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Health Beat: TOPS fusion alternative | Health Beat

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PITTSBURGH, Pa. – Nathan Snyder has been an athlete his entire life.

He played football at Harvard University, but his back pain started even before college. Little by little, the pain got the best of him.

“As it progressed, it started as nerve pain down my leg and it eventually got all the way to my toes on both sides,” Nathan said.

Nathan was diagnosed with spinal stenosis, which is a wear and tear of the joints in the lower spine that creates bone spurs that push on the nerves.

“I stopped running,” said Nathan. “Consistently running seemed to trigger it. I had to stop playing basketball.”

Dr. Donald Whiting, chair of neurosurgery at Allegheny Health Network, offered Nathan an alternative to spinal fusion that would relieve his pain and preserve his range of motion.

The procedure is called TOPS posterior arthroplasty. Surgeons alleviate nerve pressure by substituting bone with two movable titanium joints, and they do not insert the rigid rod that is typical of a spinal fusion.

“There’s less wear and tear on the levels above and below and less a need for further surgery down the road,” Dr. Whiting explained.

Nathan said he knew immediately it had worked. Now he’s pain-free and can do all the things he couldn’t do for decades like bend, flex, walk, etc. 

“I feel better than I did at 30,” said Nathan with relief. 

Nathan was part of a clinical trial, but now, the TOPS device is FDA-approved and can be used for patients with problems in the spine from vertebrae L3 to L5, the segments of the spine most commonly affected by spinal stenosis.





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