LimiFlex Clinical Trial for the Treatment of Degenerative Spondylolisthesis With Spinal Stenosis

Exclusion Criteria

• •1. A primary and predominate diagnosis of discogenic back pain;
• •2. A primary and predominate diagnosis of facet-mediated back pain;
• •3. Back or non-radicular leg pain of unknown etiology;
• •4. Significant peripheral vascular disease causing vascular claudication;
• •5. Significant peripheral neuropathy caused by conditions other than spinal stenosis;
• •6. History of fixed or permanent neurological deficit related to spinal cord injury;
• •7. History of any previous surgery\* at any level in the lumbosacral spine except for a discectomy or decompression;
• •8. History of any previous surgery\* at the level planned for treatment;
• •* previous surgery includes spinal stimulator placement but does NOT include epidural injections, rhizotomy or nerve ablation.
• •9. Isthmic spondylolisthesis or spondylolysis (pars fracture) at any level in the lumbar spine;
• •10. Clinically significant compromise of vertebrae at L1 to S1 levels due to osteoporotic vertebral compression fracture or any traumatic, neoplastic, metabolic or infectious pathology or congenital abnormality;
• •11. Spinous process fracture(s) or other posterior element fracture(s) of the segment to be instrumented that would preclude secure fixation of the LimiFlex Device to the spinous process;
• •12. Spinous process insufficiency or deformity that would preclude secure fixation of the LimiFlex Device to the spinous process including spinous process length \<10 mm from lamina to dorsal tip or other significant deformity due to trauma, or congenital abnormality such as spina bifida occulta at the planned instrumented level that would preclude secure fixation of the LimiFlex Device to the spinous process;
• •13. The estimated distance between the LimiFlex Device strap attachment points (midpoint of the cranial edge of the cranial spinous process and the midpoint of the caudal edge of the caudal spinous process) is \<30mm on pre-operative lateral standing radiographs at the segment to be instrumented;
• •14. Degenerative lumbar scoliosis with a Cobb angle \>10° at the affected motion segment;
• •15. Symptomatic lumbar stenosis that is not amenable to a direct decompression
• •16. Anklyosed motion segment at the target operative level
• •17. Severe osteoporosis, defined as history of fragility fracture and DXA T-score \<-2.5 or QCT T-score \<80mg/cubic cm. History of a fragility fracture requires that a DXA scan or QCT scan is completed;
• •18. Planned hip or knee replacement surgery, severe osteoarthritis or other musculoskeletal pathology of the hip or leg that could preclude reliable patient self reporting assessment scales and/or that would likely progress to surgery during study period;
• •19. Documented allergy to titanium or polyethylene;
• •20. Active local or systemic infection;
• •21. Receiving immunosuppressive or long-term steroid therapy;
• •22. Known history of bone metabolic disorder, including Paget's disease, hyperparathyroidism, renal osteodystrophy, and osteomalacia;
• •23. Disease or condition that would preclude accurate clinical evaluation of the safety and effectiveness of the study treatment or any significant medical conditions which would place the patient at excessive risk for surgery, such as:
• •1. severe rheumatoid arthritis or other severe autoimmune disease
• •2. active hepatitis (viral or serum) or HIV positive
• •3. unstable cardiac disease
• •4. uncontrolled diabetes
• •5. renal failure
• •6. severe muscular, neural or vascular diseases that endanger the spinal column
• •7. cauda equina syndrome
• •8. severe neurologic disorders including paralysis
• •24. Morbid obesity defined as BMI \>40;
• •25. Active malignancy or history of metastatic malignancy within the last five years;
• •26. Women who are pregnant or are interested in becoming pregnant within the study period;
• •27. Currently seeking or receiving worker's compensation for back pain or spinal condition;
• •28. Currently involved in spinal litigation that potentially is associated with secondary financial gain;
• •29. Current involvement in a study of another investigational product for similar purpose;
• •30. Demonstrates three or more Waddell's Signs of Inorganic Behavior;
• •31. Active treatment of a major psychiatric condition, such as major depression, anxiety disorder, bipolar disorder, schizophrenia, personality disorder, that could prevent accurate completion of self reporting assessment scales;
• •32. Current history (within 12 months) of substance abuse, including alcohol abuse; or
• •33. A prisoner.