But basically we put this little spacer device between the spinus processes to help open the spinal canal.
Host: So, when we think about recovery time, outcomes, what folks can expect throughout this process, because it does sound pretty revolutionary and great to hear that you're doing it at Franciscan. I don't know if it's become the gold standard yet or not, but it sounds pretty awesome. So, what about recovery times and outcomes and people getting back to maybe what life was like before the spinal stenosis began to sort of make decisions for them, if you will?
Dr. Kihlken: Sure. Well, we've had a really good outcomes with this procedure. I guess, in terms of what to expect sorta afterwards and recovery wise, I mentioned just a moment ago, this procedure is done through about a one inch incision. This is always done as an outpatient procedure. So you'd go home the same day.
There's really, I would say minimal restrictions. I, you know, when I perform this procedure, I do ask folks to restrict their strenuous activity for about four to six weeks afterwards. So, I really don't want you to placing a lot of stress on the device right after it's been put in.
So it's really not a very strenuous recovery. However, what we do see is that device is placed and it's working. And folks can walk more than they used to be able to because they have less pain. A lot of times, about a month or six weeks after the implant, we actually go back to physical therapy because now people can walk better. And now it's a matter of getting their muscles retrained to be able to walk where they couldn't walk before it was placed.
Host: Yeah, it's pretty amazing. And as I said before we got rolling here, a little free medical advice for me, and of course everybody else today. So, Doctor, when we think about longevity for the Vertiflex system, is this something that folks can have, they, they get it put in once and then they're good to go for the rest of their lives? What are your expectations on how long the system will last?
Dr. Kihlken: The system itself is a permanently placed system. So, I mean, once it's put in there, it doesn't get removed or changed or anything. I will say it is possible to remove it if you had to. But it's a permanent situation. Now that the data and the studies typically go out for five years after implant, and there's really good results.
You know, anyone who's really interested can quickly Google Vertiflex and you'll come up with a lot of different studies, but typically about 80 to 81% of people who have this device report improvement in their physical function, which is the goal of the procedure.
Host: Yeah. Those, those are great odds. I like that 80 to 81%. It's, it's really amazing. And I just love science and medicine and technology and hearing about this. So, I really do appreciate you, you know, sharing your expertise with us today. As we wrap up here, what are your takeaways for listeners if they suspect, or they've been diagnosed with lumbar spinal stenosis? And when they're thinking about their treatment options, I assume that you would recommend the Vertiflex system, but I'll leave it to you.
Dr. Kihlken: Yeah, I think probably to wrap this up, I would just say that, there are several different options. Treatment of lumbar spinal stenosis is really kind of a continuum all the way from conservative treatment, like physical therapy to, really invasive treatment, like spine surgery or larger types of spine surgery. And I would just say that, you know, as technology moves forward and we get new devices like this, it's important to seek out and find all the different options that are available. And this Vertiflex one is one that so far, in my hands, has been successful.
Host: Yeah, it sure sounds like it. And I, as I said, I really do appreciate you sharing this with listeners and myself today. This is, is really cool and something that I may have to consider myself, but, I've taken up enough of your time today, Doctor. So, thanks so much and you stay well.
Dr. Kihlken: All right. Thank you so much. Have a good day.
Host: For more information on Vertiflex, check out our YouTube video at youtube.com/myFranciscan. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.
Scott Webb (Host): Lumbar spinal stenosis or LSS is quite literally a pain in the rear, as well as the back and legs. This degenerative spine condition occurs when nerves in the lower spine become pinched, typically caused by normal wear and tear of the spine. It most commonly affects those aged 60 and older. Franciscan Health doctors now offer a new treatment option that benefits many patients called Vertiflex, which acts as a spacer to reduce or eliminate pressure on the nerves.
This device essentially acts as a doorstop in the spine, preventing the canal from becoming fully narrow and reducing the crowding around the spinal nerves. And joining me today is Dr. John Kihlken. He's the Franciscan Health Spine Center Medical Director, and he's Board Certified in Anesthesia and Pain Medicine. This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, thanks so much for your time today. We were just talking off the air here a little bit. I'm 53. I probably have spinal stenosis, I'm sure many listeners may have, or may suspect that they have it. So, before we get rolling here and talk about this amazing Vertiflex system, let's just have you kind of set the scene a little bit. What is lumbar spinal stenosis?
John Kihlken, M.D (Guest): Well, what stenosis means, the word itself, just means that you've got a hole that is too small. And so in your spine, what is in your spinal canal or the hole in your spine is your nerves. And so if you've got a hole that's too small and your nerves are passing through that, that can cause nerve irritation.
And so you can have nerve pain. We call that neuropathic pain. So, spinal stenosis usually presents with people who have low back pain and not always, but a lot of the time they'll have pain that runs down their leg in the distribution of a nerve. That's the kind of behind the scenes or the definition, I guess, of spinal stenosis.
Typically it affects older folks, because most of the time, this is kind of a chronic degenerative, change in the spine that causes the narrowing or causes the stenosis. And so a lot of times, as we age, our spinal canals get smaller and people in that demographic end up with spinal stenosis and symptomatic spinal stenosis.
Host: Yeah, that's great to kind of lay the foundation there and, you know, I've suspected and heard from other guests that I've had, that it's not really an acute thing, that this is a chronic degenerative condition. One in which a number of treatment options, interventions may be tried, but I really want to talk about this Vertiflex system. I was reading about this. I watched a video on this, this sounds and seems really amazing, but I want to have you explain to folks what it is, how it's used, when it's indicated. And so on.
Dr. Kihlken: Sure. So Vertiflex is a super exciting new treatment that we're using here at St. Francis. I've been using it for over a year now and I've seen some really good results with it. Basically what it is, is essentially, it's kind of like a wedge. So, what it does is it opens the spinal canal. And so the people who are gonna benefit the most from this device, or from this procedure are going to be people who have pain in certain positions.
So, there's a positional component to spinal stenosis. And usually what that classically, I guess, presents as, is people when they stand up straight or when they extend their lumbar spine, that can tighten the spinal canal. And when you either sit forward or lean forward on something, you can open your spinal canal just a little bit. And so Vertiflex tries to address this problem. It's a small implant. It's placed by making about a one inch incision in the skin. But basically we put this little spacer device between the spinus processes to help open the spinal canal.
Host: So, when we think about recovery time, outcomes, what folks can expect throughout this process, because it does sound pretty revolutionary and great to hear that you're doing it at Franciscan. I don't know if it's become the gold standard yet or not, but it sounds pretty awesome. So, what about recovery times and outcomes and people getting back to maybe what life was like before the spinal stenosis began to sort of make decisions for them, if you will?
Dr. Kihlken: Sure. Well, we've had a really good outcomes with this procedure. I guess, in terms of what to expect sorta afterwards and recovery wise, I mentioned just a moment ago, this procedure is done through about a one inch incision. This is always done as an outpatient procedure. So you'd go home the same day.
There's really, I would say minimal restrictions. I, you know, when I perform this procedure, I do ask folks to restrict their strenuous activity for about four to six weeks afterwards. So, I really don't want you to placing a lot of stress on the device right after it's been put in.
So it's really not a very strenuous recovery. However, what we do see is that device is placed and it's working. And folks can walk more than they used to be able to because they have less pain. A lot of times, about a month or six weeks after the implant, we actually go back to physical therapy because now people can walk better. And now it's a matter of getting their muscles retrained to be able to walk where they couldn't walk before it was placed.
Host: Yeah, it's pretty amazing. And as I said before we got rolling here, a little free medical advice for me, and of course everybody else today. So, Doctor, when we think about longevity for the Vertiflex system, is this something that folks can have, they, they get it put in once and then they're good to go for the rest of their lives? What are your expectations on how long the system will last?
Dr. Kihlken: The system itself is a permanently placed system. So, I mean, once it's put in there, it doesn't get removed or changed or anything. I will say it is possible to remove it if you had to. But it's a permanent situation. Now that the data and the studies typically go out for five years after implant, and there's really good results.
You know, anyone who's really interested can quickly Google Vertiflex and you'll come up with a lot of different studies, but typically about 80 to 81% of people who have this device report improvement in their physical function, which is the goal of the procedure.
Host: Yeah. Those, those are great odds. I like that 80 to 81%. It's, it's really amazing. And I just love science and medicine and technology and hearing about this. So, I really do appreciate you, you know, sharing your expertise with us today. As we wrap up here, what are your takeaways for listeners if they suspect, or they've been diagnosed with lumbar spinal stenosis? And when they're thinking about their treatment options, I assume that you would recommend the Vertiflex system, but I'll leave it to you.
Dr. Kihlken: Yeah, I think probably to wrap this up, I would just say that, there are several different options. Treatment of lumbar spinal stenosis is really kind of a continuum all the way from conservative treatment, like physical therapy to, really invasive treatment, like spine surgery or larger types of spine surgery. And I would just say that, you know, as technology moves forward and we get new devices like this, it's important to seek out and find all the different options that are available. And this Vertiflex one is one that so far, in my hands, has been successful.
Host: Yeah, it sure sounds like it. And I, as I said, I really do appreciate you sharing this with listeners and myself today. This is, is really cool and something that I may have to consider myself, but, I've taken up enough of your time today, Doctor. So, thanks so much and you stay well.
Dr. Kihlken: All right. Thank you so much. Have a good day.
Host: For more information on Vertiflex, check out our YouTube video at youtube.com/myFranciscan. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.