Becker's Spine Review

42 Sponsored by: 30 Minimally Invasive Spine Products to Know M inimally invasive spine surgery is becoming more common as technological advancements in surgical procedures and pain management make less invasive surgery safer and more effective than traditional open procedures. Here are 30 minimally invasive spine devices and companies to know. Advance Table L2P Platform (Allen Medical). e Advance Table L2P Platform is designed for minimally invasive lateral spine surgery patient positioning. e system works with Allen Medical's Allen Advance Table to deliver lateral flex up to 32 degrees and quick rotation directly from the lateral to the prone position through manual rotation. L2P could reduce the number of staff required for repositioning and elimi- nate the need to transfer patients from one table to another. AxiaLIF (TranS1). e AxiaLIF procedure allows surgeons to perform reproducible anterior retroperitoneal pre-sacral access routes to the L5- S1 vertebral bodies. With more than 85 published research studies sup- porting its use, AxiaLIF has a shorter procedure time and results in less blood loss on average than TLIF, PLIF and ALIF approaches. TranS1 also conducted an economic study, released in 2015, which found Axi- aLIF reduced the cost per procedure for L5-S1 fusions by $3,500 when compared with TLIF procedures through shortened hospital stays, lower readmission rates and faster return-to-work for patients. Avenue T TLIF Cage (Zimmer Biomet). Zimmer Biomet launched the Avenue T TLIF Cage with integrated VerteBRIDGE plating in the U.S. on Oct. 2. e system facilitates simplified cage insertion and zero-profile, intradiscal fixation through the direct minimally invasive surgical approach. Avenue T is the first posteriorly implanted cage with integrated, anti-migration fixation, and is indicated for intervertebral body fusion from L2 to S1 in skeletally mature patients. e cage and VerteBRIDGE plates can be simultaneously loaded on the inserter and, once implanted, surgeons can advance both at the same time to reduce implantation steps. Battalion Lateral System (Alphatec Spine). Alphatec Spine launched the Battalion Lateral System with the Squadron Retractor as a minimal- ly invasive lateral access procedure in April. e Battalion system is a next-generation lateral system that reduces tissue creep, minimizes pso- as retraction time, and aims to achieve alignment and fusion objectives. e system's design allows surgeons to customize access to match the patient's unique anatomy through independent retraction of the cranial and caudal blades. Battalion was Alphatec Spine's introduction into the $500 million U.S. lateral market. Coflex (Paradigm Spine). e coflex Interlaminar Technology is a stabilization device indicated for use in one- or two-level procedures for lumbar spinal stenosis from L1-5. With more than five years of long- term, Level 1 data proving the procedure is effective when compared to fusion, coflex received a boost when the International Society for the Advancement of Spine Surgery issued a policy statement recom- mending coverage of decompression with interlaminar stabilization in December 2016. Payers took notice, with Blue Cross Blue Shield of Michigan Medical Policy becoming the first commercial payer to issue positive coverage for coflex in September 2017. Surgeons in more than 40 countries now use the technology to treat patients worldwide in the inpatient and outpatient settings. Dreal (Carevature Medical). Dreal is a curved device designed to cut bone in all sections of the spine and could improve access to the fora- men. A relatively new device — it's been used in around 550 patients worldwide — Dreal spinal decompression and bone removal system has been used in over 60 successful commercial lumbar and cervical procedures at Baylor Scott & White Medical Center in Frisco, Texas. Surgeons performing those procedures are optimistic; John Peloza, MD, one of the initial surgeons using the technology, reported shorter decompression time and maximum healthy tissue preservation when using Dreal in cervical and lumbar cases. Endoskeleton Next Generation nanoLOCK Surface Technology (Titan Spine). e next generation nanoLOCK surface technology is used in Titan Spine's full line of Endoskeleton interbody devices and designed to increase the osteogenic response. Titan's nanoLOCK was the first FDA-cleared interbody device to feature nanotechnology, a proprietary blend of textures at the macro, micro and cellular levels. Fully launched in the U.S. in 2016, the Endoskeleton titanium implants with nanoLOCK surface technology have been used at more than 14 hospitals and received a new technology code from CMS. e compa- ny's sales grew 51 percent as a result of the launch, and Titan saw rapid surgeon adoption nationwide. ExcelsiusGPS (Globus Medical). e first spine surgeries using Globus Medical's ExcelsiusGPS system were performed in October at Johns Hopkins Hospital in Baltimore and St. Mark's Hospital in Salt Lake City. Designed to take typical surgical workflow into account and facilitate procedural efficiency, the robotic system combines surgical navigation and robotic guidance for spinal procedures to improve accuracy and reduce radiation exposure. ExcelsiusGPS supports minimally invasive and open screw placement and integrates with Globus Medical implants and instruments. Everest Minimally Invasive XTower (K2M). K2M launched the Ever- est Minimally Invasive XTower instrumentation globally in September as an enhancement to the Everest MI XT Spinal System, originally launched last year. e percutaneous screw platform provides a new surgical solution to treat complex deformities with a less invasive approach and achieve 3D spinal balance. XTower instrumentation includes entire tab-to-screw assembly and can be used throughout the procedure with streamlined instrumentation. Surgeons can treat the full spectrum of pathologies with the single system. iFuse (SI-Bone). iFuse is SI-Bone's minimally invasive sacroiliac joint fusion system, which has been used in more than 28,000 procedures since 2008. Over the past half-decade, several Medicare Advantage,

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