Advanced Spine Technologies

Three Degree Cervical Plate

The titanium Three Degree plate by Orthofix Spine incorporates several design features meant to minimize risks such as screw backout. An innovative drill and screw guide effectively retracts soft tissues near the plate while holes are drilled into the spine and screws are delivered.

• Holes in the plate allow visualization of vertebral bodies for correct placement.
• Locking plates fit over screws to prevent them from backing out.
• Reduces risk of injury to normal structures after fastening.

Zero-P System

Cervical fusion surgery typically involves the placement of a plate on the anterior surface of the cervical spine. In very thin patients, the "profile" of the plate can sometimes be felt when swallowing.

Synthes Spine developed the "Zero-P", a zero-profile plate which cleverly fits between the vertebral bodies instead of in front of them. Screws to fix the plate go through it and are recessed within it. We typically use the Zero-P in thin patients whom we suspect may not tolerate a typical cervical plate.

Kyphon Inflatable Bone Tamps

Vertebroplasty is a commonly used method of addressing vertebral compression fractures by injecting a bone cement called methylmethacrylate. The cement not only "glues" fracture fragments together, but also destroys pain fibers within the bone by releasing heat while setting.

Kyphon revolutionized this treatment by introducing "kyphoplasty", where a balloon or "inflatable bone tamp" is used to expand, or "reduce", the fracture before the bone cement is introduced. We use these exclusively for all our kyphoplasty procedures due to their adaptability for a wide variety of fracture configurations.

Spotlight Tubular Retractor

During lumbar laminectomy, retractors must be used to keep muscles away from bones and ligaments that must be removed. Traditional retractors use two blades that retract from side to side, creating a rectangular exposure.

Tubular retractors allow for the most efficient retraction of muscle because they create a circular exposure, exposing the most area for the size of any given incision. The Spotlight retractor by Depuy connects to a high-intensity light source that provides superior visibility for minimally invasive laminectomies.

X-Stop Interspinous Spacer Device

Interspinous spacer devices are used for patients who have lumbar stenosis with back and leg pain (neurogenic claudication) that resolves with bending forward. They are implanted between the spinous processes of the spine at the affected level, thus causing a patient to be (unnoticeably) "bent over" at that level to relieve pressure.

The X-Stop was one of the first interspinous spacer devices approved by the FDA, and has been quite effective. Versions made with non-metallic components are now available and may prove useful in patients with softer bone.

Neurovision Nerve Monitoring

One of the risks of any type of spine surgery is injury to a nerve either directly or indirectly. Neurovision is an innovative technology introduced by Nuvasive that allows us to continuously stimulate screws and instruments with an electrical current, up to five times a second, while they are being used.

If a nerve is contacted by a screw or instrument during surgery, Neurovision alerts us to stop and re-evaluate our trajectory. This allows us to perform minimally invasive surgery with the lowest possible risk to nerve roots.

O-Arm & Stealth Navigation

During complex instrumentation and fusion surgery, it becomes necessary to view the trajectory that a particular screw will take before placing it, ensuring exactly correct location.

The "O-Arm" by Medtronic is an imaging station that allows us to take live CT scans before, during, and after surgery. We use these scans along with Stealth image guidance software to aim our screws precisely. After we are done, we verify that all screws have been placed appropriately.

Minimally Invasive Decompression

In lumbar disc surgery, minimizing muscle damage is key to a fast recovery. Traditional open retractors create a large rectangular exposure, stripping muscle away from the bone.

We utilize specialized tubular retractors like the Spotlight system, which gently separate muscle fibers rather than cutting them. By creating a circular exposure and connecting directly to a high-intensity light source, we achieve superior visibility of the herniated disc and compressed nerve. This results in less postoperative pain, shorter hospital stays, and a quicker return to normal activities.