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Recent CommentsmDesk: Improving preoperative planning for Orthopaedic Surgeons?
April 28, 2008
mDesk, the preoperative planning software widely used in Europe, is expanding to the U.S. market. What type of software is this?
Answer:
mDesk is manufactured by RSA Biomedical in Sweden, and is designed to improve preoperative planning for orthopaedic surgeons. The software includes templates for all joints and all major manufactured implants and is capable of providing highly accurate measurements and reconstructive anatomy prior to surgery and during follow up.
Recently, RSA Biomedical announced the addition of templates from Synthes to the mDesk software. These templates will increase the range of applications in which mDesk can be used.
“This, together with the new version (mdesk 3.0), our coming expansion within the US, and our continued success in Europe, will make 2008 a very interesting year”, said Product Manager Erik Wetter.
The mDesk software is capable of providing analysis for most orthopaedic patients, including trauma, pediatric, joint replacement and osteotomies. The software is available in a variety of configurations, suitable for use in larger treatment centers or smaller private clinics.
Source: http://www.rsabiomedical.se/mdesk/ - mdesk product website
Tantalum implants vs. Bone Grafts for Anterior Cervical Spinal Fusion?
April 28, 2008
Is there any data available comparing the use of tantalum implants to bone grafts for anterior cervical fusion?
Answer:
A recent article in the journal Spine compared tantalum implants to autologous bone grafts with plate fixation for 1-level cervical disc disease, and found all three methods to have similar efficacy at 24 month follow up. However, tantalum implants had significantly fewer complications than either autologous bone grafting with plate fixation. Most of the complications seen in the grafting patients related to donor site harvesting.
Twenty-eight patients received tantalum implants and 33 received autologous grafts. Radiological and clinical outcomes were similar for both groups.
Autologous grafting requires donor bone harvest, with the concomitant risks of pain, infection and bleeding, among others, at the donor site. Tantalum implantation removes the need for donor site harvesting and the need for plating.
Source: Fernandez-Fairen M et al. Anterior cervical fusion with tantalum implant: a prospective randomized controlled study. Spine 33(5):465-72, 2008
Spinal Nonfusion Technologies Achieve Rapid Adoption
April 28, 2008
Surgeons and patients alike are becoming more aware of the nonfusion treatment options for spinal surgery, and the number of hospitals offering this surgical option is growing rapidly.
Millennium Research Group’s (MRG) US Spine Marketrack™ survey reported that the number of hospitals performing dynamic stabilization doubled from 10% to 20% between 2006 and 2007, and the number offering artificial disc implantation increased from 6% to 13% in the same year.
A number of new products have entered the dynamic stabilization market in the last 3 years, including products like Medtronic Spinal and Biologics’ Prestige-ST and the X-STOP, Synthes Spine’s ProDisc-C and ProDisc-L, DePuy Spine’s Charite, and Zimmer Spine’s Dynesys.
“Patients are excited about nonfusion technology,” says Kevin Flewwelling, Manager of MRG’s Orthopedics division. “Not only do they benefit from increased motion preservation, but the recovery times are shorter, enabling them to return quickly to their regular lifestyles.”
Source: Millennium Research Group
Plexur Bone Filler Technology Approved for Spinal Applications
April 28, 2008
Osteotech’s Plexur P bone filler was recently awarded FDA approval for use in the spine. How is this product designed, and does it have any special benefits?
Answer:
Plexur P Biocomposite is a bone filler and bone graft extender. It is composed of cortical fibers suspended in a resorbable, porous polylactide-co-glycolide scaffold. It also contains minerals and trace elements, including calcium, phosphate, and extracellular matrix proteins, to promote bone healing.
Sam Owusu-Akyaw, Osteotech’s President and Chief Executive Officer, stated, “We continue to receive many favorable comments from orthopedic surgeons about the efficacy of Plexur P and we will immediately offer our Plexur P product to spine surgeons supported by the clinical information and experience we have gained over the last year.”
Plexur P Biocomposite was previously approved for use in boney voids within the pelvis and extremities. It comes in a variety of forms, including wedges, sheets and granules, to allow for optimal implantation and filling of boney spaces.
Source: Osteotech
Minimally invasive laminectomy: Better Than Traditional Open Procedure?
April 22, 2008
Decompressive laminectomy offers an effective surgical treatment of lumbar spinal stenosis. However, is minimally invasive laminectomy proven to be any better than the traditional open procedure?
Answer:
According to a report published recently in the journal Minimally Invasive Neurosurgery, the minimally invasive approach to laminectomy offers several benefits. Compared to patients treated with open surgery, those who were operated on via the minimally invasive approach had shorter operating times and less blood loss. They also had a shorter hospital stay, fewer and less severe complications, and better postoperative mobility.
This study compared the medical records of 38 minimally invasive surgical patients to 88 open-technique patients. The findings are similar to those found when comparing minimally invasive techniques for other surgical procedures to the traditional open approaches. By allowing for smaller incisions, less muscle dissection and minimal tissue manipulation, an experienced surgeon can produce similar clinical results with less tissue damage.
Source:
Minim Invasive Neurosurg. 2008 Apr;51(2):100-5.Click here to read Links
Comparison of Techniques for Decompressive Lumbar Laminectomy: the Minimally Invasive versus the “Classic” Open Approach.
Rahman M, Summers LE, Richter B, Mimran RI, Jacob RP.
Department of Neurological Surgery, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
Treating Degenerative Disc Disease with Injectable Polymers?
April 22, 2008
What is the idea behind the development of injectable polymers to treat degenerative disc disease? How do these work?
Answer
Research is currently being conducted on a variety of chemical polymers that can be used to replace degenerated intervertebral discs. Researchers hope to develop a chemical compound that displays properties similar to the nucleus pulposus – mainly, a combination of flexibility, strength and resistance to compression. One such polymer in development is a pH-responsive microgel, recently reported in the journal Soft Matter.
This material is composed of nanometer-sized microsponges that can be injected into the intervertebral disc. As the material reached the pH of the nucleus pulposus, the particles swell to fill the space within the disc. The gel becomes harder, and resists axial compression as a normal, healthy disc would do.
Promising features of this microgel are its minimally invasive application technique, the capacity to fill the irregular space within the disc, and the ability to perform revision procedures (such as fusion) should further intervention be necessary.
For more information see:
http://www.rsc.org/Publishing/ChemScience/Volume/2008/06/gels_fix_bad_backs.asp
http://www.rsc.org/delivery/_ArticleLinking/DisplayHTMLArticleforfree.cfm?JournalCode=SM&Year=2008&Manu
Disc Motion Technologies Spinal Joint Replacement Device
April 22, 2008
Disc Motion Technologies is working on a lumbar spinal-joint replacement device. What is it and When can we expect to see it in clinical trials and on the market?
Answer:
The Disc Motion surgical device is currently in development; the company has received over $8 million in capital investments, and clinical trials are scheduled to begin soon. The device is already available in some countries, but FDA approval can be expected to take 3 to 4 years.
The new device has several potential advantages over current disc replacement surgery. Disc Motion’s system replaces not only the disc, but also the facets of the degenerated joint. It is also designed for a posterior approach, through two paraspinal incisions, rather than the traditional abdominal approach.
“This [posterior approach] gives you an advantage. You can see all the problems. The disease is right in front of you. You see the nerve roots, the facets, arthritic spurs,” said Ed DeMarco, a retired orthopedic surgeon and investor. “All you can see is the disc space when you go through the abdomen.”
Source:
http://www.palmbeachpost.com
Enhance Lumbar Fusion Procedure with CONCORDE Device?
April 22, 2008
I’ve heard about the CONCORDE implant from Depuy Spine, and I’m wondering what you know about the new CONCORDE Bullet Vertebral Body Replacement device from the company? What is it designed to do?
Answer:
The CONCORD Bullet Vertebral Body Replacement is designed with a “bullet” shaped nose, meant to allow easier insertion. The bullet shape allows surgical placement of the device with less manipulation of the adjacent vertebral bodies.
It also has pyramidal “teeth” which prevent anterior migration of the device, as sometimes occurs with posterior or minimally invasive surgical procedures. The Bullet can also be placed obliquely across the midline to create 5 degrees of lordosis.
“The CONCORDE Bullet takes the proven clinical success of the CONCORDE implant and improves on it with the bulleted nose and lordotic options,” said Wade M. Ceola, M.D., of the Springfield Neurological and Spine Institute in Springfield, MO. “These are important innovations that enhance lumbar fusion procedures.”
Since its release last July, over 2,000 CONCORDE Bullet devices have been implanted.
Source: DePuy Spine
Void Creation in Fractured Vertebrae: Is the Parralax Contour an Advance?
April 12, 2008
As spinal surgeons, we are constantly looking for devices that are very easy to use to create a space in soft bone. I was therefore excited by the introduction of the Parralax Contour from Arthocare. But, how is the new Parallax Contour product different from other methods used to prepare vertebral bodies for cement injection?
Answer:
ArthroCare developed the Parallax system for the displacement of soft bone during stabilization of vertebral compression fractures. The Parallax Contour is a curved stylet that is used to “sweep” the soft bone out of the way. It is designed to allow minimally invasive movement of the soft central portion of the vertebral body, which can then be filled with bone cement to stabilize the spine.
More traditional methods to clear the space within the vertebrae prior to injection of cement include high-pressure injections like balloon kyphoplasty. According to the ArthroCare, the new Parallax Contour is more precise, potentially cheaper and can be performed more quickly.
“Physicians report that the Contour is fast, easy to use and provides tactile feedback that is missing in some competitive systems. The bone can be displaced easily with precise control by the surgeon,”
says Jim Pacek, vice-president and general manager, ArthroCare Interventional Therapies.
The Contour stylet is designed to work in conjunction with ArthroCare’s other products, including cement delivery systems and bone biopsy needles.
Source: Arthocare
SpineMark: Better Access to Spine Care Therapies Under Research?
April 9, 2008
We’d all like to offer our patients greater treatment options, but we have been limited by the amount of infrastructure necessary to participate in large, national trials. As such, we’re happy to see that SpineMark Corporation is launching a multi-site research organization. But, will this actually help surgeons and patients to access investigational therapies?
Answer:
SpineMark recently announced the creation of SpineMark Spine Research Organizations (SRO) in Los Angeles and Denver. The idea behind the SRO is to allow physicians and patients the ability to participate in clinical trials of advanced spinal care therapies, which are still in the investigational stage.
Surgeons located in Los Angeles and Denver will be able to collaborate with the SRO, and will have access to new products and devices and will receive clinical support from SpineMark and other participating organizations.
Dr. Robert J. Bess, an orthopedic spine surgeon and co-founder of the SpineMark SRO of Denver, said
“By partnering with SpineMark, we are able to provide patients with the best of all worlds — access to community practices that can provide quality, personalized care coupled with the clinical trial opportunities of larger facilities.”
Several more SpineMark SROs are planned in other cities, in an effort to provide the infrastructure and access needed to treat patients with the most advanced therapies available. The first clinical trial to be introduced by the SRO is an evaluation of StabiliMax, a device manufactured by Applied Spine Technologies for dynamic stabilization without fusion.
Source: http://www.spinemarksro.com/. – SpineMark SRO website