TAKING MIS TLIF TO THE NEXT LEVEL (Orthopedics This Week)
In an arena of rapid technological advancement, it takes an innovation powerhouse to design products that have the ability to disrupt the spine industry. Life Spine, a manufacturer of spinal implants that launched 27 products in 2016, has revolutionized the TLIF taking it from a 90+ minute minimally invasive procedure to a micro-invasive procedure that has been completed in as little as 25 minutes.
Surgeons like Zeshan Hyder, D.O. of the Bone and Joint Specialists of Northwest Indiana are executing up to six of these procedures in one day. The potential benefits of a drastic reduction in procedural time are directly realized by surgeons and their patients. The system is designed to offer the benefits of: less time in the hospital and OR, reduced incision size, a safer surgery and a more reproducible procedure that caters to an ambulatory surgery center (ASC) setting.
The main benefit of the micro-invasive TLIF is less time in the operating room which typically correlates to a faster recovery.
Traditional TLIF procedures can take up to six hours. Six hours of muscle retraction, anesthesia, blood loss and fatigue to the hospital staff. Additionally, the longer the operating time, the fewer the patients a surgeon can operate on and the higher the cost of surgery.
To put it into perspective, each minute in the OR costs $62 on average, making a six-hour TLIF about 10x the cost of a micro-invasive TLIF. As Dr. Hyder said, “another benefit is the reduced need for sequential trialing and instrument passes to prepare for the placement of PROLIFT, which decreases my operating time. The system also features a torque-limiting driver that prevents over distracting of the disc space and possibly forcing the device thru the vertebral body endplate, which makes it a safe option for my patients.”
Another potential benefit of the micro-invasive TLIF is the reduced incision size.
For the patient, this can mean less muscle retraction, less scarring, less pain and an easier road to recovery. These benefits are possible with innovations like Life Spine’s PROLIFT Expandable Spacer System.
PROLIFT has a 3mm leading edge and with controlled, in situ expansion can allow for foraminal and disc height restoration up to 16mm, as well as restoration of normal physiological levels of lordosis and the capability to post-pack.
“Before expandable cages, you would have to make an incision large enough for the size of the implant needed, which would require removal of excess bone and retraction of nerves. This could lead to nerve pain after surgery and potential nerve damage,” said Dr. Hyder.
Patients may also seek out the micro-invasive TLIF as a procedure designed to be a safer option than the traditional TLIF approaches, “with this procedure you are not disturbing the spinal elements and have reduced tissue damage and risk of injury to the nerves, which also means less postoperative pain for the patient,” said Dr. Hyder.
The Life Spine TLIF Retractor used for access features independent angulating blades and modular taps, which anchor to the pedicles and allow for optimal disc space distraction. The system creates ample access to the working space through minimized incisions.
The micro-invasive TLIF is also reproducible and caters to a surgery center setting.
“We looked at the actual cost incurred by insurance if they have surgery in the hospital versus having it at an outpatient surgery center and found that by using minimally invasive approaches with new techniques like PROLIFT, there is significantly less cost for both the insurance company and the patient. And that is just a difference in cost. The potential reductions in chance of infection and pain experienced by the patient, allows them to return to their day-to-day lives faster” said Dr. Hyder.
There are many reasons that surgeons like Dr. Hyder are utilizing the Life Spine technologies that afford a faster, micro-invasive TLIF, but the main reason is the patient.
To quote Dr. Hyder, “Think of it like putting a ship inside a bottle. You can cut the bottle, put the ship in and glue it (that is kind of the old way), or you can build the ship inside the bottle, piece by piece protecting the fragile glass and saving time.” Patients opting for the micro-invasive TLIF approach may experience less time in the OR, smaller incisions, and a safe, reproducible procedure that can be done in a surgery center.
In 2016, Life Spine released 27 innovative products and expect to release 20 more before the end of 2017. They offer surgeons training through their PULSE™ program.
Life Spine will be at NASS and you can visit them at Booth #1109.