Minimally Invasive Lumbar Fusion

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Minimally Invasive Lumbar Fusion"

Transcription

1 Minimally Invasive Lumbar Fusion

2 Biomechanical Evaluation (1) coflex-f screw

3 Biomechanical Evaluation (1) coflex-f intact Primary Stability intact Primary Stability Extension Neutral Position Flexion Coflex crimped Coflex rivet Rotation in Test w/o intervertebral support!

4 Biomechanical Evaluation (1) coflex-f Segmental Tilt y- Axis x- Axis Test w/o intervertebral support!

5 Philosophie Minimally Invasive Lumbar Fusion The missing piece The coflex-f implant offers an alternative to pedicle screw fixation. bridging the gap

6 ConceptMinimally Invasive Lumbar Fusion Interspinous stabilization with coflex-f is an ideal adjunct to fusion in cases of degenerative disc disease with or without mild instabilities in the lumbar spine. coflex-f allows for segmental stabilization in combination with interbody fusion cages and is bridging the gap between stand-alone anterior solutions and 360-Fusions using pedicle screw fixation. coflex-f can be applied in a less-invasive tissuesparing procedure significantly reducing iatrogenic damage and promoting shorter rehabilitation for patients.

7 ConceptAdjunct to Interbody Fusion Reduced Iatrogenic Trauma Less muscle trauma Less blood loss Smaller skin incision Reduced Cost Shorter operating time Faster patient rehabilitation Reduced Surgical Risks Excellent safety profile of implant Protection of neurological structures Easy and precise application Ease of use Simple surgical technique Easy instrumentation

8 coflex-fbiomechanical Rationale (2) Extension Flexion intact defect cage stand alone Cage / coflex-f Cage / Ped. Screw System 250% 200% 150% 100% 50% 0% 0% 50% 100% 150% 200% 250% Range of motion and neutral zone normalized with the intact state (100%) ROM NZ Prof. H.-J. Wilke: coflex-f: Biomechanical comparison of two posterior fixation systems. Institute of Orthopaedic Research and Biomechanics, Germany In combination with cages anteriorly both the coflex-f implant and the pedicle screw system reduced the ROM significantly.

9 Product Features

10 Design Features coflex-f Design Features Pin allows pressfit wing attachment on spinous process Secure anchorage through screw and sleeve fixation U-shape provides large surface area, different sizes allow adjustment of sagittal balance Good bone anchorage through teeth on inside of wings

11 Design Features coflex-f Design Features Ball and socket screw/wing interface for optimized load distribution in various wing angulations

12 Design Featurescoflex versus coflex-f Standardhole Ømm Ball and Socket connection with Rivet Ø mm 1,5 mm 2,1 mm Patent Pending!

13 Design Featurescoflex versus coflex-f 1,5 mm 2,1 mm Patent Pending!

14 Design Featurescoflex versus coflex-f Patent Pending! Standard Trials Special Trials

15 Overview Overview Indication vs. Contra-Indications

16 IndicationsAdjunct to Interbody Fusion The coflex-f system is intended for permanent implantation as an adjunct to fusion in the region from L1-L5 in up two levels. + The purpose is to achieve stabilization and to promote fusion in patients with degenerative disc disease

17 IndicationsContra-Indications The coflex-f system is contraindicated in cases of: Degenerative Spondylolisthesis greater than 1 according to Meyerding classification. Any forms of isthmic spondylolisthesis. Prior decompressive laminectomy, hemilaminectomy or significant lamina fenestration which weakens the spinous process. Multilevel applications Cases of L5/S1

18 Surgical Technique

19 Surgical Technique Surgical Technique Patient Positioning The patient is placed in the prone position on a surgical frame avoiding hyperlordosis of the spinal segment(s) to be operated upon.

20 Surgical Technique Surgical Strategy Lumbar Interbody Fusion L1 to L5 Anterior Lumbar Interbody Fusion (ALIF) 1. ALIF 2. coflex-f Insertion Posterior Lumbar Interbody Fusion (PLIF) 1. PLIF 2. coflex-f Insertion Transforaminal Lumbar Interbody Fusion (TLIF) 1. TLIF 2. coflex-f Insertion 1 2

21 Surgical Technique Intervertebral Implants Select lordotic cages to ensure maximum cage endplate contact. Avoid undersizing cages! Bone graft should be placed anterior, lateral and medial to the cages to ensure optimal fusion success. Intervertebral space preparation: Care is taken to remove all nucleus material (which inhibits osteogenesis) prior to cage insertion. ALL

22 Surgical Technique Facet Joints Status Maintain at least 50% of the medial facet and all of the facet capsules Add bone chips (anterior/ lateral and medial to cages) to promote fusion process OK Too much

23 Surgical Technique Surgical Technique Implant Site Preparation After the intervertebral device (cage or machined allograft) has been inserted, trials are utilized to define the appropriate implant size. Trial instrument is placed to evaluate the proper contact with the spinous processes avoiding any facet distraction.* * It is most appropriate to use a coflex-f implant one size smaller than to have distraction of the facets.

24 Surgical Technique Surgical Technique-PLIF Make sure that the oposing facing surfaces of the superior and inferior spinous processes are parallel for enhanced contact onto the legs of the coflex-f implant Flat surfaces can be obtained using either osteotomes, rongeurs or drills. Maintain adequate spinous process anatomy for optimal fixation strength.

25 Surgical Technique Intervertebral Implants If the laminae are steeply pitched (which can block proper seating of device wings), use a burr or rongeur to bilaterally fashion the juncture of laminae and base of interspinous process so that the wings seat at the appropriate depth. The device should seat so that the apex of the U rests at midlevel of the corresponding facet joints of the treated level. Mid Portion of facet joint ideal place for U portion

26 Surgical Technique Surgical Technique Implant Insertion Prior to insertion bending pliers may be necessary to separate the wings. The coflex-f implant is introduced via impaction utilizing a mallet. Proper depth is determined if a beaded tip probe can be passed freely leaving 2-3 mm separation from the dura. By deep insertion at the level of the facet joints the coflex-f continues to counteract the majority of posterior column forces.

27 Surgical Technique Surgical Technique It is recommended to crimp the implant wings prior to screw insertion. This ensures proper contact to the spinous processes and delivery of the fixation screw later. Once proper placement has been achieved punching pliers are utilized to create holes in the spinous processes for later introduction of the coflex-f screws.

28 Surgical Technique Surgical Technique Implant Insertion Prior to insertion of the coflex-f screws it is recommended to clean the holes using the coflex-f probe.

29 Surgical Technique Surgical Technique Implant Insertion The coflex-f screws are applied using the screw inserter. A tight fit is required for controlled fixation. Teeth of both wings should be firmly engaged into the cortices of the spinous processes. Slight additional compression can be obtained manually with wrenches.

30 Surgical Technique Surgical Technique

31 Surgical Technique Surgical Technique Wound Closure A surgical drain may be placed as per surgeon preference. The supraspinous ligament is reattached through bone. Skin is closed in the usual manner.

32 Coflex-F Marketing Tools coflex-f Marketing Tools

33 Coflex-F Marketing Tools coflex-f Marketing Tools - Product Brochure Table of Content: Coflex-F (Introduction + Key Features) Surgical Technique Patient Cases Product Information

34 Coflex-F Marketing Tools Coflex-F Marketing Tools - Advertisement The coflex-f implant provides significant segmental stability with all the advantages of an interspinous implant and is the alternative to pedicle screw fixation as an adjunct to interbody fusion. Reduced iatrogenic trauma Faster patient rehabilitation Protection of neural structures Shorter operating time Secure anchorage through screw and sleeve fixation

35 Coflex-F Marketing Tools coflex-f Marketing Tools - Models coflex-f Models are available! Please contact Customer Service.

36 Coflex-F Marketing Tools DCI Workshop Friday May 30 th, 2008

PARADIGM SPINE. Minimally Invasive Lumbar Fusion. Interlaminar Technology

PARADIGM SPINE. Minimally Invasive Lumbar Fusion. Interlaminar Technology PARADIGM SPINE Minimally Invasive Lumbar Fusion Interlaminar Technology Lumbar Fu Minimally Invasive With the introduction of pedicle screws in the 1980s and cages in the 1990s, lumbar fusion with instrumentation

More information

Surgical Technique. coflex Surgical Technique

Surgical Technique. coflex Surgical Technique Surgical Technique coflex Surgical Technique Interspinous Implant Overview I. Preparation II. Microsurgical Decompression III. Implant Site Preparation IV. Implant Insertion Preparation Patient Positioning

More information

POSTERIOR LUMBAR INTERBODY FUSION. PLIF with Instrumentation. Basic Anatomical Landmarks: Posterior View Lumbar Spine

POSTERIOR LUMBAR INTERBODY FUSION. PLIF with Instrumentation. Basic Anatomical Landmarks: Posterior View Lumbar Spine POSTERIOR LUMBAR INTERBODY FUSION PLIF with Instrumentation Posterior In human anatomy, referring to the back surface of the body or the position of one structure relative to another Lumbar Relating to

More information

Treatment Concepts for Degenerative Spinal Diseases PARADIGM SPINE

Treatment Concepts for Degenerative Spinal Diseases PARADIGM SPINE Treatment Concepts for Degenerative Spinal Diseases PARADIGM SPINE What You Need To Know About Your Spine It is important to understand the role of the spine, the changes that occur in your spine as your

More information

Coflex Dynamic Interlaminarinterspinous. stabilization device for lumbar degenerative disease (Initial Experience)

Coflex Dynamic Interlaminarinterspinous. stabilization device for lumbar degenerative disease (Initial Experience) Coflex Dynamic Interlaminarinterspinous distraction stabilization device for lumbar degenerative disease (Initial Experience) Mohamed Mohi Eldin, MB-BCH, M.Sc., MD Prof. of Neurosurgery, Faculty of Medicine,

More information

Biomechanics of the Lumbar Spine

Biomechanics of the Lumbar Spine Biomechanics of the Lumbar Spine Biomechanics of the Spine 6 degrees of freedom Extension & Flexion Translation Rotation Compression & Distraction The disc/annulus/all/pll complex is the major restraint

More information

visualized. The correct level is then identified again. With the use of a microscope and

visualized. The correct level is then identified again. With the use of a microscope and SURGERY FOR SPINAL STENOSIS Laminectomy A one inch (or longer for extensive stenosis) incision is made in the middle of the back over the effected region of the spine. The muscles over the bone are moved

More information

coflex Interlaminar Stabilization for Lumbar Spinal Stenosis

coflex Interlaminar Stabilization for Lumbar Spinal Stenosis NEW MINIMALLY INVASIVE SOLUTIONS FOR LUMBAR SURGERY coflex Interlaminar Stabilization for Lumbar Spinal Stenosis STEPHEN R. GOLL, M.D. ORLANDO ORTHOPAEDIC CENTER 1 What is Lumbar Spinal Stenosis (LSS)?

More information

ANTERIOR CERVICAL DISCECTOMY AND FUSION. Basic Anatomical Landmarks: Anterior Cervical Spine

ANTERIOR CERVICAL DISCECTOMY AND FUSION. Basic Anatomical Landmarks: Anterior Cervical Spine Anterior In the human anatomy, referring to the front surface of the body or position of one structure relative to another Cervical Relating to the neck, in the spine relating to the first seven vertebrae

More information

Patient Guide to Stenosis

Patient Guide to Stenosis Patient Guide to Stenosis For Your Spinal Education Compliments of Your Spine Health Professional Dr. Schlesinger & Dr. Thomas Arkansas Neurosurgery Clinic 501-661-0077 www.arneuro.com Stenosis Description:

More information

ANTERIOR LUMBAR INTERBODY FUSION (ALIF) Basic Anatomical Landmarks: Anterior Lumbar Spine

ANTERIOR LUMBAR INTERBODY FUSION (ALIF) Basic Anatomical Landmarks: Anterior Lumbar Spine (ALIF) Anterior In human anatomy, referring to the front surface of the body or the position of one structure relative to another Lumbar Relating to the loins or the section of the back and sides between

More information

coligne treatment technology

coligne treatment technology coligne treatment technology coligne a strategy in spine Leadership begins before the patient enters the surgical theater, among the spine care professionals forming the coalliance. This may be a small

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Interspinous Fixation (Fusion) Devices Page 1 of 6 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: See Also: Interspinous Fixation (Fusion) Devices Lumbar Spine

More information

4052 Slimplicity Tech final_layout 1 6/29/15 3:29 PM Page 2 Surgical Technique

4052 Slimplicity Tech final_layout 1 6/29/15 3:29 PM Page 2 Surgical Technique Surgical Technique TABLE OF CONTENTS Slimplicity Anterior Cervical Plate System Overview 2 Indications 2 Implants 3 Instruments 4 Surgical Technique 6 1. Patient Positioning and Approach 6 2. Plate Selection

More information

Anterior Lumbar Interbody Fusion (ALIF). Instrument set supports placement of ALIF spacers using anterior or anterolateral approach.

Anterior Lumbar Interbody Fusion (ALIF). Instrument set supports placement of ALIF spacers using anterior or anterolateral approach. Anterior Lumbar Interbody Fusion (ALIF). Instrument set supports placement of ALIF spacers using anterior or anterolateral approach. Technique Guide Instruments and implants approved by the AO Foundation

More information

Surgical Treatment for Lumbar Spinal Stenosis Dynamic Interspinous Distraction Interlaminar Stabilization Implant - Coflex

Surgical Treatment for Lumbar Spinal Stenosis Dynamic Interspinous Distraction Interlaminar Stabilization Implant - Coflex International 31st Course For Percutaneous Endoscopic Spinal Surgery And Complementary Minimal Invasive Techniques Zurich, Switzerland January 24-25, 2013 Surgical Treatment for Lumbar Spinal Stenosis

More information

Implant Failure of Posterior Lower Spinal Instrumentation

Implant Failure of Posterior Lower Spinal Instrumentation Implant Failure of Posterior Lower Spinal Instrumentation (A clinical & surgical Challenge) B Y Mohamed Mohi El-Din, MD The Department of Neurosurgery, Faculty of Medicine, Cairo University The purpose

More information

Minimally Invasive Spine Surgery What is it and how will it benefit patients?

Minimally Invasive Spine Surgery What is it and how will it benefit patients? Minimally Invasive Spine Surgery What is it and how will it benefit patients? Dr Raoul Pope MBChB, FRACS, Neurosurgeon and Minimally Invasive Spine Surgeon Concord Hospital and Mater Private Hospital Sydney

More information

Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF).

Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF). Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra, allows

More information

Self-blocking thread reduces risk of set-screw loosening. Small screw head accommodates 40 angle variation

Self-blocking thread reduces risk of set-screw loosening. Small screw head accommodates 40 angle variation MonoPoly PRODUCT INFORMATION the Implant Designed to meet Signus high standard of quality, the MonoPoly system offers a large selection of implants: mono- and -polyaxial screws in a diverse range of sizes

More information

Motion Preservation. Hansen Yuan, MD President, Spine Arthroplasty Society

Motion Preservation. Hansen Yuan, MD President, Spine Arthroplasty Society Motion Preservation Procedure Codes Hansen Yuan, MD President, Spine Arthroplasty Society Who are we? The Spine Arthroplasty Society (SAS) is a group of medical and associated specialists devoted to the

More information

Direct Lateral Interbody Fusion A Minimally Invasive Approach to Spinal Stabilization

Direct Lateral Interbody Fusion A Minimally Invasive Approach to Spinal Stabilization APPROVED IRN10389-1.1-04 Direct Lateral Interbody Fusion A Minimally Invasive Approach to Spinal Stabilization Because it involves accessing the spine through the patient s side, the Direct Lateral approach

More information

TABLE OF CONTENTS. Indications and Contraindications 3. Features and Benefits 4. Ease of connection 4 Stable fixation concept 5

TABLE OF CONTENTS. Indications and Contraindications 3. Features and Benefits 4. Ease of connection 4 Stable fixation concept 5 Surgical Technique TABLE OF CONTENTS Indications and Contraindications 3 Features and Benefits 4 Ease of connection 4 Stable fixation concept 5 Surgical Technique Steps 6 Identification and preparation

More information

Sciatica: Low back and Leg Pain Diagnosis and Treatment Options. Presented by Devesh Ramnath, MD Orthopaedic Associates Of Dallas Baylor Spine Center

Sciatica: Low back and Leg Pain Diagnosis and Treatment Options. Presented by Devesh Ramnath, MD Orthopaedic Associates Of Dallas Baylor Spine Center Sciatica: Low back and Leg Pain Diagnosis and Treatment Options Presented by Devesh Ramnath, MD Orthopaedic Associates Of Dallas Baylor Spine Center Sciatica Compression of the spinal nerves in the back

More information

Advances In Spine Care. James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery

Advances In Spine Care. James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery Advances In Spine Care James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery Introduction The Spine - A common source of problems Back pain is the #2 presenting

More information

LUMBAR LAMINECTOMY AND DISCECTOMY. Basic Anatomical Landmarks: Posterior View Lumbar Spine

LUMBAR LAMINECTOMY AND DISCECTOMY. Basic Anatomical Landmarks: Posterior View Lumbar Spine Lumbar Relating to the loins or the section of the back and sides between the ribs and the pelvis. In the spinal column, the last five vertebrae (from superior to inferior, L1-L5) Laminectomy Surgical

More information

University of Jordan. 1/15/2011 Professor Freih Abuhassan -

University of Jordan. 1/15/2011 Professor Freih Abuhassan - Freih Odeh Abu hassan F.R.C.S.(.(Eng.), g), F.R.C.S.(Tr.& Orth.). Professor of Orthopedics 1 Anatomy of the Spine Each vertebra articulates with adjacent vertebrae at three points 1- Intervertebral disk

More information

Evaluation and Treatment of Spine Fractures. Lara C. Portmann, MSN, ACNP-BC

Evaluation and Treatment of Spine Fractures. Lara C. Portmann, MSN, ACNP-BC Evaluation and Treatment of Spine Fractures Lara C. Portmann, MSN, ACNP-BC Nurse Practitioner, Neurosurgery, Trauma Services, Intermountain Medical Center; Salt Lake City, Utah Objectives: Identify the

More information

Minimally Invasive Spine Surgery For Your Patients

Minimally Invasive Spine Surgery For Your Patients Minimally Invasive Spine Surgery For Your Patients Lukas P. Zebala, M.D. Assistant Professor Orthopaedic and Neurological Spine Surgery Department of Orthopaedic Surgery Washington University School of

More information

Patient Information. Anterior Lumbar Interbody Fusion

Patient Information. Anterior Lumbar Interbody Fusion Patient Information Anterior Lumbar Interbody Fusion Table of Contents Anatomy of the Spine 2 The Healthy Spine 3 General Treatment Options 4 General Conditions of the Lumbar Spine 5 What is Spondylolisthesis?

More information

Atlanto-Occipital Dislocation (Craniovertebral Dissociation)

Atlanto-Occipital Dislocation (Craniovertebral Dissociation) Preface The staff in accident and emergency departments and doctors in fracture clinics alike may at times find themselves inadequately equipped to identify the exact type of a given fracture without access

More information

SURGICAL TECHNIQUE GUIDE

SURGICAL TECHNIQUE GUIDE SURGICAL TECHNIQUE GUIDE True Spinal Fixation System Surgical Technique Guide TABLE OF CONTENTS Implants & Instruments 3 Supplemental Non-Disposable Instruments 13 True Rods Overview 17 Technique for Opening

More information

Anterior Approaches for Lumbar Interbody Fusion. Glen Manzano, MD

Anterior Approaches for Lumbar Interbody Fusion. Glen Manzano, MD Anterior Approaches for Lumbar Interbody Fusion Glen Manzano, MD Anterior Techniques ALIF Lateral transpsoas approaches (XLIF/DLIF) Anterior Approaches - Contraindications ALIF Contraindications Calcified

More information

BIOMECHANICS OF THE SPINE. Presented by: Shashwat Mishra

BIOMECHANICS OF THE SPINE. Presented by: Shashwat Mishra BIOMECHANICS OF THE SPINE Presented by: Shashwat Mishra What is biomechanics? In the context of the spine: Biomechanics is the study of the consequences of application of external force on the spine Motion

More information

Title: Interspinous Process Decompression with the X-Stop Device for Lumbar Spinal Stenosis: A Retrospective Review. Authors: Jennifer R.

Title: Interspinous Process Decompression with the X-Stop Device for Lumbar Spinal Stenosis: A Retrospective Review. Authors: Jennifer R. Title: Interspinous Process Decompression with the X-Stop Device for Lumbar Spinal Stenosis: A Retrospective Review. Authors: Jennifer R. Madonia-Barr, MS, PA-C and David L. Kramer, MD Institution: Connecticut

More information

Degenerative Spine Solutions

Degenerative Spine Solutions Degenerative Spine Solutions The Backbone for Your Surgical Needs Aesculap Spine Backbone for Your Degenerative Spine Needs Comprehensive operative solutions, unique product technology and world-class

More information

Processed by MTF, designed and available through Synthes Spine. ALIF Spacer. An allograft spacer for anterior lumbar interbody fusion.

Processed by MTF, designed and available through Synthes Spine. ALIF Spacer. An allograft spacer for anterior lumbar interbody fusion. Processed by MTF, designed and available through Synthes Spine ALIF Spacer. An allograft spacer for anterior lumbar interbody fusion. ALIF Spacer Features Designed with curved superior and inferior surfaces

More information

Contents. Introduction... Page 1. Implant Design... Page 2. Instruments... Page 4. Surgical Technique... Page 6. Product Information...

Contents. Introduction... Page 1. Implant Design... Page 2. Instruments... Page 4. Surgical Technique... Page 6. Product Information... Surgical Technique Contents Introduction... Page 1 Implant Design... Page 2 Instruments... Page 4 Surgical Technique... Page 6 Product Information... Page 18 Post Operative Care... Page 20 Indications...

More information

Does the pain radiating down your legs, buttocks or lower back prevent you from walking long distances?

Does the pain radiating down your legs, buttocks or lower back prevent you from walking long distances? Does the pain radiating down your legs, buttocks or lower back prevent you from walking long distances? Do you experience weakness, tingling, numbness, stiffness, or cramping in your legs, buttocks or

More information

The information contained in this document is intended for healthcare professionals only.

The information contained in this document is intended for healthcare professionals only. The information contained in this document is intended for healthcare professionals only. Dall-Miles Cabling System Dall-Miles Recon and Trauma Cable System Trochanteric Reattachment Using the Trochanteric

More information

Thoracolumbar Burst Fracture: A New Type with Combined Injury Mechanisms a Case Report

Thoracolumbar Burst Fracture: A New Type with Combined Injury Mechanisms a Case Report Cronicon OPEN ACCESS NEUROLOGY Case Report Tarek A Aly* Thoracolumbar Burst Fracture: A New Type with Combined Injury Mechanisms a Case Report Department of orthopedic surgery, Tanta University School

More information

Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery

Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery REVISION SPINE SURGERY Revision surgery is a very complex field which requires experience, training and evaluation in a very individual

More information

CERVICAL PROCEDURES PHYSICIAN CODING

CERVICAL PROCEDURES PHYSICIAN CODING CERVICAL PROCEDURES PHYSICIAN CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) Anterior interbody fusion, with discectomy and decompression; cervical below C2 22551 first interspace 22552

More information

Cervical Spondylotic Myelopathy Associated with Kyphosis or Sagittal Sigmoid Alignment: Outcome after Anterior or Posterior Decompression

Cervical Spondylotic Myelopathy Associated with Kyphosis or Sagittal Sigmoid Alignment: Outcome after Anterior or Posterior Decompression Cervical Spondylotic Myelopathy Associated with Kyphosis or Sagittal Sigmoid Alignment: Outcome after Anterior or Posterior Decompression 1 Journal of Neurosurgery: Spine November 2009, Volume 11, pp.

More information

PARADIGM SPINE. Brochure. coflex Interlaminar Stabilization

PARADIGM SPINE. Brochure. coflex Interlaminar Stabilization PARADIGM SPINE Brochure Interlaminar Stabilization SPINAL STENOSIS WITH BACK PAIN THE RATIONALE FOR STABILIZATION For the treatment of spinal stenosis, surgeons have various treatment options. The continuum

More information

Presented by Zoran Maric, M.D. Orthopaedic Spine Surgeon May 22, 2010

Presented by Zoran Maric, M.D. Orthopaedic Spine Surgeon May 22, 2010 Presented by Zoran Maric, M.D. Orthopaedic Spine Surgeon May 22, 2010 1 cervical area thoracic area lumbar area sacrum coccyx Mayfield Clinic 2 3 4 5 Zoran Maric, MD Spine Surgery Procedures How to Document

More information

TABLE OF CONTENTS. Surgical Technique 2. Indications 4. Product Information 5. 1. Patient Positioning and Approach 2

TABLE OF CONTENTS. Surgical Technique 2. Indications 4. Product Information 5. 1. Patient Positioning and Approach 2 Surgical Technique TABLE OF CONTENTS Surgical Technique 2 1. Patient Positioning and Approach 2 2. Intervertebral Device Implanted 2 3. Buttress Plate Selection 2 4. Awl Insertion 2 5. Screw Insertion

More information

spine ALLEN SPINAL SYSTEM Spine Table Extension

spine ALLEN SPINAL SYSTEM Spine Table Extension spine ALLEN SPINAL SYSTEM Spine Table Extension Sagital Control Flex Intra - Operative Control Spondylolisthesis Fusion Larger Cages 2 www.allenspine.com Neutral Extension Control Access to Disc Space

More information

Getting to the Backbone of Spinal Coding in ICD-10-PCS

Getting to the Backbone of Spinal Coding in ICD-10-PCS Getting to the Backbone of Spinal Coding in ICD-10-PCS Sponsored by 1915 N. Fine Ave #104 Fresno CA 93720-1565 Phone: (559) 251-5038 Fax: (559) 251-5836 www.californiahia.org Program Handouts Tuesday,

More information

Percutaneous Transforaminal Endoscopic Spine Surgery: Introduction - Part 1

Percutaneous Transforaminal Endoscopic Spine Surgery: Introduction - Part 1 Percutaneous Transforaminal Endoscopic Spine Surgery: Introduction - Part 1 Anthony T. Yeung, M.D. Orthopaedic Spine Surgeon Arizona Institute for Minimally Invasive Spine Care Phoenix, AZ Christopher

More information

Information for the Patient About Surgical

Information for the Patient About Surgical Information for the Patient About Surgical Decompression and Stabilization of the Spine Aging and the Spine Daily wear and tear, along with disc degeneration due to aging and injury, are common causes

More information

CoNGRUENT RADIAL HEAD PLATE

CoNGRUENT RADIAL HEAD PLATE Mayo Clinic CoNGRUENT RADIAL HEAD PLATE Since 1988 Acumed has been designing solutions to the demanding situations facing orthopedic surgeons, hospitals and their patients. Our strategy has been to know

More information

Lumbar Decompression and Stabilisation for Degenerative Spondylolisthesis

Lumbar Decompression and Stabilisation for Degenerative Spondylolisthesis Lumbar Decompression and Stabilisation for Degenerative Spondylolisthesis Issue 6: March 2016 Review date: February 2019 Following your recent investigations and consultation with your spinal surgeon,

More information

Reimbursement Overview Supporting Adjunctive Use of the coflex-f Implant During Lumbar Fusion Procedures

Reimbursement Overview Supporting Adjunctive Use of the coflex-f Implant During Lumbar Fusion Procedures Interlaminar Technology Reimbursement Overview Supporting Adjunctive Use of the coflex-f Implant During Lumbar Fusion Procedures Coding Recommendations Overview Implant Description & Device Type Differentiation

More information

CPT Changes in Spine 2012

CPT Changes in Spine 2012 CPT Changes in Spine 2012 Are you prepared? Presented by Barbara Cataletto, MBA, CPC Disclaimer The following presentations are not to be considered a replacement for the Current Procedural Terminology

More information

LUMBAR SPINAL STENOSIS OBSERVATIONS, EVIDENCE, AND TRENDS FULILLING THE UNMET CLINICAL NEED WRITTEN BY: HALLETT MATHEWS, MD, MBA

LUMBAR SPINAL STENOSIS OBSERVATIONS, EVIDENCE, AND TRENDS FULILLING THE UNMET CLINICAL NEED WRITTEN BY: HALLETT MATHEWS, MD, MBA LUMBAR SPINAL STENOSIS OBSERVATIONS, EVIDENCE, AND TRENDS FULILLING THE UNMET CLINICAL NEED WRITTEN BY: HALLETT MATHEWS, MD, MBA Overview of Lumbar Spinal Stenosis Spine stabilization, which has equated

More information

SPINAL FUSION. North American Spine Society Public Education Series

SPINAL FUSION. North American Spine Society Public Education Series SPINAL FUSION North American Spine Society Public Education Series WHAT IS SPINAL FUSION? The spine is made up of a series of bones called vertebrae ; between each vertebra are strong connective tissues

More information

Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF).

Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF). Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra,

More information

Case Study: Reduction and Stabilization of Grade III L5-S1 Dysplastic Spondylolisthesis in 15-Year-Old Female Using Posterior Approach

Case Study: Reduction and Stabilization of Grade III L5-S1 Dysplastic Spondylolisthesis in 15-Year-Old Female Using Posterior Approach Case Study: Reduction and Stabilization of Grade III L5-S1 Dysplastic Spondylolisthesis in 15-Year-Old Female Using Posterior Approach Terrence L. Piper, MD Piper Spine Care Background Context: A female

More information

Technique Guide. Bone Graft Harvesting Set

Technique Guide. Bone Graft Harvesting Set Technique Guide Bone Graft Harvesting Set Table of Contents System Description 2 Instruments 3 Indications/Contraindications 5 Surgical Technique Harvesting at the Iliac Crest 6 Harvesting at the Lumbar

More information

USS Variable Axis Screw (VAS) System. For posterior fixation of the lumbar spine.

USS Variable Axis Screw (VAS) System. For posterior fixation of the lumbar spine. USS Variable Axis Screw (VAS) System. For posterior fixation of the lumbar spine. Technique Guide Instruments and implants approved by the AO Foundation Table of Contents Introduction USS Variable Axis

More information

Patient Guide to Lower Back Surgery

Patient Guide to Lower Back Surgery The following is a sampling of products offered by Zimmer Spine for use in Open Lumbar Fusion procedures. Patient Guide to Lower Back Surgery Open Lumbar Fusion Dynesys The Dynesys Dynamic Stabilization

More information

Thoracic Pedicle Screws Pedicular Approach

Thoracic Pedicle Screws Pedicular Approach 17 Thoracic Screws Pedicular Approach Archibald H. von Strempel Goals of Surgical Treatment To stabilize the thoracic spine; to correct a kyphotic deformity. Diagnosis Instability of the thoracic spine

More information

Post operative Spinal Imaging- A multimodality approach

Post operative Spinal Imaging- A multimodality approach Post operative Spinal Imaging- A multimodality approach UKRC June 2014 Dr Sajid Butt Consultant Radiology, RNOH Summary Common Spinal Surgeries Image Optimisation Spinal Instrumentation Clinical Scenarios

More information

Minimally Invasive Spine Surgery

Minimally Invasive Spine Surgery Chapter 1 Minimally Invasive Spine Surgery 1 H.M. Mayer Primum non nocere First do no harm In the long history of surgery it always has been a basic principle to restrict the iatrogenic trauma done to

More information

CeSpace Titanium / PEEK

CeSpace Titanium / PEEK Aesculap Anterior Cervical Interbody Fusion System CeSpace Titanium / PEEK Aesculap Spine CeSpace Content A Foreword 3 B Implant Material 4 C Implant Features 6 D Surgical Technique 8 E Ordering Information

More information

Anatomy and Terminology of the Spine. Bones of the Spine (Vertebrae)

Anatomy and Terminology of the Spine. Bones of the Spine (Vertebrae) Anatomy and Terminology of the Spine The spine, also called the spinal column, vertebral column or backbone, consists of bones, intervertebral discs, ligaments, and joints. In addition, the spine serves

More information

Lumbar Decompression and Stabilisation for Degenerative Spondylolisthesis

Lumbar Decompression and Stabilisation for Degenerative Spondylolisthesis Lumbar Decompression and Stabilisation for Degenerative Spondylolisthesis Spinal Unit Tel: 01473 702032 or 702097 Issue 5: August 2014 Review date: July 2017 Following your recent investigations and consultation

More information

Vivian Gonzalez Gillian Lieberman, MD. January 2002. Lumbar Spine Trauma. Vivian Gonzalez, Harvard Medical School Year III Gillian Lieberman, MD

Vivian Gonzalez Gillian Lieberman, MD. January 2002. Lumbar Spine Trauma. Vivian Gonzalez, Harvard Medical School Year III Gillian Lieberman, MD January 2002 Lumbar Spine Trauma Vivian Gonzalez, Harvard Medical School Year III Agenda Anatomy and Biomechanics of Lumbar Spine Three-Column Concept Classification of Fractures Our Patient Imaging Modalities

More information

EXPERIMENTAL AND THERAPEUTIC MEDICINE 5: 567-571, 2013

EXPERIMENTAL AND THERAPEUTIC MEDICINE 5: 567-571, 2013 EXPERIMENTAL AND THERAPEUTIC MEDICINE 5: 567-571, 2013 Treatment of multilevel degenerative lumbar spinal stenosis with spondylolisthesis using a combination of microendoscopic discectomy and minimally

More information

Value Analysis Brief MIS Lateral Approach to Interbody Fusion

Value Analysis Brief MIS Lateral Approach to Interbody Fusion Value Analysis Brief MIS Lateral Approach to Interbody Fusion Methods This value analysis brief presents information on the clinical and economic benefits of the minimally invasive lateral approach to

More information

ONE MUST FIRST UNDERSTAND THE ANATOMY OF THE SPINE AND

ONE MUST FIRST UNDERSTAND THE ANATOMY OF THE SPINE AND Lesson No. CIS 246 (Instrument Continuing Education - ICE) Sponsored by: by Carol Petro, RN, BSN, CNOR, CRCST, CIS O.R. Educator, Surgery & Sterile Processing Indiana University Health North Hospital Indiana

More information

Cervical Spine Surgery. Orthopaedic Nursing Seminar. Dr Michelle Atkinson. Friday October 21 st 2011. Cervical Disc Herniation

Cervical Spine Surgery. Orthopaedic Nursing Seminar. Dr Michelle Atkinson. Friday October 21 st 2011. Cervical Disc Herniation Cervical Spine Surgery Dr Michelle Atkinson The Sydney and Dalcross Adventist Hospitals Orthopaedic Nursing Seminar Friday October 21 st 2011 Cervical disc herniation The most frequently treated surgical

More information

Xia Low Profile Spinal System Universal Application. Surgical Technique

Xia Low Profile Spinal System Universal Application. Surgical Technique Xia Low Profile Spinal System Universal Application Surgical Technique Xia universal application Introduction Introduction The Xia System is a comprehensive system of implants and instruments for stabilization

More information

OPERATIVE TECHNIQUE TDX. Posterior Dynamic Stabilization System. This device is not cleared by the FDA for distribution in the United States.

OPERATIVE TECHNIQUE TDX. Posterior Dynamic Stabilization System. This device is not cleared by the FDA for distribution in the United States. OPERATIVE TECHNIQUE TDX Posterior Dynamic Stabilization System This device is not cleared by the FDA for distribution in the United States. TABLE OF CONTENTS Introduction 1 Features and Benefits 2 Operative

More information

Disc Replacement or Fusion: which is best for me?

Disc Replacement or Fusion: which is best for me? Disc Replacement or Fusion: which is best for me? After anterior discectomy in either the cervical or lumbar region there is a need to replace the removed disc with something and the choice lies between

More information

Spinal Surgery 2. Teaching Aims. Common Spinal Pathologies. Disc Degeneration. Disc Degeneration. Causes of LBP 8/2/13. Common Spinal Conditions

Spinal Surgery 2. Teaching Aims. Common Spinal Pathologies. Disc Degeneration. Disc Degeneration. Causes of LBP 8/2/13. Common Spinal Conditions Teaching Aims Spinal Surgery 2 Mr Mushtaque A. Ishaque BSc(Hons) BChir(Cantab) DM FRCS FRCS(Ed) FRCS(Orth) Hunterian Professor at The Royal College of Surgeons of England Consultant Orthopaedic Spinal

More information

Bankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor

Bankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor Shoulder Series Technique Guide *smith&nephew BIORAPTOR 2.9 Suture Anchor Bankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor Gary M. Gartsman, M.D. Introduction Arthroscopic studies of

More information

.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description

.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can

More information

MINIMAL ACCESS SPINE SURGERY

MINIMAL ACCESS SPINE SURGERY MINIMAL ACCESS SPINE SURGERY Spinal ailments are amongst the most common ailments that afflict mankind. Back pain, for example, has achieved epidemic proportions worldwide in the last two decades and is

More information

Lumbar Spine Fusion (1 of 5)

Lumbar Spine Fusion (1 of 5) Lumbar Spine Fusion (1 of 5) i If you need this information in another language or medium (audio, large print, etc) please contact the Customer Care Team on 0800 374 208 email: customercare@ salisbury.nhs.uk.

More information

IMAGING OF THORACOLUMBAR TRAUMA

IMAGING OF THORACOLUMBAR TRAUMA IMAGING OF THORACOLUMBAR TRAUMA William B. Morrison, M.D. Thomas Jefferson University Hospital William. Morrison @ Jefferson. edu Thoracolumbar Trauma Anatomy Stability / instability Basic trauma vectors

More information

Minimally Invasive Hip Replacement through the Direct Lateral Approach

Minimally Invasive Hip Replacement through the Direct Lateral Approach Surgical Technique INNOVATIONS IN MINIMALLY INVASIVE JOINT SURGERY Minimally Invasive Hip Replacement through the Direct Lateral Approach *smith&nephew Introduction Prosthetic replacement of the hip joint

More information

ZERO-P VA. Variable angle zero-profile anterior cervical interbody fusion (ACIF) device SURGICAL TECHNIQUE

ZERO-P VA. Variable angle zero-profile anterior cervical interbody fusion (ACIF) device SURGICAL TECHNIQUE ZERO-P VA Variable angle zero-profile anterior cervical interbody fusion (ACIF) device SURGICAL TECHNIQUE Table of Contents Introduction Zero-P VA Instruments and Implants 2 AO Principles 4 Indications

More information

The Four Elements. CPT 2012 Professional Edition

The Four Elements. CPT 2012 Professional Edition The Four Elements Presented by Barbara Cataletto, MBA, CPC Disclaimer The following presentations are not to be considered a replacement for the Current Procedural Terminology (CPT) book or the International

More information

Low Back Pain (LBP) Prevalence. Low Back Pain (LBP) Prevalence. Lumbar Fusion: Where is the Evidence?

Low Back Pain (LBP) Prevalence. Low Back Pain (LBP) Prevalence. Lumbar Fusion: Where is the Evidence? 15 th Annual Cleveland Clinic Pain Management Symposium Sarasota, Florida Lumbar Fusion: Where is the Evidence? Gordon R. Bell, M.D. Director, Cleveland Clinic Low Back Pain (LBP) Prevalence Lifetime prevalence:

More information

Introduction Approach Rod insertion Rod reduction Rod lever Approach 3.2.

Introduction Approach Rod insertion Rod reduction Rod lever Approach 3.2. SPINE Sanat Spine 1 References Content 1. Introduction 4 4. Implant list 26 Varga Péter Pál, dr. Chief director, spine surgeon, orthopedic surgeon 1.1 1.2 The implant The instruments 4 4 National Center

More information

Universal Spinal System (USS). Designed to achieve the goals of scoliosis surgery.

Universal Spinal System (USS). Designed to achieve the goals of scoliosis surgery. Universal Spinal System (USS). Designed to achieve the goals of scoliosis surgery. Technique Guide and implants approved by the AO Foundation Table of Contents Introduction Universal Spinal System 2 AO

More information

Instinct Java System Your everyday spinal fixation solution

Instinct Java System Your everyday spinal fixation solution Instinct Java System Your everyday spinal fixation solution Surgical Technique Solutions by the people of Zimmer Spine. zimmerspine.eu Table of Contents Indications/Contraindications 5 Instrumentation

More information

THORACOLUMBAR SURGICAL TECHNIQUE

THORACOLUMBAR SURGICAL TECHNIQUE THORACOLUMBAR U.S. Patent no. 5,607,425, no. 5,716,357, no. 6,010,504, no. 6,019,759, no. 6,017,343 Other Patents Pending CONTENTS 1 Introduction...Page 2 Description...Page 3 Surgical Technique Posterior

More information

Synergy. Low Back Surgical Technique. Spinal Systems. Developed in conjunction with J. Abbott Byrd III, M.D. Biologic & Structural Innovation

Synergy. Low Back Surgical Technique. Spinal Systems. Developed in conjunction with J. Abbott Byrd III, M.D. Biologic & Structural Innovation Spinal Systems Surgical Technique Synergy IQ Low Back Surgical Technique Developed in conjunction with J. Abbott Byrd III, M.D. Universal system Modular packaging maximizes screw options Low-profile design

More information

DUKE ORTHOPAEDIC SURGERY GOALS AND OBJECTIVES SPINE SERVICE

DUKE ORTHOPAEDIC SURGERY GOALS AND OBJECTIVES SPINE SERVICE GOALS AND OBJECTIVES PATIENT CARE Able to perform a complete musculoskeletal and neurologic examination on the patient including cervical spine, thoracic spine, and lumbar spine. The neurologic examination

More information

Xia Anterior System Anterior System of the Xia Family. Surgical Technique

Xia Anterior System Anterior System of the Xia Family. Surgical Technique System Anterior System of the Xia Family Surgical Technique Introduction Introduction Stryker Spine is proud to introduce the Xia Anterior Spinal System. This System provides surgeons with a simple solution

More information

LUMBAR CANAL STENOSIS

LUMBAR CANAL STENOSIS LUMBAR CANAL STENOSIS Abstract The clinical consequence of this compression is neurogenic claudication and varying degrees of leg and back pain. Degenerative lumbar spinal stenosis is a major cause of

More information

McCULLOCH. Micro-Discectomy Instruments The premium neurospine retractor system. Solutions in highest quality and precision

McCULLOCH. Micro-Discectomy Instruments The premium neurospine retractor system. Solutions in highest quality and precision McCULLOCH Micro-Discectomy Instruments The premium neurospine retractor system Usage and fields of application: MICROSURGERY FOR LUMBAR DISC DISEASE Special features: Black coated instruments to reduce

More information

Fractures of the Thoracic and Lumbar Spine

Fractures of the Thoracic and Lumbar Spine Copyright 2010 American Academy of Orthopaedic Surgeons A spinal fracture is a serious injury. Fractures of the Thoracic and Lumbar Spine The most common fractures of the spine occur in the thoracic (midback)

More information

Research Article Partial Facetectomy for Lumbar Foraminal Stenosis

Research Article Partial Facetectomy for Lumbar Foraminal Stenosis Advances in Orthopedics, Article ID 534658, 4 pages http://dx.doi.org/10.1155/2014/534658 Research Article Partial Facetectomy for Lumbar Foraminal Stenosis Kevin Kang, 1 Juan Carlos Rodriguez-Olaverri,

More information

APSS YANGON OPERATIVE SPINE COURSE. Local Organizing Chairman: Prof Myint Thaung. Venue: Yangon Orthopaedic Hospital

APSS YANGON OPERATIVE SPINE COURSE. Local Organizing Chairman: Prof Myint Thaung. Venue: Yangon Orthopaedic Hospital 5 th - 8 th Feb 2015 Pls insert Hospital Logo here Local Organizing Chairman: Prof Myint Thaung Venue: Yangon Orthopaedic Hospital Invited International and Local Faculties Arvind Jayaswal (India) Chung-Chek

More information

SURGICAL TREATMENT FOR SPINE PAIN

SURGICAL TREATMENT FOR SPINE PAIN Lots of MEDICAL POLICY SURGICAL TREATMENT FOR SPINE PAIN Policy Number: 2015T0547J Effective Date: April 1, 2015 Table of Contents BENEFIT CONSIDERATIONS COVERAGE RATIONALE APPLICABLE CODES.. DESCRIPTION

More information

Synapse System. An enhanced set of instruments and implants for posterior stabilization of the upper spine.

Synapse System. An enhanced set of instruments and implants for posterior stabilization of the upper spine. Synapse System. An enhanced set of instruments and implants for posterior stabilization of the upper spine. Technique Guide 100º Instruments and implants approved by the AO Foundation Table of Contents

More information