PATIENT INFORMATION

Procedures

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Interbody Fusion Techniques
Treatment alternatives for low back pain include conservative care (e.g., rest, heat, analgesics, physical therapy) and surgical treatment, including laminectomy, disc resection and other types of nerve root decompression, and fusion. The intent of fusion is to restore disc space height, alignment, and stability. There are a number of ways to approach the spine.

XLIF® (eXtreme Lateral Interbody Fusion): With this procedure, the spine is approached from the side of the body. With the patient positioned on the surgical table on the side, two small incisions are made: one directly over the side of the waist, and the other slightly behind the first.

The advantages of this approach are that it does not require dissection of the sensitive back muscles or bones, or the retraction of nerves, and allows for more complete disc removal and predictable implant insertion, compared with PLIF or TLIF. Nor does it require the delicate abdominal exposure or removal of the front ligament, or present the same risk of vascular injury as an ALIF procedure.

By allowing greater access to the disc space, a larger implant can be used, which indirectly decompresses nerves by restoring disc height and spine alignment.

It is important that you discuss the potential risks, complications, and benefits of XLIF® with your doctor prior to receiving treatment, and that you rely on your physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

Maximum Access Surgery
MAS® is a unique NuVasive® technology that combines tools for accessing the spine with implants for resolving spine problems.

The MaXcess® System provides customized maximum surgical access while minimizing the soft tissue disruption that often occurs during open surgery. As opposed to “minimal access systems,” which provide minimal spinal access, minimal visualization, and minimal surgical confidence, the MaXcess System from NuVasive offers customized access and improved visualization for positioning instruments and implants. Additionally, since there are no adjunctive visualization tools (e.g., endoscope, monitor), the MaXcess System enables direct illuminated visualization of the patient's anatomy through conventional methods. This provides the surgeon all the benefits of a minimally disruptive surgical approach without compromising conventional surgical techniques.

Combined with NeuroVision,® MaXcess provides the surgeon with accurate, real-time feedback about nerve health, location, and function during surgery. Together, they create the opportunity for dramatically less disruptive spine procedures.

Nerve Avoidance Technology
During spine surgery, it is important to protect the nerves associated with the spinal column. These nerves carry messages to and from the brain, organs, and limbs, aiding them with proper movement and sensation.

The NeuroVision Intraoperative Monitoring System provides real-time, precise, and reliable feedback to ensure nerve and spinal cord safety. By using this unique and advanced technology, the surgeon is provided with intraoperative information about the location and function of the nerves, assisting with safe implant placement and surgical technique during minimally disruptive spine procedures.

Indications for Use
The NeuroVision® System is intended for use in the operating room and non-critical care clinical environment for neurological monitoring and status assessment. The System may be used alone or in conjunction with other NuVasive devices to assist in gaining controlled access to the spine.

It is important that you discuss the potential risks, complications, and benefits of the NeuroVision System with your doctor prior to receiving treatment, and that you rely on your physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

Talk to your doctor to learn more about the NeuroVision System. Or, use the Physician Locator on www.lateralaccess.org to search for a SOLAS™ surgeon in your local area.

NuVasive Biologics
The ultimate goal of fusion is to restore disc height, alignment, and stability. In order to help promote fusion, NuVasive offers a line of biologics intended to help in the bone healing process.

Osteocel® Plus is a novel biologics solution for use in various musculoskeletal applications, including spine procedures, to facilitate fusion. An allograft cellular matrix containing viable mesenchymal stem cells, it mimics the biologic profile of autograft and contains all three natural components for bone healing: osteogenic cells, osteoconductive scaffold, and osteoinductive signals. Osteocel Plus is a complete bone graft that provides an advanced solution for restoring quality of life.

FormaGraft® supplements the biologics offering as a scaffold for new bone growth. A synthetic biologic comprised of minerals naturally occurring in the body (hydroxyapatite and beta-tricalcium phosphate) and bovine collagen, when combined with bone marrow aspirate, FormaGraft offers the three necessary components for fusion.

Fusion


ALIF (Anterior Lumbar Interbody Fusion):
ALIF uses an anterior approach to the lumbar spine to achieve intervertebral disc height and alignment restoration, as well as to achieve fusion. In this procedure, the spine is approached from the front of the body. This approach spares the back from trauma but requires delicate manipulation of the major blood vessels in front of the spine. Relative contraindications for anterior lumbar fusion include osteopenia, severe peripheral vascular disease, active infection, and obesity.

PLIF (Posterior Lumbar Interbody Fusion):
PLIF was introduced in the 1950s, using grafts from the hip bone, following removal of the intervertebral disc. This procedure is performed through the middle back, which allows direct access to the area being treated. The downside is that this approach requires significant disruption to the muscles, bones, and ligaments of the back, which can lead to pain and desensitization after surgery, as well as requires the surgeon to work directly around nerves.

TLIF (Transforaminal Lumbar Interbody Fusion):
TLIF is similar to PLIF - the difference being that only one side of the back is accessed and affected. As with PLIF, significant disruption to the muscles, bones, and ligaments of the back can occur. Although most often limited to one side of the back, the TLIF procedure can sometimes lead to pain and desensitization of the back muscles after surgery. This procedure can also be performed minimally disruptively, using novel access technology such as MaXcess.®

The materials on this Web site are for your general educational information only. Information you read on this Web site cannot replace the relationship that you have with your healthcare professional. We do not practice medicine or provide medical services or advice as a part of this Web site. You should always talk to your healthcare professional for diagnosis and treatment. Please use the Physician Locator on www.lateralaccess.org to find a SOLAS™ surgeon in your area.

Nate “Rock” Quarry is a paid spokesperson for NuVasive®, Inc.