A minimally invasive fusion technique may result in faster recovery screw fusion surgery, the coflex-F procedure often results in a Lanx® Aspen™ = %. Orthopedics Today | It is generally accepted that spinal fusion, in conjunction with decompression, produces better clinical outcomes in patients with. The Aspen line of spinal instrumentation products from Lanx is unique These devices can be used for less invasive surgery under certain circumstances. This technique gets a little difficult towards the lumbrosacral junction.
|Published (Last):||14 July 2015|
|PDF File Size:||15.57 Mb|
|ePub File Size:||2.31 Mb|
|Price:||Free* [*Free Regsitration Required]|
Thereafter, aspe wing clamps of the interspinous U are tightened against both edges of the upper and lower spinal process. Contraindications include, but are not limited to:.
BioMed Research International
But in their study, they used the cost perspective of the hospital rather than that of the society; in addition, the senior author of the study was one of the inventors of the X-Stop device and had financial ties to the manufacturer.
But in this paper, the beneficial outcomes reported were misleading inflated and, in addition, there was a conflict of interest for the two primary authors. Three main causes of failure are reported in the literature: Another indirect measure published is the distance between the spinous processes. Type of Sugrical Contemporary models of fusion interspinous devices have evolved from spinous process wiring with bone blocks and early device designs as the Wilson plate: Surgical technique was as follows: Use only new implants for each case.
Any other medical or surgical condition which would preclude the potential benefit of spinal surgery, such as the presence of surical abnormalities, elevation of sedimentation rate unexplained by other diseases, elevation of the white blood count WBCaspne a marked left shift in the Lxnx differential count.
The spacers have all the same width but the heights increases from 8, 10, 12, and 14 to The facing surfaces of the spinous processes are decorticated.
But for double-level procedure, laminectomy was less costly llanx more effective than X-Stop. The 8-mm distraction trocar has a sharp pointed tip to facilitate piercing of the interspinous ligament for the subsequent trocars and for the implant. The interspinous ligament is removed sapen a gouge and, if bone trimming is necessary to improve seating of the implant, the inferior aspect of the upper spinous process at the junction with the lamina is trimmed to seat the spacer deeply as much as possible with the laminae.
The BacJac is a minimally invasive device manufactured from PEEK, implanted through a unilateral surgical surrgical that reduces operating room and patient recovery time, while preserving future surgical options. The wings of the techniquf are folded as the inserter flanges are compressed, thus the DIAM is driven as far anterior as possible using the impactor.
The arising consequence is the need to understand the pathological and mechanical causes of each degenerative problem and determine the right treatment paradigm through a critical analysis of all available experimental and clinical biomechanical information [ 33 — 38 ].
To define the appropriate implant size, trials are utilized. Posterior Fusion System Lanx. Fuchs was the first to suggest that interspinous device can be implanted with unilateral medial or total facetectomy to stabilize the spine; however, there is no biomechanical paper to show the level of stability provided by IPD after unilateral facetectomy specially that biomechanical studies have documented the destabilizing effects of unilateral facetectomy [ 5556 ].
The Aspen system can be used in single- or multi-level constructs. Removal is indicated because the implants are not intended to transfer or support forces developed during normal activities.
Recently with greater focus on motion-preservation alternatives, interest in nonfusion interspinous devices has emerged. This device is an alternative to dynamic interspinous spacers for the treatment of spinal stenosis and to conventional means of fixation to achieve fusion. Any implant implanted and then removed must be discarded.
Previously studies reported that disc bulging increases under loading conditions with consequent restrictions of the spinal canal area, irregular slipping, and abnormal movements of the articular facet joints, as well as increases in local scoliosis with asymmetric restrictions of the neuroforamen area [ 53 ]. The insertion of increasing size trocars allows for a gradual distraction of the interspinous area to measure the optimal decompression and prevent overdistraction. The system is intended for use with autograft or allograft.
Based on these data, a severely osteoporotic patient may be contraindicated for interspinous device, because a fracture of the spinous process might occur intraoperatively or postoperatively.
Aspen MIS Fusion System | Aspen MIS Fusion System by Zimmer Biomet
The first modern interspinous device, the Wallis system, was developed by Abbot Spine in and it was used primarily in patients with recurrent disc herniation [ 14 ]. Patients were randomized in a 2: It is recommended that regular postoperative follow-up is undertaken to detect early signs of failure of the implants and to consider the action to be taken.
The best indication for this device seems to be radiculopathy and neurogenic claudication secondary to lumbar spine degenerated disc diseases. The BacJac interspinous device implanted in a lumbar spinal model. This device was originally developed in France by Dr. In a retrospective study done by Tuschel et al. The Aspen system is indicated in the treatment of the following conditions: The implant has a small diameter wide-spike design with 16 spikes per implant over a broad area.
Current evidence is not sufficient to permit conclusions whether any beneficial effect from interspinous process decompression provides significant advantages over laminectomy, which is the current standard of care for surgical decompression of lumbar spinal stenosis. The pathoanatomic feature of neurogenic intermittent claudication in lumbar degenerative diseases is the venous stasis in lumbar spine extension, causing neurologic symptoms as motor weakness in the lower extremities, pain, tingling, and sensory deficit, which make walking for a long distance impossible.