Design makes a difference: Key concepts for achieving clinical success

Spine

Research has shown that restoring appropriate sagittal balance can deliver positive patient outcomes. When looking to address sagittal imbalance and maximize opportunities for fusion, implant design makes a significant difference. Surgeons have many options when selecting the best implant and approach to address sagittal imbalance and improve fusion outcomes for their patients. Centinel Spine’s STALIF technology is specifically designed to support surgeons in achieving these key goals.

The technology has a long history of clinical success and every feature of the technology is supported by a sound design rationale. STALIF devices were designed with patient anatomy in mind; they provide anterior column support with large footprints to increase the proportion of the implant that seats on the apophyseal ring, offer a range of lordotic and anatomic options to support segmental lordosis restoration and are available in a variety of heights and widths to best match each patient’s unique disc space. Additionally, the system’s integrated cancellous lag screws compress the endplates to the implant and bone graft, providing additional stability, securing sagittal alignment, and optimizing the fusion environment in line with Wolff’s Law for bone re-modelling.

“The biomechanical difference is created by the integrated screws self-contained within the implant and anterior column. This integration along with the cancellous screws produces a lag effect between the vertebral bodies and the implanted device. The lag effect provides constant compressive forces against the implant and graft material to promote fusion” says James Billys, MD, Florida Orthopaedic Institute, Temple Terrace, FL.

In a recent clinical article by Michael Bottlang in the Journal of Bone and Joint Surgery, it was shown that locked plate implants may be too stiff to provide the necessary dynamism needed to heal fractures, thereby creating non-unions. When fixation is rigidly locked to an interbody implant, loads cannot be transferred efficiently and the increased stiffness produces a phenomenon known as stress shielding, which competes with Wolff’s Law. STALIF implants are designed to achieve immediate and continued load-sharing and segmental stability. The technology includes integrated cancellous lag screws that co-function with the interbody cage and the vertebral bodies during the healing process to form a highly stable integrated fusion construct. These integrated screw elements conform to AO principles of fracture fixation, increasing the possibility of fusion.

There are additional clinical benefits to STALIF technology. In traditional spine systems with a spacer and a locking plate, the plate can sit outside the vertebral body, which may lead to dysphagia in the cervical spine, or vascular/nerve complications in the lumbar spine. STALIF has a no-profile design that sits fully within the confines of the anterior column; as a result, the external anatomy remains undisturbed. Surgeons also report longer surgical time with traditional techniques; the reduced complexity and decreased surgical steps of the STALIF technology in combination with its sterile packaged implants may reduce operating time and decrease OR costs.

"I choose to use STALIF implants in my spinal fusion procedures because they provide me and my patients the benefits of a muscle sparing approach with good sagittal restoration, indirect decompression of the neural structures, yet also provide compression at the graft site with no secondary locking step," said Dr. Billys. He continued “I and my staff also appreciate the simplicity and quality of the instrumentation. It increases our efficiency, saves us precious operating time, and decreases patient recovery time. It is a win-win for my entire practice.”

There have been well over 40,000 STALIF, Integrated Interbody devices implanted worldwide since 1991. STALIF was the first No Profile Integrated Interbody device in the spinal fusion market and it has continually evolved to remain the leading technology today. The STALIF family of products includes STALIF C-Ti, MIDLINE II-Ti and STALIF L.

 

LBL253 Rev1

 

This article is sponsored by Centinel Spine.

 

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