The minimally invasive spine (MIS) surgery market, will rise in 2020 to $900 million worldwide. It accounts for approximately 10% of the Global Spine.
Minimally Invasive spinal surgeries are growing in popularity due to its advanced features, such as high accuracy, less blood loss, reduced hospital stay, and favorable reimbursement policies. Traditional open surgeries can cause various post-operation complications, such as excessive pain, partially collapsed lungs, blood clots, fatigue, muscle atrophy, and infections. Most surgeons use MIS spine surgery to treat the severe degeneration of the disc material in the spine by placing a bone graft, resulting in the generation of a new bone that bridges the vertebrae.
Some weeks ago, we published “10 Minimally Invasive Screw Systems to know…! Today, we have added 10 MIS systems that are worth to know according to the following same criteria:
- Range of Rods diameter and length
- Fenestrated screws option
- Double Lead Screws
- Self Tapping Screws
- Range of Screws diameter and length
- Friction Tips Tulips
- Reduction-Distration Instruments
- Head Profile
1.-TiLock XT™ MIS | Genesys Spine
TiLock XT Minimally Invasive Surgery (MIS) Pedicle Screws are polyaxial cannulated screws available in various lengths and diameters.
The minimally invasive procedure is performed using K-wires and fluoroscopy, which allows the surgeon to employ smaller incisions rather than one long midline incision.
Straight-forward instrumentation, self-tapping screws, and break-away tulip designs help simplify the procedure and reduce operative time.
FEATURES:
- Connection Ring: Simply remove ring to allow for multiple MIS techniques or final implantation.
- 20mm Reduction: Threaded reduction built into the tower. Inverted box threads reduce cross threading and occurrences of tulip splaying.
- TiLock OAI: Proprietary opposing angle interface (OAI) lock system reduces rod slippage as well as instances of set cap backout. Available in a Hex or Torx Head.
- Unique Cannulated Thread: Self-tapping and double-lead thread pitch promote rapid screw insertion.
- Screw Offering: Color-coded: 4.8, 5.5, 6.5, 7.5 and 8.5mm
Length: 25-60, in 5mm increments (8.5mm screws available up through 100mm length) - Polyaxial Head Design: The polyaxial head design features a 60° conical range of motion that provides surgeons the intraoperative flexibility needed for each unique patient anatomy.
- The friction interface between the tulip and the screw allows for incremental tulip positioning to simplify rod insertion.
- Breakaway Towers: Easily and safely break away towers for tulip profile.
- One-Piece Tower: Robust 120mm tower allows for a variety of patient profiles.
2.-AVATAR | Life Spine
The AVATAR MIS System offers cannulated pedicle screws inserted over a guide wire to reduce muscle and tissue trauma. Extended tabs integrated to the screws provide a pathway for secure implantation of the rod while minimizing tissue dissection. Reduction, compression and distraction are achieved simply and effectively with intuitive instrumentation.
Features:
- Multiple methods of rod insertion including muscle splitting and true percutaneous
- Extended tabs provide rigid connection to instrumentation
- Tabs are removed with ease in a single motion
- Unique, single-step screw locking mechanism minimizes cross threading
3.- APELO MIS | ATLAS Spine
The Apelo MIS Pedicle Screw System leverages all of the advantages of its clinically proven predecessor, Apelo. The system’s modular design provides a versatile, seamless approach to addressing both percutaneous and mini-open procedures.
- The patent-pending Guidewire Handle provides complete control over wires while minimizing the need for fluoroscopy.
- Innovative titanium poly-axial heads can flex open to retract tissue, improve visualization, and widen the target for rod passage, further reducing fluoroscopy and operative time.
- Only 12.5 mm in diameter, the heads minimize the skin incision while maintaining the strength to provide 25 mm of threaded reduction without the fiddle of additional instrumentation.
- Proprietary Extended Saddle Heads bring the saddle of the head to the rod eliminating the need to bend rods, leave screws proud or risk screw pullout.
- Retractor/distractor securely attaches to the modular screws ensuring maximum visibility with minimal exposure.
- The novel Secure Rod eliminates “sliding” during placement.
4.-PICASSO II | CTL Amedica
Picasso II™ Percutaneous Polyaxial Screws are designed with simplicity in mind. Made for true percutaneous implantation, they allow for complete pedicle stabilization while minimizing tissue disruption.
Features:
- Stability ring prevents splay during implantation, reduction and set screw insertion
- 6.0 percutaneous rod is available in straight and curved, designed with a bulleted tip, which allows for smooth insertion
- Polyaxial Screw angulation ± 36°
- Slim integrated tower sleeve provides stability and control during insertion and reduction
- 25mm of internal threads aid in rod reduction
- Laser scored and tapered housing provides a clean break every time
- Dual lead thread for more efficient implantation
5.-CosmoLock® MIS | KALITEC
The CosmoLock® MIS System offers an optimal minimally invasive solution capable of treating a myriad of pathologies in the thoracic and lumbar spine. The system is designed to be extremely low profile and simple to use, while providing intuitive surgeon friendly instrumentation.
Features:
- 4.75, 5.5, 6.5, 7.5 & 8.5mm Screws
- Dual Lead Threads With Tapered Tip
- Low Profile Break Away Tabs
- 15mm Built-In Reduction
- Innovative Locking Cap Starter
- Multiple Rod Delivery Options
- Simple Easy to Use Instrumentation
6.-TOWERLOX-EXT MIS Extended Tab Pedicle Screw | Captiva Spine
Developed through close collaboration with leading MIS surgeons, the TowerLOX MIS Pedicle Screw System represents the next generation in minimally invasive spine surgery. TowerLOX provides simple and intuitive function in a cannulated pedicle screw system for minimally invasive surgeries. The smooth and reliable integration of the tower system, coupled with state of the art rod insertion and reduction instrumentation, allows for enhanced control and ease of rod delivery; even in the most challenging anatomical situations.
Features:
- Narrow insertion diameter reduces tissue trauma
- In-situ tower attachment capabilities provide an MIS rescue/revision option not available with other extended tab systems
- Robust connection with TowerLOX MIS pedicle screw instrumentation; all-encompassing system
- Internal counter torque shaft eliminates the need to expand the wound during set screw final tightening
- Compatible with Tower Pivot tool for efficient compression, distraction, and spondylolisthesis reduction
- Open extended tabs allow visual confirmation of rod passage
- 15mm of controlled built-in rod reduction above the break-off
7.-VALENCIA | ALTUS SPINE
The Altus Spine Valencia Extended Tab Pedicle Screw System is a simple, effective pedicle fixation system incorporating reliable rod delivery and dependable rod reduction. In less invasive procedures, the integrated extension tabs provide additional control and guidance during construct placement and locking.
Features
- Integrated Extended Tab Screws
- Integrated extension tabs provide visual guidance for rod delivery and construct locking
- Efficient and robust hybrid square thread minimizes cross threading during rod reduction
- Dual lead cannulated screws provide for faster insertion
- Simplified Instrumentation & System
- Screws and locking caps use common driver interface to reduce required instrumentation
- Reliable, over-the-skin rod length measurement
- Constraint collar provides good control and is removable for more flexibility
- Product Offerings
- 5.5mm, 6.5mm, 7.5mm and 8.5mm cannulated screws available in lengths up to 60mm
- 5.5mm pre-lordosed rods available up to 160mm length
- 5.5mm straight rods available up to 220mm length
8.-Orthros MIS | Camber Spine
ORTHROS MIS is the Percutaneous pedicle screw system from Camber Spine.
Features:
- Poly drag in screw head for easy reception of rod
- Blunt-tipped for bi-cortical purchase
- Straight and Pre-lordosed rods with self-dissecting bulleted tip
- Easy break screw tabs that leave a low-profile and clean break
- 25mm Threaded Reduction in screw tab
- Controlled but adjustable compression and distraction technique utilizing the fulcrum
- Low-profile Rod Inserter maintains a rigid rod control, but keeps incision sizes shorter for multi-level cases
- 1-Step Dilator provides quick access to pedicle
9.- PALISADE | Spineology
The Palisade™ Pedicular Fixation System is designed for anatomy conservation and surgical efficiency. The integrated break-off screw extension system minimizes procedural steps and limits tissue disruption during screw insertion and rod placement.
Features:
- Anatomy-Conserving
- Construct size and exposure are minimized by the use of a 4.75mm cobalt chrome Rod and break-off extensions.
- Surgical Efficiency
- Reduction threads are integrated into the screw extension to allow the use of the Set Screw for rod reduction. Integrated reduction eliminates steps and increases efficiency.
- Advanced Rod Placement
- Multiple rod placement options include an articulating rod placement method which preserves tissue and effectively places a short rod under the fascia in a deep construct.
10.- PathLoc-L MIS System | Aegis Spine
PathLoc-L MIS System is for minimally invasive posterior rod and screw fixation. It is designed to minimize soft tissue trauma by using a transmuscular approach and subfascial rod insertion. Patient benefits from the reduced trauma with less pain, shorter hospitalization, and shortened recovery time.PathLoc-L MIS System is based on a wire-guided insertion of cannulated polyaxial long sleeve screw and sleeve-guided rod insertion through the same incision site.The instruments have built-in safety mechanisms and provide surgeons with tactile feedback.The logical flow of the surgery guarantees efficiency and excellent results.
Features
- Overall
- Cannulated polyaxial screw consists of three components: shank screw, tulip of the screw, and pressure valve. The shank screw has a combined thread type where the core has a conical upper region, a cylindrical lower region, and a cylindrical outer thread.
- Pressure valve within the tulip head locks the polyaxial screw into a fixed angle screw when used with a torque and a set screw. This also maintains a friction fit allowing the tulip to remain in place during rod and set screw application. 360 ̊ total angulation is possible.
- Extra-Long Thread
- Long sleeve cannulated screw with 30mm extra long thread can make easy reduction of rod with less invasive surgery.
- Double Thread
- Unique double thread pitch offers improved pullout strength in the vertebral body.
- Double Self-Tapping
- Particular double self-tapping design allows the screw to tap its own hole as it’s driven into the bone.