25 years ago, Synthes introduced the Click`X, one of the first modular pedicle screw systems on the market. This product, while highly successful, also sparked controversy among spine surgeons. It certainly had advantages in introducing the screw without the tulip, allowing for insertion at the beginning of surgery with greater visibility of the pedicles and then being able to work on the spine without the tulips getting in the way. However, it also had its detractors due to the distrust in the screw-tulip connection or concerns about its long-term performance and fixation.
Today, modular spine screw systems have become increasingly popular, with a growing variety of options available in the market. Several factors contribute to this trend:
- Minimally Invasive Surgery (MIS) Compatibility: Modular spine pedicle screw systems are compatible with minimally invasive surgical techniques, offering benefits such as smaller incisions.
- Midline Approach Surgery: These systems provide visibility advantages, particularly in midline approach surgeries, enhancing surgical precision and outcomes.
- Market Segmentation: Surgeons’ preferences vary widely, with some embracing modular screw systems while others remain skeptical. In response, companies in the market strive to cater to the diverse needs of surgeons by offering products tailored to different preferences and practices.
As in 1997, with the Click`X, concerns persist regarding the potential risks of assembly errors or compatibility issues between modular components during surgery. Mismatched or improperly fitted components can compromise the stability and effectiveness of the implant, necessitating intraoperative adjustments or replacement.
However, technology has advanced significantly, and these systems undoubtedly provide reliability and numerous advantages:
- optimize visualization,
- increase options for distraction,
- allow a better decortication,
- can be implanted via a conventional open approach, midline, or minimally invasive.
- Eliminates tulip interference throughout the procedure.
As we look to the present day, we update the list of modular screw systems to include 20 leading options:
- TiLock Modular Spinal System (Genesys Spine)
- Ventotene (Tsunami Medical)
- ARx Spinal Fixation System
- Apelo Pedicle Screw System
- CentraFix Midline Fixation System
- CREO AMP®
- CD Horizon™ ModuLeX™ 5.5 spinal system
- Centerline Modular
- Canaveral Modular
- DIPLOMAT®
- Firebird NXG
- F1 MPS™
- Golden Isles Pedicle Screw System™
- Inertia® Connexx™ Modular Screw System
- Mariner® Pedicle Screw System
- Masada
- MOSS VRS
- Reform® Modular Pedicle Screw System
- Salvo® 5.5/6.0mm Spine System
- Taurus™ Modular Thoracolumbar Pedicle System
- Whistler Modular Pedicle Screw System
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