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Source : Shutterstock metal rods and screws rears its ugly head .
Lumbar spine fusion is a well-established standard of care for treating degenerative spondylolisthesis , stenosis and other spine pathologies . While spine fusion success rates are high , between 65-95 %, they are not without potential complications . [ ii ]
In strong , non-osteoporotic bone , pedicle screw loosening rates are about 1-15 %. In osteoporotic bone those rates soar to more than 60 %. Old
[ iii ] [ iv ] spines need new ideas .
What would spine fusion look like , particularly in patients with low bone density if implant fixation and the resulting spinal stabilization was non-metal ?
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Spine surgeons want to do the right thing , which can also mean doing the familiar thing . But , when the patient is older or diabetic or under a course of care that affects bone quality , then is a big spine fusion surgery where a mass of metal is deployed to treat spinal stenosis , degenerative spondylolisthesis and perhaps instability , still “ the right thing ?”
“ Probably not ,” says Pierce D . Nunley , M . D ., founder and director of the Spine Institute of Louisiana . “ When it comes time to discuss surgery with my over-65 patients who have spondylolisthesis , low bone mass , and stenosis , I show them a model with the two options : on one side a bulky pedicle screw model , and the other side a metal-free , small zip tie-looking strap made of PEEK .”
“ Once they see that , no one wants the metal .”
Fixation and Stability for Older Spines – It ’ s Karma !
“ We have no shortage of patients contending with complications associated with the aging spine ,” states Dr . Nunley . “ These cases can be particularly complex , so we need evolved solutions such as Karma . This device gives surgeons a sense of confidence that they have a spinal device that addresses the challenges in treating the aging spine patient .
The “ this is what you ’ ve been waiting for ” procedural solution — known as the Karma Posterior Fixation System — was designed by the engineers at Spinal Elements to perform in either an open or MIS [ minimally invasive surgery ] approach .
It ’ s a low-profile device that successfully stabilizes the spine during the fusion and throughout the healing process . It ’ s Karma !!
Fusion plus hardware works like a charm — until it doesn ’ t . The key , we know , is patient selection . Not all patients need metal . Fact is , estimates of lumbar fusion failure rates remain stubbornly in the 30 % to 46 % range . [ v ] Should it really be called “ the gold standard ?”
Old Spines Need New Ideas
In 2020 , according to the World Health Organization , 619 million people had low back pain , globally .
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