[ NEWS - FEATURE ]
By 2050 , because of aging and population growth , that number could very well rise to as much as 843 million cases . [ vi ]
Face it , old spines are a growth industry . Every spine surgeon needs ( and patients deserve ) rigorously tested and viable options for any patient who presents with life altering back pain yet contends with low bone density .
Anchoring for Stability – It ’ s Good Karma !
Karma is the first-ever spine fixation device to take advantage of the corticopedicular corridor — the densest portion of the spine .
“ You get exceptional purchase with Karma because you are drilling through four areas of cortical bone — the part of the spine with the most closely compacted bone ,” says Dr . Nunley . “ The density of cortical bone is far less effected by age-related degeneration , so surgeons can obtain excellent fixation via good quality , stable bone .”
And with a recent study indicating that corticopedicular fixation is safe and reproducible , [ vii ] Karma is well-positioned to address the ongoing issues of pedicle screw fixation .
Pedicle fixation plus poor bone quality … What could possibly go wrong ?
“ Pedicle fixation is imperfect and coupled with bone quality issues , can lead to loosening and implant failure ,” adds Dr . Nunley . Indeed , says the research , screw loosening occurs in about 10 % of patients , a number that increases to above 60 % for osteoporosis patients . [ viii ]
Versatile Karma !
According to Terrence Crowder , M . D ., an orthopedic spine surgeon with Sonoran Spine in Arizona , there are many indications for a non-metal , low bone density solution .
“ First of all , there are legions of people with degenerative spondylolisthesis who don ’ t know they have it , in part because it can take 15-20 years to develop . This is accompanied by a slow onset of lumbar stenosis and neurogenic claudication , and , since it ’ s slow it is easy to miss because as people age , they think — or are told — that it ’ s arthritis . Unfortunately , primary care physicians , physician assistants and nurse practitioners are often misdiagnosing these patients . There is a clear educational gap here .”
“ Second , looking at the range of treatments , i . e ., from injections to interspinous devices to laminectomy then fusions with posterior screws , I think laminectomy
In strong , nonosteoporotic bone , pedicle screw loosening rates are about 1-15 %. In osteoporotic bone those rates soar to more than 60 %. Old spines need new ideas . Time for Karma , a better approach for spine fixation when bone quality is suspect .
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