CLYDESDALE PTC Direct Lateral Interbody Fusion procedure provides spine surgeons with a complete minimally invasive solution for the treatment of degenerative lumbar conditions. By utilizing a direct lateral approach to the spine, this procedure enables placement of a large interbody graft into the disc space or anterior column support while avoiding the obstacles associated with traditional anterior or posterior approaches. The DLIF procedure incorporates a comprehensive set of instruments and implants including fully integrated neuromonitoring, streamlined access instrumentation, anatomically designed implants and percutaneous fixation systems.
Medtronic’s PTC devices represent an evolution in interbody fusion technology because they are constructed of a combination of the two materials most commonly used in interbody fusion procedures: titanium and polyetheretherketone (PEEK). Both materials have a long clinical history of being used in orthopaedic and other medical implants. Surgeons have historically preferred interbody spacers made of titanium because of their strength and long clinical history. However, over the last 10 years PEEK has largely replaced titanium as the material of choice because it has a modulus of elasticity that is similar to human cortical bone1 and it does not show up on X-rays2. This radiolucency enables the surgeon to more easily assess the surgical site over time after surgery.
With the application of a thin layer of textured pure titanium about 1/10th of a millimeter thick to the top and bottom of each PEEK implant, the PTC devices possess attributes of both PEEK and titanium. Specifically, as demonstrated in mechanical testing compared to PEEK alone, the pure titanium coating has a greater coefficient of friction.3Additionally, this textured coating increases the surface area of the implant, which means there is more area for bone to come into contact with the surface of the implant.4 Yet, the titanium layer is thin enough that it does not change the radiolucency or mechanical properties of the underlying PEEK implant.
Benefits:
- Bullet nosed tip to aid in distraction
- Convex design to contact vertebral body end plates
The Lateral Lumbar Interbody Fusion (LLIF) procedure is a minimally disruptive surgical technique in which the surgeon approaches the spine from the side of the patient’s body, rather than the front or back as in traditional spine surgeries. This side (lateral transpsoas) approach can reduce the risk of injury to muscles, nerves, and blood vessels.
The XLIF and DLIF are types Lateral Lumbar Interbody Fusion, or LLIF, which is a category of fusion in which the disc in the front of the spine is removed and replaced with an implant containing a bone graft to set up the condition for the two vertebrae to fuse together through the disc space.
XLIF uses a minimally invasive, transpsoas approach to the spine. The surgeon uses his or her finger to perform blunt dissection through a posterior paraspinal incision to escort dilators and a guide wire into position directly over the psoas muscle. Using his or her finger the surgeon is able to create a retroperitoneal space and protect the viscera and prevent possible injury.
With the DLIF technique, some surgeons have chosen to perform this procedure through a single miniopen lateral approach without the use of the posterior incision to create the retroperitoneal space. With the single incision, the layers of the abdominal wall are directly visualized, and the retroperitoneal space is created under direct vision with passage of instruments through the psoas. In addition, the use of electrophysiological monitoring, including triggered and freerunning electromyography (EMG), reduces the likelihood of injury to the lumbosacral plexus when accessing the disc space through the psoas muscle. Dilators, which contain insulated tips allow for EMG monitoring as they are introduced via the transpsoas approach to the disc space. If a dilator passes in proximity to the lumbosacral plexus, the surgeon is warned both visibly on a graphic display and also via auditory feedback. The surgeon can then adjust his or her trajectory to reduce the likelihood of neural injury.
Company: http://www.medtronic.com