Cushion
These devices only replace the inner portion of the disc (the nucleus).
The PDN® device is the first and only commercially available (outside the U.S. and Canada) prosthetic disc nucleus. The PDN device offers spine surgeons and low back pain sufferers a completely unique and new option for the treatment of degenerative disc disease.
Charles D. Ray, M.D., the inventor of the PDN device, had the ambitious goal of finding a way to relieve low back pain that accompanies degenerative disc disease (DDD) by restoring normal biomechanical function to the disc, rather than removing it and risking a degenerative cascade. Dr. Ray vision took the treatment of DDD down a new, evolutionary path away from metallic implants and permanent immobilization of the entire affected spinal segment and toward treatment that stabilizes the spine and allows patients to regain their quality of life.
Unlike spinal fusion, which results in loss of mobility in the spinal joint, the PDN device may allow patients to resume normal levels of activity with little or no pain. This is especially important to the increasing numbers of patients who are active and athletic and expect to stay that way until late in life. Furthermore, because it is a minimally invasive procedure, PDN device implantation can reduce time spent in the operating room and the length of hospital stays.
The PDN prosthetic disc nucleus device is indicated for the treatment of patients with DDD resulting in low back pain, with or without concomitant leg pain, which has not responded to six months of conservative care. PDN devices may be surgically implanted at a single level (L2 to S1) in appropriate patients. The PDN device is intended to:
· Reduce back pain
· Restore or maintain disc height at the operative level
· Maintain or improve range of motion of the low back
The PDN device is composed of two parts, a hydro gel pellet and a polyethylene jacket. The hydro gel is designed to absorb fluid and swell. This ability to expand is what allows the PDN device to restore or maintain normal disc height. The woven polyethylene jacket maintains the shape and height of the hydro gel nucleus.
The PDN device carries the CE (Conformite Europeen) Mark required for European sales of the product.
Farcet Rhizotomy
Epiduroscopy
The first posterior lumbar interbody fusion (PLIF) was reported by Jaslow in 1946 when he utilized a bone peg that was placed within the lumbar interspace after discectomy. He augmented this with autogenous bone chips harvested from the posterior elements placed posteriorly.
Posterior lumbar interbody fusion (PLIF) is a surgical technique for placing bone graft between adjacent vertebrae (interbody). Typically, screws and rods or other types of spinal instrumentation are used to hold the spine in position while the bone heals. Indications for this procedure may include pain and spinal instability resulting from spondylolisthesis, degenerative disc disease, or when a discectomy is performed to relieve nerve compression and the patient has associated mechanical low back pain. Spinal fusion uses bone graft to promote specific vertebrae to grow or fuse together into a solid and stable construct. Instrumentation, also called internal fixation, incorporates the use of rods, screws, cages, and other types of medical hardware to provide immediate stability to the spine and facilitate fusion.
In minimally invasive procedures, the surgical incisions are small, there is no need (or minimal need) for muscle stripping, there is less tissue retraction, and blood loss is minimized. Special surgical tools allow the surgeon to achieve the same goals and objectives as the open surgery while minimizing cutting and retracting of the paraspinous muscles. Therefore, tissue trauma (injury) and post-operative pain are reduced, hospital stays are shorter, and patients can recover more quickly.