Innovative Tension Band Targets Degenerative Spondylolisthesis

A new device offers an alternative to fusion for patients receiving surgical decompression for lumbar degenerative spondylolisthesis with spinal stenosis.

The Empirical Spine (San Carlos, CA, USA) LimiFlex Paraspinous Tension Band is designed to resist the separation of two adjacent spinous processes by applying progressive tensile forces via ultra-high molecular weight (UHMW) polyethylene straps (attached in a loop) to a pair of titanium couplers sitting on either side of the spinal midline. By resisting spinous process separation, LimiFlex reduces segmental flexion and maintains facet engagement, stabilizing the treated segment; and because flexion and segmental translation are coupled, segmental translation is also stabilized.


The LimiFlex is implanted through a dorsal approach, most often through the same incision used for performing the surgical decompression procedure, and typically takes less than 20 minutes to place in position. The less invasive nature of the procedure also offers promise as an outpatient or ambulatory surgical procedure, providing significant flexibility both to patients and their surgeons, as well as the potential for significant cost savings, as compared to inpatient fusion surgery.

“My experience with LimiFlex has been very positive; the device may offer a minimally invasive way to stabilize the spine yet preserve motion,” said Rick Sasso, MD, of the Indiana Spine Group (Indianapolis, USA). “Many patients are extremely interested in less invasive stabilization options that avoid the complications of fusion, so they are attracted to LimiFlex. The device is easy to implant and has demonstrated great results in Europe.”

Lumbar spinal stenosis is a common disease of the aging spine that involves a narrowing of the space around spinal facet joints and enlarged ligaments, encroaching on nerves and causing pain, numbness, and weakness in the legs and hips with an impaired ability to walk and, in some cases, back pain. Some patients with lumbar spinal stenosis also have degenerative spondylolisthesis, where one vertebra slips forward relative to another, causing compression of the spinal canal and excessive movement when the lumbar spine flexes when bending forward.

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