The market for expandable cages is approximately $400 million. Today we have choosen 15 PLIF that from our point of view are worth to know according to the following criteria:
- Height of insertion: It is important since it is one of the main advantages of these expandable cages. It reduces endplate disruption, nerve root retraction, and impaction forces.
- Lordosis Restoration: Also critical since it helps restore sagittal balance and foraminal height.
- Expandable Technology: We have considered how simple and efective is the expandable procedure.
1.- SABLE™ | GLOBUS MEDICAL
SABLE™ is an expandable posterior lumbar interbody spacer with 3D printed titanium endplates designed to minimize endplate disruption, maximize sagittal balance restoration, and optimize fusion with in situ graft delivery.
Benefits:
- Minimize Disruption: SABLE™ may be inserted at a contracted height as low as 6mm to help reduce endplate disruption, nerve root retraction, and impaction forces.
- Maximize Restoration: SABLE™ provides up to 22° of lordosis and continuously expands up to 8mm to help restore sagittal balance and foraminal height.
- Optimal Fusion Environment: The 3D printed titanium endplates along with in situ graft delivery provide an optimal environment for fusion.
2.- FORZA® XP Expandable | Orthofix
The FORZA® XP Expandable Spacer System offers titanium alloy expandable interbodies for Posterior Lumbar Interbody Fusion (PLIF) and Transforaminal Lumbar Interbody Fusion (TLIF) procedures. After insertion into the disc space, the interbodies can be expanded to fit the patient anatomy. Unlike many competitive expandables that trade off graft space in order to stay within the limits of their expansion design, FORZA XP has a large graft window and affords the user the ability to pack the graft window in situ while retaining its expansion capability.
- FORZA® XP Expandable: VIDEO ANIMATION
- FORZA-XP-Brochure-Orthofix.pdf
- FORZA-XP-SGT.Orthofix.pdf
Features and Benefits
- Minimized insertion height helps to reduce nerve root retraction and minimize impaction force
- Controlled continuous expansion† – not incremental like some competitors
- In situ distraction allows disc height restoration and an optimized fit
- Automatic locking – height stability without an extra locking step
- Anatomic profile – optimal fit within vertebral endplates*
- Inserter stays in place for insertion, expansion, and graft material post packing – fewer passes by the nerve root with instrumentation
- Placement of bone graft after expansion – able to fill the graft window space with implant in situ
*Note: 6.5mm implants do not have anatomic endplates
†Controlled expansion up to 3mm
3.-PROLIFT Expandable | Life Spine
The PROLIFT Expandable Spacer System with Osseo-Loc Surface Technology, provides a micro-invasive solution for TLIF and PLIF procedures. With up to 6mm of in situ expansion, ProLift allows for restoration of normal anatomic disc height and decompression of neural elements. Streamlined instrumentation provides the surgeon minimal tissue disruption and nerve retraction while achieving surgical goals and restoring patient alignment.
- PROLIFT Expandable Spacer System: VIDEO ANIMATION
Features and Benefits
- Controlled in situ expansion allows for foraminal and disc height restoration, as well as physiological levels of lordosis
- Bulleted tip simplifies insertion in collapsed degenerative discs without compromising the apophyseal ring
- Tactile and visual confirmation of expansion prevents over distraction
- Multiple lordotic options to assist in the restoration of normal spino pelvic alignment
- Post pack design allows for insertion of graft material after expansion to assist with sentinel and columnar fusion through implant
- Designed to be used with the Osteo-Line™ Graft Delivery System without the need for removal of the implant inserter
Implant Specifications
- 400-600 micron porosity
- 3 mm bulleted tip
- 0°, 7°, 12°, and 15° lordosis
- 28 mm pre-expansion length, 22 mm post-expansion length
- 8 mm – 13 mm height options in small implant
- 10 mm – 16 mm height options in large implant
4.-Half Dome X | Astura Medical
The Half Dome X Posterior Lumbar Interbody Spacer System delivers a new level of intraoperative flexibility and efficiency by providing infinitely adjustable expansion in height and width of the interbody spacer for a controlled restoration of disc height and optimized fit. These features coupled with acid-etched endplates of the implant and an integrated bone graft delivery system within the inserter, maximize bone graft volume and endplate contact. The wide array of implant options and expansive instrumentation delivers a streamlined, efficient procedural sequence that can address even the most difficult pathologies through multiple approaches.
- Half Dome X:VIDEO ANIMATION
Features and Benefits
- Infinitely adjustable expansion in height and width for a controlled disc height restoration and optimized fit
- Integrated bone graft delivery system within the inserter to maximize bone graft volume and endplate contact
- Acid-etched endplates resist migration postoperatively and minimizes stress on the vertebral endplates, which can lead to subsidence
Implant Specifications
- Heights: 7-10.5, 9.5-14, or 12-17mm
- Widths: 9-10 or 11-13mm
- Lengths: 22, 24, 26, 28, or 30mm
- Lordosis: 0°, 3°, 10°, or 15°
5.-dualX TLIF | Amplify Surgical
The dualX technology is comprised of a family of titanium expandable interbody devices designed to be implanted in lateral lumbar interbody fusion (LLIF), posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) spinal procedures. The dualX portfolio contains varying footprints, heights and degrees of lordosis with post-expansion bone grafting to provide a customized anatomical fit for a clinically-successful fusion environment.
- dualX TLIF: VIDEO ANIMATION
Features and Benefits
- Accommodates surgeon preferred surgical approach
- Three variations of implants for LLIF, T/PLIF and TLIF procedures
- Minimal starting height and width for endoscopic, minimally-invasive or open delivery
- Powerful, vertical expansion
- Designed to restore disc height for decompression
- Optimized fit ensures endplate-to-endplate contact for bone graft apposition
- Wide, lateral expansion
- Provides a large, stable foundation engineered to reduce subsidence risk
- Large, center bone graft chamber for post-expansion grafting
- Innovative dual locking mechanism
- Simple and efficient, two-phase locking
- Engineered to maintain disc height long term
- Built in lordotic angle
- Designed for up to 18° lordosis
- Assists in sagittal alignment restoration
- Post-expansion bone grafting
- Easily-accessed, open-architecture bone graft chamber
- Enables delivery of large volume of surgeon-preferred bone graft
6.-Elite™ Expandable | Spineology
The Elite™ Expandable Interbody Fusion System represents the next generation of expandable technology. Its unique design minimizes both neural retraction and insertion force, accommodates a larger graft channel than many competitive expandable cages, and provides controlled expansion to restore disc height, potentially providing indirect decompression. When paired with Incite Cortical Fibers, Elite’s clinical advantages promote fusion and quick recovery while conserving patient anatomy.
- Elite™ Expandable: VIDEO Animation
Features and Benefits
- Minimal Impaction: Tapered distal nose and contracted height eases insertion, minimizing the potential of endplate damage
- Minimal Retraction:Contracted insertion height and narrow footprint minimizes neural retraction and may reduce the potential of neural damage
- Controlled Expansion: The expansion mechanism locks the implant at any point in the expansion range. The distractive force during expansion is designed to restore anatomic height and may provide indirect decompression
- Optimal Through-Growth: Large graft chamber with low-profile drive mechanism maximizes bone graft volume spanning endplate to endplate
7.-RISE® | GLOBUS MEDICAL
RISE® is an all titanium expandable lumbar interbody spacer designed for posterior approaches, such as Transforaminal Lumbar Interbody Fusion (TLIF) or Posterior Lumbar Interbody Fusion (PLIF).
Benefits:
- Minimal Insertion Height: Inserted at a reduced height to minimize impaction and preserve endplate integrity.
- Continuous Expansion: Up to 7mm of continuous expansion to restore disc height.
- Optimized Fit: When expanded in the disc space, the implant optimizes endplate-to-endplate fit
8.-Lucent XP | Spinal Elements
The Lucent XP Expandable Interbody device is a unique addition to the spinal fusion market. The main features of the device are its ability to expand in height and increase in lordotic angle after it has been surgically implanted.The height expansion helps restore the height of the spinal disc space and the lordotic angling helps correct the curvature of the spine. With the Lucent XP device, surgeons can achieve up to 15 degrees of lordotic angle, helping restore sagittal balance for the patient
Features and Benefits
- Expanding Options
- 3mm of expansion
- Up to 15° of lordosis
- Multiple implant options
- Self-locking expansion mechanism
- Ti-Bond Titanium Porous Coating
- Unique Macro, Micro, and Nano structured surface
- Hydrophilic
- Radiolucent
- Increased surface topography
- Designed for immediate stability
- Elastic modulus and strength of PEEK with benefits of microtextured titanium
- Coupled Lordosis
- Controlled placement and expansion to fit patient anatomy
- Lordotic angle increases concurrently with height expansion
- Restores disc height and sagittal balance
9.-eZspand™ PLIF | Zavation
eZspand™, the latest addition to Zavation’s portfolio, features unmatched expandable precision paired with continual expansion to provide an optimized fit for each patient. This optimized fit allows for enhancement of structural stability and improved sagittal balance. eZspand™ does not require secondary locking, minimizing procedural steps. Each implant expands to 4.5mm from the insertion height to create a large graft window that facilitates fusion. The benefits of continuous height adjustment (not incremental) up to 4.5mm expansion paired with no secondary locking step separate eZspand™ from its competitors.
- eZspand™:VIDEO ANIMATION
Features and Benefits
- Continuous height adjustment, not incremental
- No secondary locking step required
- Large graft window
- Post expansion packing of graft material through inserter
10.- X-Pac Expandable Lumbar | Expanding Innovations (Distributed by DePuy Synthes)
On February 2, 2021, DePuy Synthes signed an agreement with Expanding Innovations Inc. to distribute the X-Pac Expandable Lumbar Cage System in the U.S. The X-Pac Cage augments DePuy Synthes’ existing suite of products to provide a comprehensive procedural solution within the lumbar degenerative and minimally invasive spine segments.
Expanding Innovations Inc. has been dedicated to developing differentiated intellectual property and is deeply committed to revolutionizing expandable cages. The X-Pac Cage product portfolio is an example of the company’s commitment to offering innovative technology to spine surgeons.
The X-Pac Expandable Lumbar Cage’s expansion mechanism provides controlled expansion of both height and lordosis to allow for intra-operative adjustment depending on the patient’s anatomy to meet their clinical needs. A differentiated lock ramp-feature built into the cage endplates leaves a large available graft space inside the cage for post graft packing. These benefits can enable surgeons to tailor treatment options for patients undergoing spinal fusion surgery.
11.- Flarehawk 9 | Integrity Implants
A bi-directional expandable cage with the strength and rigidity of a monolithic implant.
- Flarehawk 9: VIDEO ANIMATION
Features and Benefits
- Bidirectional Expansion: Stent-like technology delivers an increase in width, height, and lordosis, which is intended to reduce subsidence and restore disc space height.
- Minimal Insertion Profile: Designed to minimize neural retraction during implant insertion.
- Maximum Graft Delivery: The open architecture allows for continuous graft delivery in through the implant and out into the disc space. Graft volume is only restricted by the quantity of disc removed.
12.- Catalyft PL40 | Medtronic
Building upon the unique benefits of Catalyft™ PL, the titanium Catalyft™ PL40 expandable interbody provides 40% more surface area distally compared to the Catalyft™ PL implant, which allows for increased anterior rim contact to reduce the risk of subsidence.3 The anatomic beveled tip allows for greater apophyseal ring contact and ease of insertion.
- Medtronic: Catalyft PL40: VIDEO ANIMATION
- Catalyft-pl-Brochure.Medtronic.pdf
Benefits:
- Robust titanium design for stability you can count on2 Grit-blasted, titanium surface for anti-migration and osteoconduction
- Topographical features including teeth, machined scallops, and roughened titanium work together to resist migration of cage during expansion
- Anatomic beveled tip for greater apophyseal ring contact and ease of insertion
- Catalyft™ PL40 implant: 40% more surface area distally compared to the Catalyft PL implant, which allows for increased anterior rim contact to reduce the risk of subsidence
13.- Mojave PL 3D Expandable | Stryker
The Mojave PL 3D Expandable Interbody System is a fusion device designed to allow for independent control of the anterior and posterior height in the lumbar spine. This implant may be locked at any desired height and lordosis to aid in the restoration of sagittal balance. Lamellar 3D Titanium Technology incorporates 500 um longitudinal channels throughout the implant, which in conjunction with transverse windows, create an interconnected lattice designed to allow for bony integration.
Features:
- Intraoperative adjustment allows for the implant to be in a collapsed position during insertion to help minimize risk of damaging the ligaments, nerve roots, and intervertebral endplates
- Comprehensive height and lordotic expansion ranges to fit patient anatomy
- Graft chamber allows the implant to be packed with bone graft prior to insertion.
- Intuitive all-in-one instrumentation designed for fast and simple insertion and expansion of the implant
14.-PROCAYMAN™ | PRODORTH
Standart PLIF – Expandable PLIF – PLIF withThread
Standard and Expandable types besides various sizes are available
- Made of PEEK (ASTM F2026) which is a polymer based composite material and Ti6Al4V (ASTM F 136) materials.
- Holding inferior and superior are as strongly with appropriate surface design.
- X-Ray Markers for easy visualization during implantation.
- Toothed surface design to prevent migration
- Anatomical geometry
For more information please visit: https://www.prodorth.com/plif-peek-cages
To learn more contact us at [email protected]
15.- Pronaos | Neurostructures
Neurostructures Expanding Solutions implants are designed to be placed seamlessly into the disc space due to their low profile and bulleted design. They then can be expanded and then rapidly post packed through a proprietary inserter, optimizing surgical efficiency. The Expanding Solutions implants provides restoration of sagittal alignment with customizable degrees of lordosis. They were also designed to induce lordosis in an anatomical fashion, unique to what is currently on the market.
The NeuroStructures innovative Expandable Spacer Systems with proprietary 3D printed Neuro-LOC Surface Technology is the next generation in micro invasive technology for TLIF/PLIF and Lateral procedures. Designed to allow for true positioning of the implant, all NeuroStructures expandable devices provides a pure cephalad/caudal height expansion allowing for increased end plate coverage. All devices also provide a continuous tactile feedback for the surgeon during expansion for precise optimal fit. With streamlined – multifunction instrumentation, this family of expandable devices can help simplify the procedure while minimizing tissue disruption, nerve retraction, and restore patient alignment.
Benefits:
- Titanium Alloy Implant with 3D Printed Textured Titanium Endplates Promotes Immediate Mechanical Fixation & Potentially Upregulating the Production of Osteogenic Factors that are Critical for Bone Growth & Fusion
- Inserted at a Reduced Height to Minimize Impaction & Preserve Endplate Integrity
- Automatic Locking Once Desired Expansion Height is Achieved Without Loss of Height Restoration Helps to Streamline Procedure
- Large Graft Window with the Ability to Pack Bone Graft After Being Expanded, Assists with Sentinel & Columnar Fusion Through the Implant
- There is No Loss of Length When the Implant is Fully Expanded – Length is Not Compromised
- Controlled & Continuous In Situ Expansion Allows for Foraminal & Disc Height Restoration
- When Expanded in the Disc Space, the Implant Optimizes Endplate-to-Endplate Fit to Assist in the Restoration of Normal Alignment
- Bulleted Tip Simplifies Insertion in Collapsed Degenerative Discs Without Compromising the Apophyseal Ring
- Adjustable Trials Reduces Trailing Steps & Accurately Determines Optimal Implant & Disc Height
- Multiple Footprints With Effective Sizing Allows for Minimally Invasive Surgery (MIS) Approach & Optimal Fit for Larger Patient Anatomies
- Streamlined Instrumentation Provides the Surgeon Minimal Tissue Disruption & Nerve Retraction While Restoring Patient Alignment
This product is not cleared by the FDA for distribution in the U.S.
NOTE:
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Flarehawk
You mean the Failhawk?
Flarehawk
Flarehawk: small entry profile, bi-directional, titanium coat option, no point loading/end plate conforming, large foot print and graft delivery.
Zavation all day long!
Zavation eZspand
Zavation EZspand!
NeuroStructures Pylon – Lordosis and Expansion accurately dialed in