Dr. Ehsan Jazini Performs First Customized Two-Level Lumbar Disc Replacement Combined with TOPS™ on the East Coast

RESTON, VA – November 7, 2025 – VSI® Spine Surgeon, Dr. Ehsan Jazini, has achieved a monumental milestone in motion preservation spine surgery, performing the East Coast’s first two-level lumbar disc replacement surgery combined with the TOPS™ (Total Posterior Spine) System. This marks the first surgery of its kind on the East Coast, and the second nationwide.

The groundbreaking surgery was performed at Reston Hospital Center (HCA Virginia Health System), combining two advanced techniques: lumbar disc replacement at L4–L5 and L5–S1 with the TOPS system at L4–L5 — to restore function, stability, and motion in a patient with a complex history of spinal degeneration.

The patient, a military veteran, came to VSI seeking a solution that would allow him to remain active with his family while minimizing long-term restrictions. Having previously undergone a spinal fusion at L3–L4, he was now facing severe spinal stenosis at L4–L5 and disc degeneration at L5–S1.

“Because of his prior fusion and desire to maintain motion, we needed a very tailored approach,” explained Dr. Jazini. “By combining disc replacement and TOPS, we were able to fully decompress his nerves, reconstruct the stabilizing elements, and restore motion in his spine to function dynamically instead of rigidly.”

This 360-degree approach addressed multiple spinal conditions in one procedure. The disc replacements restored height and mobility from the front, while TOPS replaced the damaged joints and ligaments from the back, maintaining stability and motion across both treated levels.

“For a patient with only five motion segments in the lumbar spine, preserving two of them makes a tremendous difference in long-term mobility, balance, and quality of life,” Dr. Jazini added.

Recovery for this patient follows VSI’s evidence-based Enhanced Surgical Recovery (ESR) protocols, which include pre-habilitation, fluid optimization, multimodal pain management to minimize opioid use, and advanced postoperative therapies such as hyperbaric oxygen therapy, blood flow restriction training, dry needling, and laser therapy.

“If this surgery had been done even a few years ago, the only option would have been multilevel lumbar fusion,” noted Dr. Jazini. “That would have permanently limited motion and placed significant stress on adjacent segments. What we can offer today is fundamentally different – a comprehensive, motion-preserving reconstruction that lets patients get back to their lives faster and stronger.”

This milestone reflects VSI’s ongoing leadership in advancing motion-preserving technologies and delivering personalized solutions for complex spinal conditions.