1<br />NEXT GENERATION <br />MINIMALLY INVASIVE SPINE SURGERY (MISS)<br />AxiaLIFAxial Lumbar Interbody Fusion<br />Saqib ...
2<br />Agenda<br />Spinal Anatomy<br />Spine Conditions<br />Introduction to Spinal Fusion<br />Traditional Open Technique...
3<br />Spinal Anatomy<br />
4<br />Degenerative Disc Disease (DDD)<br />DDD is a slow deterioration of discs located between vertebrae. <br />Since th...
5<br />Degenerative Disc Disease (DDD)<br />The inner core of a disc, or the nucleus pulposus, is very soft and can cause ...
6<br />Spondylolisthesis<br />Occurs when one vertebra slips forward in relation to an adjacent vertebra, usually in the l...
7<br />Spondylolisthesis<br />May result from the physical stress placed on the spine, improper lifting of heavy items, we...
8<br />Spondylolisthesis<br />Depending on how far the vertebra has slipped, doctors label spondylolisthesis in four grade...
9<br />Spinal Stenosis<br />Spinal stenosis is the narrowing of the bony ring that surrounds the spinal cord. Some specifi...
10<br />Spinal Stenosis<br />This degeneration of the spine can cause pain in the back as well as in other parts of the bo...
11<br />Discogenic Issues<br />Discogenic Pain<br />Caused by a damaged disc. While this pain can be felt directly in the ...
12<br />Discogenic Issues<br />Pinched Nerve<br />Also known as radiculopathy, or sciatica, a pinched nerve in the spine o...
13<br />Discogenic Issues<br />Pinched Nerve<br />Sometimes it is difficult to identify the source of pain. For example, y...
14<br />Discogenic Issues<br />Bulging or Herniated Disc<br />Definition: a disc that is protruding beyond its normal loca...
15<br />Discogenic Issues<br />Bulging or Herniated Disc<br />Herniated Disc occurs when the jelly-like center (nucleus) o...
16<br />Spinal Fusion<br />Spinal fusion is a surgical procedure in which two or more of the vertebrae in the spine are un...
17<br />Traditional Fusion<br />
18<br />Interbody Fusion Approaches<br />
19<br />Posterior Lumbar Interbody (PLIF) Fusion <br />Direct decompression<br />Exposes dural elements<br />Retraction ri...
20<br />Anterior Lumbar Interbody (ALIF) Fusion <br />Excellent visualization of disc space<br />Avoids dural sac<br />App...
21<br />Transforaminal Lumbar Interbody (TLIF) Fusion <br />Avoids dural sac<br />Direct decompression possible<br />Poten...
22<br />Axial Lumbar Interbody (AxiaLIF) Fusion <br />Preservation of Native Tissues & Muscles<br />May Preserve Annulus<b...
23<br />AxiaLIF Pre-Sacral Fusion<br />Unique Features<br />Only interbody graft option where:<br />No muscle is dissected...
24<br />AxiaLIF Immediate Results <br />Distraction <br />Pre Op<br />Post Op<br />
25<br />AxiaLIF Immediate Results <br />Indirect Decompression & Neural Foraminal Opening<br />Pre Op<br />Post Op<br />
26<br />Addressing the Limitations<br />
27<br />AxiaLIF Benefits<br />Short term<br />Cosmetically beneficial<br />Less narcotic use<br />Earlier mobilization<br ...
28<br />AxiaLIF Clinical Studies<br />
29<br />FAQs<br />What are the risks of this procedure?<br />As with any surgical procedure, there are risks. However, whe...
30<br />FAQs<br />How long will it take to return to my daily activities?<br />Your doctor will likely recommend that you ...
31<br />FAQs<br />How much pain should I expect after the procedure is performed?<br />The amount of pain that a patient w...
32<br />FAQs<br />How many scars will I have from this procedure? How big will they be?<br />The AxiaLIF portion of the pr...
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Axia lif patient presentation

  1. 1. 1<br />NEXT GENERATION <br />MINIMALLY INVASIVE SPINE SURGERY (MISS)<br />AxiaLIFAxial Lumbar Interbody Fusion<br />Saqib Siddiqui, MD<br />
  2. 2. 2<br />Agenda<br />Spinal Anatomy<br />Spine Conditions<br />Introduction to Spinal Fusion<br />Traditional Open Techniques<br />MIS Pathway<br />AxiaLIF<br />Patient Testimonials<br />
  3. 3. 3<br />Spinal Anatomy<br />
  4. 4. 4<br />Degenerative Disc Disease (DDD)<br />DDD is a slow deterioration of discs located between vertebrae. <br />Since these discs act as a shock absorber between each vertebra, the reduction or loss of disc height can cause pain. <br />The degenerated disc is not getting enough nutrients and will not be able to repair itself once injured.<br />
  5. 5. 5<br />Degenerative Disc Disease (DDD)<br />The inner core of a disc, or the nucleus pulposus, is very soft and can cause severe leg pain if it comes into contact with the surrounding nerves. <br />If the outer portion, or annulusfibrosus, tears, the nucleus pulposus can herniate and can cause back pain. <br />
  6. 6. 6<br />Spondylolisthesis<br />Occurs when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine. <br />Symptoms include pain in the low back, thighs and/or legs, muscle spasms, weakness, and/or tight hamstring muscles. <br />Some people are symptom free and find the disorder exists when revealed on an x-ray. <br />
  7. 7. 7<br />Spondylolisthesis<br />May result from the physical stress placed on the spine, improper lifting of heavy items, weightlifting, football, gymnastics, trauma, and general wear and tear. <br />As the vertebral components degenerate, the spine’s integrity is compromised. Pain is the primary symptom associated with spondylolisthesis.<br />
  8. 8. 8<br />Spondylolisthesis<br />Depending on how far the vertebra has slipped, doctors label spondylolisthesis in four grades, I (one) being the least amount of slippage, all the way up to IV (four), which is the most slippage. <br />Not all cases of spondylolisthesis require surgery.<br />
  9. 9. 9<br />Spinal Stenosis<br />Spinal stenosis is the narrowing of the bony ring that surrounds the spinal cord. Some specific conditions that can cause spinal stenosis include:<br />Bone spurs<br />Disc degeneration<br />Arthritis<br />This condition is most common in elderly people, who have had years of wear-and-tear on their intervertebral discs.<br />
  10. 10. 10<br />Spinal Stenosis<br />This degeneration of the spine can cause pain in the back as well as in other parts of the body. <br />The narrowing of the spinal canal can lead to reduction in oxygen and blood to the spinal cord, and can cause numbness in pain from irritated nerves and lack of blood flowing through the spine.<br />
  11. 11. 11<br />Discogenic Issues<br />Discogenic Pain<br />Caused by a damaged disc. While this pain can be felt directly in the lower back, it may also be felt outside of the area of the damaged disc, such as in the buttocks or upper thighs. <br />Specific movements that put stress on this damaged disc can worsen the pain. The pain may radiate to different areas of the body via the irritated nerve roots.<br />
  12. 12. 12<br />Discogenic Issues<br />Pinched Nerve<br />Also known as radiculopathy, or sciatica, a pinched nerve in the spine occurs when something rubs or presses on a nerve to cause irritation. This irritation can lead to numbness in a specific area of the body.<br />
  13. 13. 13<br />Discogenic Issues<br />Pinched Nerve<br />Sometimes it is difficult to identify the source of pain. For example, you may experience pain in your buttocks, leg or foot which is directly associated with an irritation in your lower back. This pinched nerve can cause weakness in muscles and loss of reflexes in the location of your pain.<br />Herniated discs and collapsed discs are the most common causes of a pinched nerve. Less common causes include bone spurs, fractures or tumors.<br />
  14. 14. 14<br />Discogenic Issues<br />Bulging or Herniated Disc<br />Definition: a disc that is protruding beyond its normal location between vertebrae.<br />Bulging discs are somewhat common.<br />Can occur in the aging process of an adult. <br />Can occur with the degeneration of an intervertebral disc. <br />
  15. 15. 15<br />Discogenic Issues<br />Bulging or Herniated Disc<br />Herniated Disc occurs when the jelly-like center (nucleus) of the intervertebral disc ruptures and tears.<br />Only becomes cause for alarm when it compresses a nerve root. <br />Causes material to be pushed outside of the disc, causing pain.<br />Pressure on the spinal cord and nerve roots cause pain, weakness, and/or numbness to certain areas of the body, similar to a pinched nerve.<br />
  16. 16. 16<br />Spinal Fusion<br />Spinal fusion is a surgical procedure in which two or more of the vertebrae in the spine are united together so that motion no longer occurs between them. <br />The diseased disc is removed and replaced with supplementary bone tissue. Ideally, this bone tissue allows the adjacent vertebrae to fuse together, thus immobilizing the vertebrae.<br />Various hardware is often used to hold the vertebrae together while this fusion process occurs. <br />Spinal fusion can restore stability, correct alignment & reduces pain.<br />
  17. 17. 17<br />Traditional Fusion<br />
  18. 18. 18<br />Interbody Fusion Approaches<br />
  19. 19. 19<br />Posterior Lumbar Interbody (PLIF) Fusion <br />Direct decompression<br />Exposes dural elements<br />Retraction risks to nerves<br />
  20. 20. 20<br />Anterior Lumbar Interbody (ALIF) Fusion <br />Excellent visualization of disc space<br />Avoids dural sac<br />Approach risks to organs and vascular structures<br />No decompression option<br />
  21. 21. 21<br />Transforaminal Lumbar Interbody (TLIF) Fusion <br />Avoids dural sac<br />Direct decompression possible<br />Potential nerve irritation<br />
  22. 22. 22<br />Axial Lumbar Interbody (AxiaLIF) Fusion <br />Preservation of Native Tissues & Muscles<br />May Preserve Annulus<br />Robust Anterior & Posterior Fixation<br />Dynamic Decompression via Distraction <br />
  23. 23. 23<br />AxiaLIF Pre-Sacral Fusion<br />Unique Features<br />Only interbody graft option where:<br />No muscle is dissected<br />No ligaments are cut<br />The disc annulus is preserved<br />
  24. 24. 24<br />AxiaLIF Immediate Results <br />Distraction <br />Pre Op<br />Post Op<br />
  25. 25. 25<br />AxiaLIF Immediate Results <br />Indirect Decompression & Neural Foraminal Opening<br />Pre Op<br />Post Op<br />
  26. 26. 26<br />Addressing the Limitations<br />
  27. 27. 27<br />AxiaLIF Benefits<br />Short term<br />Cosmetically beneficial<br />Less narcotic use<br />Earlier mobilization<br />Decreased hospital stay<br />Faster return to work<br />Long term<br />Less muscle atrophy, denervation <br />Better support of lordosis, strength<br />Long term prevention adjacent level disease<br />
  28. 28. 28<br />AxiaLIF Clinical Studies<br />
  29. 29. 29<br />FAQs<br />What are the risks of this procedure?<br />As with any surgical procedure, there are risks. However, when compared to other fusion procedures which enter your spine through the abdomen (ALIF) or directly through the back (PLIF), AxiaLIF has fewer risks. There is no need to bypass vital nerves, arteries or muscle, and no need to strip back muscles from your spine to get to the diseased disc. This sparing of soft tissue and muscle provides fewer risks and complications after your surgery. <br />How long will it take to get back to work?<br />Many people can return to work in as little as 15 days. However, individual results may vary. <br />
  30. 30. 30<br />FAQs<br />How long will it take to return to my daily activities?<br />Your doctor will likely recommend that you restrict your activity immediately after your AxiaLIF surgery. After about two weeks, most AxiaLIF patients will be able to resume normal daily activities. However, results do vary from patient to patient.<br />How long will I have to stay in the hospital after surgery?<br />For a traditional fusion surgery, the average length of stay is four days*. AxiaLIF length of stay is typically one to two days. Some AxiaLIF procedures are performed on an outpatient basis and patients go home on the day of surgery. <br />*Selected Percentile Lengths of Stay, FY06 Final Notice Data, CMS 2006. <br />
  31. 31. 31<br />FAQs<br />How much pain should I expect after the procedure is performed?<br />The amount of pain that a patient will experience immediately following the procedure can vary. This discomfort will tend to diminish over a short period of time.<br />The AxiaLIF procedure results in less soft tissue disruption than other fusion approaches which means that post-op pain is often less intense for AxiaLIF patients. Please keep in mind that any surgery, even minimally invasive, involves some pain and recovery time. AxiaLIF patients tend to show significant improvement in back pain as a result of their surgery.<br />
  32. 32. 32<br />FAQs<br />How many scars will I have from this procedure? How big will they be?<br />The AxiaLIF portion of the procedure creates only one scar which is about one-inch long and located next to your tailbone. Depending upon your condition, you may require further stabilization in your spine that would result in additional incisions/scars.<br />

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