For more than two years, Sandwich resident Mary Wiley struggled with crippling back pain.
“I'd gone through physical therapy and had multiple steroid injections,” she said. “Nothing helped.”
Wiley’s job as a hairdresser required her to spend all day on her feet. She could stand, but walking or bending would cause debilitating pain.
Finally, David Peng, MD, an interventional pain physician at Endeavor Health, referred Wiley to George Alexander Jones, MD, a neurosurgeon at Endeavor Health.
Dr. Jones explained that Wiley had a condition called spinal stenosis: “Spinal stenosis is a narrowing of the spinal canal, the passage where all the nerves travel to the legs,” he said. “The most common cause is underlying arthritis, which is often age-related.”
According to Dr. Jones, spinal stenosis is often accompanied by neurogenic claudication, meaning compressed nerves are transmitting pain signals from the legs, and sometimes spondylolisthesis, meaning one of the vertebrae in the spine has slipped forward on another.
Dr. Jones told Wiley she was a good candidate for a relatively new procedure: an operation to place a Total Posterior Spine (TOPS) System on her spine.
“The goal of the operation is to decompress the nerves so that patients can walk more comfortably,” explained Dr. Jones. “Traditionally, we put in screws and rigid rods to fuse the bones, so they don’t slip further. Now, TOPS allows us to place a dynamic stabilization device instead.”
TOPS is an FDA-approved device that preserves spinal motion, mimicking the body’s normal motion and reducing stress on adjacent spinal segments.
While relatively new to the public, the TOPS device has more than 10 years of clinical data, including a controlled trial demonstrating superior outcomes at two years when compared with fusion.
“For somebody with Mary’s diagnosis, we would traditionally do a fusion,” explained Dr. Jones. “TOPS has now become my first choice for many of those patients.”
“At first, I was really nervous about the surgery,” explained Wiley. “As a hairdresser, I work with a lot of people who have had back surgery, and some made it sound like a nightmare.”
But Wiley became less nervous when Dr. Jones explained that TOPS ensures patients keep spinal mobility. “Dr. Jones explained everything. He even showed me pictures of what they were going to do,” said Wiley.
In June 2025, Wiley underwent surgery. She was the first patient in suburban Chicago to get the TOPS procedure.
“The operation is similar to a fusion — we place the patient under general anesthesia, we remove the bone and ligaments compressing the nerves, and we put in the screws,” explained Dr. Jones. “That's where it diverges, because then instead of putting in the rigid rods to tie the screws together, we implant this motion preservation device.”
The procedure typically takes around three hours. Most patients will stay in the hospital for two or three days after the procedure.
“I came home and I was driving by the weekend once I was off the pain medication,” she recalled. “Within three weeks, I was back to work.”
Wiley, like most patients, did not require any physical therapy after her surgery.
“I usually recommend my patients not to lift anything over 10 pounds for three weeks, followed by a gradual return to activities,” said Dr. Jones. “It's not uncommon to see patients in the office three weeks after surgery who are already walking a mile or two a day.”
Dr. Jones explained that the device should last patients for the rest of their lives. TOPS likely also reduces the risk of impacting the adjacent spinal segments and requiring another operation.
“I've been looking at spinal motion preservation devices for 20 years, and this is the first one that I've decided to adopt in my clinical practice,” said Dr. Jones. “We want to see patients achieve a better quality of life, and that's typically what we see with TOPS.”
While there are many nonsurgical treatments for back problems, when those options are exhausted, Dr. Jones encourages people to consider surgery. “This procedure allows people to get back to a better quality of life with relatively low risk,” he explained.
“I'm really glad I had this procedure because now, I have no back pain at all — I even shovel in my driveway,” said Wiley.
“Don't be afraid of back surgery, especially with this new procedure,” she added.
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