Motion-Preserving Technology

Motion-Preserving Technology that changes lives!

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If you’re dealing with pain and have exhausted all non-surgical treatments, and now find yourself considering surgery, it’s important to consider options that prioritize preserving the mobility of your spine. Such options include Artificial Disc Replacement, Facet Joint Replacement, and Dynamic Stabilization Systems (DSS) which focus on maintaining movement while addressing your pain.

While a spinal fusion may be necessary in certain cases, our spine specialists view it as a last resort when other motion-preserving solutions are not feasible. Artificial Disc Replacement (ADR), Facet Joint Replacement and Dynamic Stabilization Systems (DSS) are surgical procedures designed to alleviate pain and restore healthy movement to your affected spine.

Unlike a traditional spinal fusion, which can restrict movement in exchange for pain relief, these advanced procedures aim to restore the natural height of your spine and enable controlled motion. This approach can help eliminate pain and assist you in regaining an active and healthy lifestyle.

Motion-Preserving Spine Surgeries

If you have tried conservative therapies and are now facing spine surgery, your priority is to preserve motion.

The spine is a mobile structure, and a fusion is an irreversible interference in the mechanics of the spine. Even though a fusion is sometimes required, ONZi views it as a “last line of defence” and for cases where a new motion-preserving solution cannot be offered.

Both Artificial Disc Replacement (ADR) and Total Lumbar Facet Replacement are surgeries designed to reduce pain and restore healthy movement to a damaged spine.

Artificial Disc Replacement (ADR) Technology

The ONZi specialists are experienced with multiple ADR implant models for use in the Cervical and Lumbar spine, including the most innovative and most studied devices worldwide. Advanced disc implants are designed to replicate the movement of a natural disc. The newer generation devices offer 6 degrees of movement, including vertical compression, with resistance increasing towards the end of every motion. This technology helps protect the facet joints and allows for safer, multi-level use in suitable patients.

Your spinal discs are positioned between each bony vertebra in your spine. They hold the vertebra together, absorb shock, and act as joints allowing multi-directional, controlled mobility of your spine.

Artificial Disc Replacement (ADR) is sometimes called Total Disc Replacement (TDR).

This surgical procedure involves removing a bulging or herniated spinal disc in the neck or lower back and replacing it with an artificial disc. A traditional spinal fusion treats pain by fixing one vertebra to the next and eliminating movement. New-generation ADR treats pain by restoring natural height and providing controlled movement for a healthy lifestyle.

The newest ‘Third Generation’ artificial discs are so advanced they mimic a healthy disc and provide 6 degrees of motion.

The Elastic Spine Pad (ESP)

The spine prosthesis consists of two titanium alloy end plates and an elastomeric cushion. The outer surfaces of the end plates have spikes to enhance primary fixation. The combination of a hydroxyapatite (HA) coating on top of a T40 rough surface is considered one of the best coatings available. The titanium alloy used for the end plates allows for clear medical imaging and ensures strong bony fixation over time.

The prosthesis is designed to replicate the properties of a natural disc. The elastomeric parts injected between the two titanium end-plates provide controlled resistance to compression, flexion, and rotation. These concentric elastomeric parts are securely fixed, preventing micro motion. The materials used in the implants have undergone biocompatibility testing according to ISO standard 10993.

The surgery to implant the prosthesis follows a minimally invasive anterior (front) approach, which reduces hospital stay and improves rehabilitation. The prosthesis has been tested for durability, withstanding up to 40 million cycles.

The use of this prosthesis, known as ESP, is expected to significantly reduce the severity of pain, restore the natural lumbar curvature, and promote normal disc function. It allows for a quick return to normal daily activities.

CP ESP
(Cervical prosthesis)

LP ESP
(Lumbar prosthesis)

6 Degrees of Freedom

Lateral Flexion | Vertical Translation | Lateral Translation | Flexion/Extension | Anterior-Posterior Translation | Axial Rotation

ADR Resources

Total Facet Replacement

There are two facet joints located at every level of your spine. Their function is to guide and limit the movement of the spinal discs. Sometimes through traumatic injury or wear-and-tear, the facet joints become damaged and painful.

How does Facet Joint Replacement Work?

Total Lumbar Facet Replacement is a new ground-breaking procedure available from leading spine surgeons. It involves the removal of your damaged facet joints via the posterior approach (from the back) and replacing them with a set of artificial facet joints. The artificial facet joints are designed to restore your vertebrae to their safe and correct position while removing pain, but retaining healthy movement.

Total Lumbar Facet Replacement is a new ground-breaking procedure. It can be offered to patients desiring a motion-preserving solution, who may not be suitable candidates for Artificial Disc Replacement (ADR).

Total Facet Joint Resources

HPS ™ 2.0 coupler is a universal system for the stabilization of the spine, with a controlled range of motion and physiological quality of movement. It allows for multi-segmental fusion with the option of dynamic stabilization of the cranial segment.

The aim is to shorten the length of fusion and to thus reduce the risk of degeneration in the adjacent segments. The dynamic coupler controls the movement of the spine in all directions. Mobility is ensured for flexion, extension and lateral bending, while translation and axial rotation are reduced to a minimum. The capacity for controlled axial adjustments in length permits changes in the distance between the pedicles of just under 2 mm. This allows the system to cushion axial forces; to reduce the load on facet joints and intervertebral discs, and preserve the physiological centre of rotation in the index and adjacent segments.

https://surgalign.com/en_gb/product/hps-hybrid-performance-system/

HPS 2.0 Hybrid Performance System

The lower back can be exposed to great force and pressure from normal daily tasks, and it’s common to see the Lumbar spine become painful and symptomatic over time. This can be caused by the natural ageing process, or by unexpected injury.

If a patient cannot manage their symptoms with conservative treatments like physiotherapy and exercise programs, surgery might be indicated. The goal of any spinal surgery is to decrease pain, correct the bony-spinal deformity, and improve stability.

Different techniques, equipment, materials, and medical devices are utilized in all spinal procedures. The procedures can be performed through a traditional open incision or via a minimally invasive procedure depending on the patient’s anatomy, condition, and diagnosis. For patients requiring a spinal fusion or fixation, the older generation of devices used stiff rods, while newer ones allow for flexibility and mobility due to the hinged screw attached to stabilizing rods.

Dynamic Stabilization System (DSS) is a unique surgical technique that uses a single-level system for non-cervical vertebrae fixation from the T4 to S1 to provide immobilization and stabilization of adult spinal segments. It is used as an alternative to fusion in the treatment of acute and chronic conditions or deformities of the lumbar, and sacral spine. DSS allows for some movement of the spine but also maintains enough stability to prevent excess movement. Pedicle-based dynamic devices unload the pressure on the degenerated disc and facets and, thus, have the potential to reduce pain associated with these damaged structures.

DSS can also be used alongside Artificial Disc Replacement (ADR) in the Lumbar Spine to create a 360-degree motion-preserving solution in carefully selected patients. Furthermore, these devices can be used to prevent disease to adjacent structures and can stabilize posterior destabilizing surgeries such as wide laminectomy and facetectomy.

For patients looking to avoid rigid spine fixation (fusion) DSS systems are similar to Total Facet Joint Replacement which is also a motion-preserving technology that has been used in Europe for 10+ years.

Sometimes a fusion is the most suitable option

Not everyone is an ideal candidate for a motion-preserving solution. Sometimes restoring full movement to a spine with these implants will cause more pain than before, or cause the spine to collapse further in the wrong direction. In these cases, a reconstructive fusion may be required to decompress the spine, restore full height, and hold it safely in the correct position.

Additional Resources