Inova Spine Institute

Inova Spine Institute, the leading collaborative spine treatment program in the Washington, D.C. area, has the most back pain specialists in the region. The physicians, nurses and the entire Inova team are committed to providing you with unparalleled individualized spine care.

At Inova Spine Institute, you’ll find a wide range of treatment alternatives, from physical therapy and rehabilitation to pain management. For patients who require surgery, Inova Spine Institute offers the most robust surgical program in the capital region, with each surgeon specializing in the unique aspects of spinal surgery.

Inova Spine Institute offers in-depth experience treating back pain as well as experts in the latest treatment techniques and procedures. And because they have locations throughout Northern Virginia and the Washington DC areas, you will find that world-class treatment for back pain doesn’t have to be a world away.

Inova Spine Institute is designed to focus on the specific needs of each person suffering with back or neck pain. Through their comprehensive, multi- disciplinary approach, they have one simple goal: returning you to the activities that you enjoy most.


Each year, more than 500,000 people in America undergo spine surgery. Primary candidates for this surgery include patients with chronic pain who have not responded to other conservative therapies or individuals who suffer from acute pain caused by progressive neurological damage that interferes with walking, exercise, leisure, recreation or work. The goal of spine surgery is to relieve pain, restore independence and return people to their daily activities.

Spine surgery is usually an option only after less invasive options have proven unsuccessful. A decision to have surgery requires careful evaluation of several factors. (These include the severity of the disorder, the presence or absence of pressure on the spinal cord or nerves, how long the pain has been present, and past medical history.) Minimally invasive surgical procedures can be good options for treatment of herniated discs or compression fractures.

Types of Spine Surgery

  • Lumbar disc replacement and cervical disc replacement
  • Laminaplasty – the lamina (the bony arches on the vertebrae) are cut free along one side and hinged open to enlarge the spinal canal and relieve pressure
  • Laminectomy – removes the bony arches on one or more vertebrae to relieve pressure
  • Spinal fusion – connects two or more vertebrae together and keeps them from moving until they have a chance to grow together, or fuse
  • Interspinous/interlaminar implant – This device is a shock absorber that fits between two vertebrae to provide cushioning and stability, and relieve pressure on the spine
  • Microendoscopic discectomy for herniated discs – Surgeons insert a tiny metal tube to access the herniated disc and remove the portion pressing on the nerve
  • Kyphoplasty for compression fractures – a balloon is inserted at the fracture and inflated, pushing the bone back to its normal height and shape
  • Minimally invasive surgery – performed through smaller incisions and reduce the risk of damage to nearby parts of the spine


If conservative treatments such as anti- inflammatory medication, physical therapy and epidural steroid injections fail to relieve symptoms, many patients consider decompression surgery.

About Decompression Surgery

This year alone, an estimated 325,000 surgical procedures that involve decompression to treat lumbar stenosis will be performed in the U.S. Decompression involves cutting away overgrown bone and tissue to relieve pressure around the impacted nerve. It is well documented as a successful spine surgery. The majority of
lumbar stenosis patients have good results with decompression, and most leave the hospital in a few days and return to normal activities in only a few weeks.

Current Limitations

Traditional decompression instruments are rigid and knife-like in design, limiting their ability to access all three areas of the spine where lumbar stenosis occurs. Failure to remove all stenosis during a traditional decompression results in poor surgical outcomes almost 60% of the time, such as continued or recurring pain or the need for another operation.
In order to reach the overgrown bone and tissue pressing on the nerve, surgeons sometimes must cut through bone and tissue in a straight line, often requiring the removal of healthy pieces of the patient’s spine needed for stability. However, removing as little as 30% of healthy bone and tissue to access the area of the patient’s lumbar stenosis during traditional decompression can lead to a complication called instability of the spine and the possible need for a spinal fusion procedure to stabilize the unstable joint.

About iO-Flex

Now there is a new alternative to traditional decompression with rigid instruments. The iO-Flex System is the first minimally invasive set of flexible instruments designed to target lumbar stenosis in all three areas, with minimal disruption to the patient’s healthy anatomy. Instead of cutting through healthy pieces of
the spine, the iO-Flex System uses a fine surgical wire to guide the thin iO-Flex shaver instrument to the location of the overgrown bone and tissue to shave away the stenosis from the inside out (iO).

The iO-Flex Advantage

Minimally Invasive Surgery
  • Designed to be less invasive and less traumatic, may lead to shorter operating times, hospital stays and recovery times compared to traditional decompression
  • Only instrument able to reach and relieve pressure surrounding up to two nerves on each side of the spine, through one small incision
Target All Three Areas of Stenosis
  • System offers improved access to target all three areas of lumbar stenosis, which occur in the lateral recess, foramen and central canal where the nerves exit the spine and travel to the lower half of the body
Preserving Healthy Bone and Tissue
  • MicroBlade Shaver instrument is guided by a Guidewire into hard to reach areas where stenosis can occur, unlike traditional knife-like tools that must cut in a straight line
  • Tissue-sparing instruments preserve healthy bone, ligaments and muscle to help maintain spinal stability

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