NuVasive Takes a Different Angle, Shakes Up Spinal Surgery Business

4/27/10Follow @xconomy

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people feel serious pain.

Spinal fusion is one way to fix this structural problem. More than 80 percent of all spinal fusion procedures done today are performed when a surgeon cuts through the front, or the back of the patient, to stabilize and support the spine. That makes for an invasive and risky procedure in which doctors move organs, major blood vessels, and even the spinal cord to get to the vertebrae that needs repair, Lambert says. Depending on the procedure, a surgeon often must cut some major ligaments, or pieces of bone. Once the path is clear, a surgeon can slide replacement disks between the vertebrae, and to anchor them with screws and rods, which restores the natural space between vertebrae and helps relieve the pressure on pinched nerves.

The patient typically can expect to stay in the hospital three to five days, start walking again after two to four days, and return to normal activities in about six months.

The NuVasive approach is all about avoiding the front or the back with all those anatomical obstacles. Instead, the company’s technology allows a doctor get to the spine by instead going through the patient’s side.

Surgeons have wondered about that for a long time for obvious reasons. But it was never really done in a widespread way, because going in the through the side means navigating something called the Psoas muscle. That muscle conceals what’s called the lumbar plexus, a network of nerves. Surgeons wouldn’t dare do back surgery through this avenue before, because they couldn’t really see exactly where the nerves are, and if you cut through them, you’ll create major trouble.

“The patient would wake up in more pain than they were in before the surgery,” Williams says. And Lambert added, the nerve damage would potentially be permanent.

So NuVasive developed a way around this problem. This surgery system through the side, called XLIF, uses a dilator which spreads apart the psoas muscle without cutting into it, Lambert says. The probe has a sensor on the bottom which delivers an electrical impulse to where the nerves are. NuVasive’s proprietary software algorithm, NeuroVision, allows the surgeon to see where the nerves are in real-time so that he can avoid them on his way into the spine.

Once he or she has navigated through the Psoas and past the nerve bundle, the surgeon is staring at a nice wide channel to insert a big replacement disk, Lambert says. That’s important, because … Next Page »

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