Originally Published MDDI October 2004R&D DIGEST

Maria Fontanazza

October 1, 2004

2 Min Read
Lumbar Fusion Procedure Made Simpler

Originally Published MDDI October 2004

R&D DIGEST

Lumbar Fusion Procedure Made Simpler

Maria Fontanazza

Using thin instruments for lumbar surgery may result in shorter recovery times and a reduced risk of complications. Photo courtesy of NuVasive. 

A procedure combining a minimally invasive technique and advanced medical devices results in less pain, a shorter recovery period, and a lower risk of complications, according to a study published in the journal Spine. Led by John J. Regan, MD, codirector of the Cedars-Sinai Institute for Spinal Disorders (Los Angeles), a team of doctors at the institute may have found a safer way to perform upper lumbar fusion surgery.

Regan, senior author of the study, said that developments in the devices used in this procedure have contributed to its success. Thin instruments and laparoscopes reduce the risk of complications associated with open surgeries because these instruments do not require big incisions in the larger back muscles.

“We've also changed from titanium to a material that is radiolucent and that allows us to see the bone fusion taking place,” says Regan. Instrumentation, such as radiolucent cages, improves rates of spinal fusion by limiting motion in critical areas.

As documented in the study, Regan performed 21 endoscopic lateral transpsoas procedures over a six-year period. The more direct lateral approach, which involves entrance through the psoas muscle, was minimally invasive and cited as being safe for anterior fusion of the upper lumbar region. Other methods used by surgeons have several risks, including small bowel obstruction, scar tissue formation, and substantial pain and swelling.

Regan said that since the study was published, collaboration with Nu-Vasive Inc. (San Diego) has led to the development of a new procedure, called Xlif (extreme lateral interbody fusion). The minimally invasive access method, or MaXcess system, combines instruments and technology to allow surgeons greater access to the spine.

“The real-time neuromonitoring allows us to probe through the muscle over the spine, to ensure that any nerve root is safely protected during that exposure,” says Regan. He added that surgeons will more easily adopt this type of approach in the future.

“The devices seem to be getting better all the time, and I think there will be improvements in the development of motion preservation devices, such as artificial disks that can be inserted through this technique,” says Regan.

Copyright ©2004 Medical Device & Diagnostic Industry

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