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Axia lif patient presentation

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1 Saqib Siddiqui, MD NEXT GENERATION MINIMALLY INVASIVE SPINE SURGERY (MISS) AxiaLIF Axial Lumbar Interbody Fusion
Transcript
Page 1: Axia lif patient presentation

1

Saqib Siddiqui, MD

NEXT GENERATION MINIMALLY INVASIVE

SPINE SURGERY (MISS)

AxiaLIFAxial Lumbar Interbody Fusion

Page 2: Axia lif patient presentation

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Agenda

Spinal Anatomy

Spine Conditions

Introduction to Spinal Fusion

Traditional Open Techniques

MIS Pathway

AxiaLIF

Patient Testimonials

Page 3: Axia lif patient presentation

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Spinal Anatomy

Page 4: Axia lif patient presentation

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Degenerative Disc Disease (DDD)

DDD is a slow deterioration of discs located between vertebrae.

Since these discs act as a shock absorber between each vertebra, the reduction or loss of disc height can cause pain.

The degenerated disc is not getting enough nutrients and will not be able to repair itself once injured.

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Degenerative Disc Disease (DDD)

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.

If the outer portion, or annulus fibrosus,

tears, the nucleus pulposus can herniate

and can cause back pain.

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Spondylolisthesis

Occurs when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine.

Symptoms include pain in the low back, thighs and/or legs, muscle spasms, weakness, and/or tight hamstring muscles.

Some people are symptom free and find the disorder exists when revealed on an x-ray.

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Spondylolisthesis

May result from the physical stress placed on the spine, improper lifting of heavy items, weightlifting, football, gymnastics, trauma, and general wear and tear.

As the vertebral components degenerate, the spine’s integrity is compromised. Pain is the primary symptom associated with spondylolisthesis.

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Spondylolisthesis

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.

Not all cases of spondylolisthesis

require surgery.

Page 9: Axia lif patient presentation

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Spinal Stenosis

Spinal stenosis is the narrowing of the bony ring that surrounds the spinal cord. Some specific conditions that can cause spinal stenosis include: Bone spurs Disc degeneration Arthritis

This condition is most common in elderly people, who have had years of wear-and-tear on their intervertebral discs.

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Spinal Stenosis

This degeneration of the spine can cause pain in the back as well as in other parts of the body.

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.

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Discogenic Issues

Discogenic Pain 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.

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.

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Discogenic Issues

Pinched Nerve 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.

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Discogenic Issues

Pinched Nerve

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.

Herniated discs and collapsed discs are the most common causes of a pinched nerve. Less common causes include bone spurs, fractures or tumors.

Page 14: Axia lif patient presentation

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Discogenic Issues

Bulging or Herniated Disc Definition: a disc that is protruding

beyond its normal location between

vertebrae.

Bulging discs are somewhat

common.

Can occur in the aging process of

an adult.

Can occur with the degeneration of

an intervertebral disc.

Page 15: Axia lif patient presentation

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Discogenic Issues

Bulging or Herniated Disc Herniated Disc occurs when the jelly-like

center (nucleus) of the intervertebral disc ruptures and tears.

Only becomes cause for alarm when it compresses a nerve root.

Causes material to be pushed outside of the disc, causing pain.

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.

Page 16: Axia lif patient presentation

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Spinal Fusion

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.

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.

Various hardware is often used to hold the vertebrae together

while this fusion process occurs.

Spinal fusion can restore stability, correct alignment & reduces

pain.

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Traditional Fusion

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Interbody Fusion Approaches

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Posterior Lumbar Interbody (PLIF) Fusion

Direct decompression

Exposes dural elements

Retraction risks to nerves

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Anterior Lumbar Interbody (ALIF) Fusion

Excellent visualization of disc

space

Avoids dural sac

Approach risks to organs and

vascular structures

No decompression option

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Transforaminal Lumbar Interbody (TLIF) Fusion

Avoids dural sac

Direct decompression possible

Potential nerve irritation

Page 22: Axia lif patient presentation

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Axial Lumbar Interbody (AxiaLIF) Fusion

Preservation of Native

Tissues

& Muscles

May Preserve Annulus

Robust Anterior & Posterior

Fixation

Dynamic Decompression via

Distraction

Page 23: Axia lif patient presentation

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AxiaLIF Pre-Sacral Fusion

Unique Features

Only interbody graft option where: No muscle is dissected

No ligaments are cut

The disc annulus is preserved

Page 24: Axia lif patient presentation

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AxiaLIF Immediate Results

Distraction

Pre Op Post Op

Page 25: Axia lif patient presentation

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AxiaLIF Immediate Results

Indirect Decompression & Neural Foraminal Opening

Pre Op Post Op

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Addressing the Limitations

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AxiaLIF Benefits

Short term Cosmetically beneficial

Less narcotic use

Earlier mobilization

Decreased hospital stay

Faster return to work

Long term Less muscle atrophy, denervation

Better support of lordosis, strength

Long term prevention adjacent level disease

Page 28: Axia lif patient presentation

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AxiaLIF Clinical Studies

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FAQs

What are the risks of this procedure? 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.

How long will it take to get back to work? Many people can return to work in as little as 15 days.

However, individual results may vary.

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FAQs

How long will it take to return to my daily activities? 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.

How long will I have to stay in the hospital after surgery? 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.

*Selected Percentile Lengths of Stay, FY06 Final Notice Data, CMS 2006.

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FAQs

How much pain should I expect after the procedure is performed? 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.

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.

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FAQs

How many scars will I have from this procedure? How

big will they be? 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.


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