Long-Term Study Proves Minimally Invasive Surgery
Effective for Correcting Spinal Deformities
CONTACT: Trace Longo
LOS ANGELES, Calif. – An estimated six million people in the United States have some form of scoliosis, a condition in which the curves of the spine are abnormal, causing strain on the body. Among the most common myths about scoliosis and other spinal deformities is that surgery to correct them is extremely invasive and painful, or that they cannot be corrected with surgery at all.
The results from a new long-term study published in the August 15, 2013 issue of the journal Spine show that minimally invasive surgery (MIS) is effective for the long-term correction of spinal deformities, including adult scoliosis. Spearheaded by Neel Anand, M.D., clinical professor of surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles, the study evaluates the overall efficacy of MIS, compared to open lumbar fusion, over two to five years and finds that a combination of three novel MIS techniques provides correction of adult spinal deformity comparable to traditional “open” surgery, but with significantly improved functional outcomes, excellent clinical and radiological improvement, and enhanced recovery times because of reduced blood loss and complication rates at early and long term follow-up.
“This is a concept we pioneered nearly 10 years ago and now we have the clinical data to demonstrate the positive long-term results of minimally invasive strategies for the correction of spinal deformities,” says Dr. Anand. “This study is especially significant for our country’s aging population in which many suffer from degenerative scoliosis. The minimally invasive techniques make it feasible for them to have their condition corrected, which otherwise would have been too invasive and painful using traditional methods.”
Over the two to five-year period, Dr. Anand and co-investigators reviewed 71 patients between the ages of 20-84 who underwent MIS correction of spinal deformity with fusion of two or more levels including degenerative scoliosis (54), idiopathic scoliosis (11), and iatrogenic scoliosis (6). All patients underwent a combination of three MIS techniques including segmental multi-level percutaneous pedicle screw fixation (posterior instrumentation) (67), direct lateral interbody fusion (DLIF) (66), and axial lumbar interbody fusion (AxiaLIF) (34). Thirty-six patients were staged with DLIF performed first followed by the posterior instrumentation and fusion including AxiaLIF done three days later.
Patients with one-stage same day surgery (<3 levels) had a mean blood loss of 412 ml and a mean surgical time of 291 minutes. Patients with two-stage surgery (>4 levels) had a mean blood loss of 314 ml and surgical time of 183 minutes for DLIF and 357 ml and 243 minutes respectively for posterior instrumentation and AxiaLIF. The mean hospital stay was 7.6 days including the three days between stages. As a result, blood loss and surgical complications were considerably less than those associated with more traditional open deformity correction procedures. At long term follow-up there was also a significant improvement in all functional and disability domains.
“This is the first study documenting the long term results of minimally invasive correction techniques for spinal deformity and it represents a paradigm shift in the way scoliosis can be effectively treated,” adds Dr. Anand.
Neel Anand, MD, Mch Orth, Eli M. Baron, MD, Babak Khandehroo, MD, and Sheila Kahwaty, PA-C. Long-term 2- to 5-Year Clinical and Functional Outcomes of Minimally Invasive Surgery for Adult Scoliosis. Spine, Volume 38, Number 00, August 00, 2013.
THE ANAND SPINE GROUP SELECTED TO STUDY
FACET JOINT REPLACEMENT SURGERY
Clinical Trial Studies Facet Joint Replacement Surgery Utilizing the Investigational ACADIA™ Facet Replacement System to Treat Lumbar Spinal Stenosis
CONTACT: Trace Longo
The Anand Spine Group in Los Angeles has received approval to participate in a clinical trial that may redefine surgery for low back and leg pain. The study, which will be led by Dr. Neel Anand, orthopedic spine surgeon and medical director of The Anand Spine Group, focuses on a new concept in spine surgery called Facet Joint Replacement. The Anand Spine Group is one of a select group of spine centers throughout the U.S. taking part in the landmark IDE study.
“We are very excited to be selected as investigators in the Facet Replacement study because it offers a unique opportunity for our patients who meet the study’s criteria to participate in cutting-edge research for lower back and leg pain,” said Dr. Anand.
The Facet Joint Replacement (FJR) study surgery utilizes investigational artificial facet joints called the ACADIA Facet Replacement System that is designed to help recreate the motion and function of healthy facet joints. These artificial facet joints are designed to provide stability to the spine without the potential loss of motion associated with spinal fusion and to enable vertebrae to move naturally in relation to one another.
“Just like knee and hip replacements, Facet Joint Replacement surgery has the potential to eliminate pain without eliminating the body’s natural range of motion,” said Dr. Anand. “We believe this new surgery could be a safer and more effective alternative to conventional spinal fusion.”
Approximately 1.2 million U.S. adults suffer from lumbar spinal stenosis, a condition in which the spinal canal narrows which can cause nerve compression and irritation. This can lead to debilitating pain, tingling, or numbness in the lower back and legs. Each year, hundreds of thousands of patients undergo surgery to treat chronic back and leg pain due to lumbar spinal stenosis. Conventional surgery for this condition involves the permanent fusing together of spine bones and joints to stabilize the spine. While effective, this also eliminates natural motion between these bones, and may cause surrounding spine bones to take on added stress, leading to further spine degeneration.
The IDE study is sponsored by Globus Medical, Inc. Study participants must be between the ages of 21 and 85 with a history of low back and leg pain. Patients can learn more about the ACADIA™ Facet Replacement System IDE study at The Anand Spine Group by contacting Dr. Anand’s clinical coordinator Amy Johnson at (310) 423-9209.
The Anand Spine Group Now Offering Patients New iFuse Implant System For Treatment of Sacroiliac Joint Problems
CONTACT: Trace Longo
The Anand Spine Group in Los Angeles recently announced that it is now offering patients with sacroiliac (SI) joint disruptions and degenerative sacroiliitis, a new minimally invasive spine surgery using the iFuse Implant System.
“We are very excited to offer the iFuse Implant System to our patients because it offers them a clinically proven solution for an often undiagnosed and mistreated condition,” said Dr. Neel Anand, orthopedic spine surgeon and medical director of The Anand Spine Group.
The iFuse Implant System, developed by San Jose, CA-based SI-BONE, Inc., is a commercially available device in the U.S. that is intended for the fixation of large bones and large bone fragments of the pelvis for SI joint maladies. iFuse is a minimally invasive surgical procedure for the delivery and implantation of small, titanium implants. The implants are coated with a porous plasma spray that acts as an interference surface, designed to help decrease implant motion. These implants also have substantial thickness and sophisticated metallurgy and are able to produce a much stronger construct than that of conventional pins or screws used to surgically fix boney structures.
The iFuse Implant System offers the following benefits for patients:
- Less invasive than traditional open surgery with no extensive soft tissue stripping
- Straightforward minimally invasive surgical approach
- Rigid titanium implants provide immediate post-op SI joint stability
- Porous plasma spray coating with irregular surface designed to support stable bone fixation/fusion
- Biomechanically rigorous implant designed specifically to stabilize the heavily loaded SI joint
- Recovery is on average 2 weeks as opposed to 6 months.
“We believe this new implant system will improve surgical outcomes and reduce recovery times by more than five months because of its minimally invasive surgical approach and biomechanical design,” added Dr. Anand.
According to studies, more than 22% of individuals who presented with lower back complaints actually had problems in their SI joint. There are approximately one million patients annually with low back complaints that have SI joint problems like degenerative arthritis and/or mal-unions of pelvic trauma. Additional studies show that nearly 25% of all low back pain is sacroiliac joint in origin and that the diagnosis of sacroiliac joint disease is frequently overlooked by physicians.
SI joint problems often mimic discogenic or radicular low back pain. Many low back pain patients go on to receive lumbar fusion surgery instead of sacroiliac joint fixation/fusion. As a result, sacroiliac joint disease is becoming for frequently considered in differential diagnosis of low back pain. A recent study shows that the incidence of SI joint degeneration in post-lumbar fusion surgery is 75% at 5 years post surgery.
Despite the large number of patients with SI joint symptoms, most of the treatment focus in the spine is centered on the disc. Orthopedic residents and neurosurgical residents are rarely taught to consider SI joint arthritis and/or old trauma as the cause of the patient’s problems. In addition, few, if any, lumbar MRI’s extend below S1 to examine the sacroiliac SI joint.
For more information about the iFuse Implant System or to schedule an appointment, please call The Anand Spine Group at (310) 423-9209.