Downtown Pain Physicians Manhattan & Brooklyn Locations (212) 404-8070

Vertiflex Procedure

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Downtown Pain Physicians NYC is on the cutting edge of the vertiflex procedure for treatment of spinal stenosis and the resultant pain and limitations.

If you’re one of the many people who experience chronic pain, tingling, or numbness related to spinal stenosis, you might benefit from a vertiflex procedure at Downtown Pain Physicians. Our physicians at both NYC area locations are experts in the treatment of pain and are very skilled in using a variety of treatments and procedures that can elicit pain relief in patients.

What Is Spinal Stenosis

Before we take a deeper dive into what the vertiflex procedure is and how it can help relieve symptoms caused by spinal stenosis, it’s good to get a thorough understanding of what spinal stenosis is and what’s happening in the body when you’re given this diagnosis.

Spinal stenosis is a narrowing of the spaces between your vertebrae. This can cause pain, tingling, numbness, and muscle weakness because it impinges or pinches the nerves that run through your spinal column. Some people don’t experience any symptoms and others report significant and debilitating symptoms. It is common for spinal stenosis to get worse over time and for the symptoms to increased in severity.

If you’ve received a diagnosis of spinal stenosis or believe you have this condition, you might be a great candidate for the vertiflex procedure.

What Is the Vertiflex Procedure

The vertiflex procedure is an FDA-approved system that relieves back pain and other spinal stenosis symptoms by increasing the compressed space between the vertebrae. An interspinous (between the spine) spacer is placed in the affected region to hold those vertebrae apart, giving your spinal cord the space it needs to function as it’s supposed to.

The vertiflex procedure is a minimally invasive technique which makes it very popular for patients and physicians. When medications, injections, and other more conservative approaches do not provide relief, the vertiflex procedure is a good solution, providing long-term relief.

The vertiflex system is also very useful for patients who are hesitant to have spine surgery or who aren’t good candidates for spine surgery, for whatever reason. It works on multiple levels, restoring crucial disc space while preserving the option for future surgery if the patient’s condition dictates that that is the best protocol.

How Does the Vertiflex Procedure Work

When you have a vertiflex procedure, an implant is placed between the compressed vertebrae, working as a spacer, to hold each vertebra in proper position. This restores the appropriate amount of space for the nerves to function appropriately, relieving pressure. The best part of this procedure is that it doesn’t compromise the stability of the spine and it preserves the range of motion. When you have recovered from your vertiflex procedure, you should expect to enjoy full motion and resume your favorite activities.

This is typically an outpatient procedure that is performed under local anesthesia. A small incision will be necessary to insert the spacer and dilators will be used to move muscle and tissue out of the way so the device can be implanted, opened to the appropriate space, and then secured in place.

While recovery is different for each patient and depends on how many spacers were used, the patient often feels significant relief within the first few days already. Healing is also relatively easy and quick because the incision is so small, and the muscles were moved rather than cut.

Before deciding if the veriflex procedure is the right one for you, it’s best to visit a doctor and gain a deeper understanding of your spinal stenosis condition and what caused it. The cause can be the key to determining if a vertiflex procedure will be the appropriate treatment plan for you.

Causes of Spinal Stenosis

Many people wonder how they got spinal stenosis or what is the cause of spinal stenosis. Most cases of spinal stenosis occur when there are degenerative changes in the body, and it doesn’t show up until people are over the age of 50. But this condition is certainly not limited to people who are older because there can be other factors at play. Some of the most common causes of spinal stenosis include:

  • Osteoarthritis is a gradual wear and tear of your joints over time and is something that happens to everyone. For some the symptoms of osteoarthritis are worse than others and some people find that their spine is greatly affected.
  • Overgrowth of bone can cause the area between the vertebrae to be narrowed. There are a few reasons why overgrowth of bone in the spine can happen, one of them is actually osteoarthritis but other conditions can be at fault too.
  • Herniated disc is a condition where the cushiony discs between your vertebrae lose their fluid centers and stop being as protective, allowing the bones to come closer together and the gaps to narrow.
  • Tumors on the spine or inside the spinal cord can press upon nerves and fill in gaps between vertebrae, causing spinal stenosis.
  • Thickened ligaments happen over time as you age and your ligaments become less effective, stiff, and thicker. When this happens, they can bulge into the spaces between vertebrae.
  • Accident or injury can be the cause of many different types of spinal conditions, including spinal stenosis. Simple swelling immediately after an accident or injury can create a temporary spinal stenosis condition or a more serious injury can cause permanent problems.

Types of Spinal Stenosis

There are two main types of spinal stenosis and they’re categorized by where the condition occurs in the body. It is possible to have both types of spinal stenosis.

Cervical Spinal Stenosis
Cervical spinal stenosis happens when the area between the cervical vertebrae is reduced or narrowed. The cervical spine is your neck region, which means the nerves that are responsible for upper body sensations and movements are most greatly affected, but the symptoms are not solely restricted to the upper body. Some symptoms of cervical spinal stenosis include:

  • Numbness and/or tingling in the hands, arms, feet, or legs
  • Weakness in hands, arms, feet, or legs
  • Noted difficulties with balance
  • Problems when walking
  • Neck pain
  • Bowel or bladder dysfunction

Lumbar Spinal Stenosis
When the lumbar or low back region of the spine is affected, the patient is diagnosed with lumbar spinal stenosis. Because this narrowing of the spaces between the vertebrae occurs lower in the spine, it tends to affect the lower extremities most frequently. Symptoms of lumbar spinal stenosis can include:

  • Numbness and/or tingling in the legs or feet
  • Weakness in the feet or legs
  • Pain or cramping in the legs when standing for long periods of time or when walking
  • Pain relief when you sit or bend forward (this opens the space between the vertebrae again)
  • Bowel or bladder dysfunction

Lumbar spinal stenosis is what benefits most from a vertiflex procedure and people with this condition often find significant or complete relief when seeking care at Downtown Pain Physicians.

If you experience any of the symptoms listed above, or if you’re suffering with chronic back pain, it’s time to visit a doctor to discover what the underlying cause is and to create a treatment plan that gets you back to living your life to the fullest and enjoying movement again.

What to Expect When You Visit Downtown Pain Physicians

Upon your first visit to either of the Downtown Pain Physician’s offices, you’ll meet with the doctor and tell them about your condition. This is a very important part of the process, and all of our doctors are good listeners, knowing that much of the information they gather about a patient’s condition comes from the patient themselves. Each person is unique, and your story is a key part of your diagnosis and treatment plan.

To further confirm or explore your symptoms, your doctor will conduct a physical examination and may recommend imaging tests such as x-rays, magnetic resonance imaging (MRI) or a CT scan or CT myelogram. These tests help them see exactly what is happening in your spine and create a more customized treatment plan.

Meet Your Doctors

Dr. Raj Raval, M.D.

Top-Rated Interventional Pain and Musculoskeletal Medicine Specialist
Dr. Raj Raval is an Interventional Pain & Musculoskeletal Medicine Specialist. As part of the best rated team of pain management doctors in New York City, he uses the most effective pain management and pain control treatment options using the latest technologies available.

Dr. Raj Raval, M.D.

  • Board certified
  • Interventional Pain & Musculoskeletal Medicine Specialist
  • Member of: AAPMR, Spine Intervention Society (SIS), North American Spine Society, American Society of Interventional Pain

Dr. Daniel P. Spunberg, M.D.

High-Ranking Specialist in Interventional Pain and Musculoskeletal Medicine
Dr. Daniel Spunberg is a triple board-certified physician in the specialties of Physical Medicine and Rehabilitation, Spinal Cord Injury Medicine, and Sports Medicine. Using the latest technology and modern state-of-the art care, he is a well-respected part of our team of pain management doctors in New York City. Working closely with his patients, he prides himself on developing rapport to help individuals find the pain solutions they seek.

Dr. Daniel P. Spunberg, M.D.

  • Board certified
  • Interventional Pain & Musculoskeletal Medicine Specialist
  • Member of: AAPMR, AMA, Spine Intervention Society (SIS), North American Spine Society, NY State Society of Physical Medicine & Rehabilitation

Our Facilities Are State of the Art

Not only do we have the best doctors around, but we also believe we have one of the best facilities. Where you receive your care and the tools the doctor has at their disposal can mean a lot when it comes to a successful treatment plan. We’re quite proud of our well-appointed and modern facility, it makes the experience more comfortable for our patients and supplies our doctors with the equipment they need.

Our pain facilities are in Brooklyn and Manhattan and conveniently located for residents in Downtown Brooklyn, Lower, Midtown and upper East Side of Manhattan, the East Village, Greenwich Village, or Murphy Hill.

Our quality of care is considered among the finest in the country and with the technology and expertise to back it up, our patients find the relief they are seeking. Connect with one of our offices today to take the first step toward relieving neuropathic symptoms.

What Our Patients Have to Say

We know we have the best doctors and facility around, and our patients agree.


  • ★★★★★


    When you enter the front desk staff is friendly. Dr. Erenburg was knowledgeable, understanding and very easy to talk to. He listened to my concerns.

  • ★★★★★


    Excellent doctor. Nice staff. Felt very thorough, patient, and good bedside manner. Highly recommend.

  • ★★★★★


    Absolutely amazing from the minute you walk through the door until you leave. Doctor Raval was very informative, listened to everything we had to say and explained and did everything step by step. Made my mother very comfortable. Was very glad I chose to take my mom to see him.

  • ★★★★★


    I wish I could give Dr. Raval 10 stars. He has been absolutely PHENOMENAL helping me with a herniated disc. He calmed my anxiety, he follows through immediately and has been fantastic through it all. His entire staff is the same.

What to Expect at Downtown Pain Physicians NYC

At your first visit to either of our offices, you can expect a thorough health examination and history so your doctor can get a good idea of your health concerns. There may be x-rays or an ultrasound evaluation necessary at your appointment to gain deeper understanding of your symptoms.

After a diagnosis is discovered, your doctor will have a thorough discussion of treatment options with you to make sure you know what steps are possible and you can make an informed decision. You’ll also receive a detailed recovery plan, so you never have to question what to do next.

We want your visit to our offices to be as pleasant as possible from the moment you walk through our doors. Individual attention is part of the fabric of our practice and it’s a critical component of an effective treatment plan. Whether you’re suffering with spinal stenosis or any other type of pain, we’re here to help you find pain relief and get back to living your life.

Page Updated on Nov 8, 2023 by Dr. Raj Raval, MD (Pain Management Doctor) of Downtown Pain Physicians Of Brooklyn
  • Dr. Raj Raval, M.D.

    1. Board Certified
    2. Interventional Pain & Musculoskeletal Medicine Specialist
  • Education & training

    1. SUNY Health Science Center
    2. Rutgers University Fellowship
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  • Dr. Raphael Jaramillo, MD

    1. Board Certified
    2. Interventional Pain & Musculoskeletal Medicine Specialist
  • Education & training

    1. Touro College of Osteopathic Medicine
    2. New York University
    3. Rutgers University
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