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Motion Preservation

Until relatively recently, the concept of surgical intervention being able to preserve the natural kinematics of the spine was unachievable and the only surgical option was fusion. Advances in medical device product engineering and bio materials along with enhanced understanding of spinal biomechanics have produced a new generation of devices aimed at restoring natural motion and avoiding fusion to mitigate against adjacent segment disease.

 

Motion Preservation

Until relatively recently, the concept of surgical intervention being able to preserve the natural kinematics of the spine was unachievable and the only surgical option was fusion. Advances in medical device product engineering and bio materials along with enhanced understanding of spinal biomechanics have produced a new generation of devices aimed at restoring natural motion and avoiding fusion to mitigate against adjacent segment disease.

Coflex®

Spinal stenosis is a relatively common complaint occurring in approximately 10% of the population. Symptoms include sciatic pain, claudication, back pain, tingling, numbness and weakness that radiates from the lower back and buttocks into the legs. Historically surgical intervention comprised decompression with or without stabilisation in the form of a fusion, instrumented or otherwise. Recent evidence (Swedish Spinal Stenosis Study, Fὅrsth et al, 2015) concluded fusion for spinal stenosis does not result in better clinical outcomes at 2 and 5 years. Conversely, the recent five year follow up level 1 RCT clinical data shows that Coflex® is an effective, sustainable and cost effective alternative to fusion, providing the stabilisation necessary following decompression whilst maintaining more natural motion at the index level and above/below.

Coflex®

Spinal stenosis is a relatively common complaint occurring in approximately 10% of the population. Symptoms include sciatic pain, claudication, back pain, tingling, numbness and weakness that radiates from the lower back and buttocks into the legs. Historically surgical intervention comprised decompression with or without stabilisation in the form of a fusion, instrumented or otherwise. Recent evidence (Swedish Spinal Stenosis Study, Fὅrsth et al, 2015) concluded fusion for spinal stenosis does not result in better clinical outcomes at 2 and 5 years. Conversely, the recent five year follow up level 1 RCT clinical data shows that Coflex® is an effective, sustainable and cost effective alternative to fusion, providing the stabilisation necessary following decompression whilst maintaining more natural motion at the index level and above/below.

HPS®

HPS (Hybrid Performance System) is a unique dual concept pedicle screw system designed to address the needs of surgeons who wish to dynamically stabilise at a single level, fuse at single or multiple levels and/or dynamically stabilise the end segment of a longer construct to mitigate against adjacent segment disease (Sears et al, 2010). Studies have shown a 52% increase in the range of motion, and 40% increase in translation of the adjacent segment following fusion, with reoperation rates a significant consideration. The HPS dynamic coupler allows for controlled motion in flexion/extension and lateral bending, and significant reduction in rotation and translation.

HPS®

HPS (Hybrid Performance System) is a unique dual concept pedicle screw system designed to address the needs of surgeons who wish to dynamically stabilise at a single level, fuse at single or multiple levels and/or dynamically stabilise the end segment of a longer construct to mitigate against adjacent segment disease (Sears et al, 2010). Studies have shown a 52% increase in the range of motion, and 40% increase in translation of the adjacent segment following fusion, with reoperation rates a significant consideration. The HPS dynamic coupler allows for controlled motion in flexion/extension and lateral bending, and significant reduction in rotation and translation.

CP-ESP Cervical Disc

Patients who undergo surgery for cervical radiculopathy who would previously have had an anterior cervical discectomy and fusion despite early intervention, maintenance of disc height and relatively healthy facet joints can now benefit from disc arthroplasty with the aim of reducing the risk of adjacent segment disease. The CP-ESP cervical disc from FH Orthopedics has been designed to mimic the natural disc with six degrees of freedom and shock absorbing capabilities. The unique manufacturing process of the visco-elastic/titanium implant has been designed to mitigate against any chance of wear debris. Based on the LP-ESP lumbar disc with over 10 years of follow up, there are no reports of migration or lateral lockdowns.

CP-ESP Cervical Disc

Patients who undergo surgery for cervical radiculopathy who would previously have had an anterior cervical discectomy and fusion despite early intervention, maintenance of disc height and relatively healthy facet joints can now benefit from disc arthroplasty with the aim of reducing the risk of adjacent segment disease. The CP-ESP cervical disc from FH Orthopedics has been designed to mimic the natural disc with six degrees of freedom and shock absorbing capabilities. The unique manufacturing process of the visco-elastic/titanium implant has been designed to mitigate against any chance of wear debris. Based on the LP-ESP lumbar disc with over 10 years of follow up, there are no reports of migration or lateral lockdowns.

LP-ESP Lumbar Disc

Lumbar disc replacement is indicated for patients with mechanical low back pain primarily in the absence of radiculopathy. The LP-ESP lumbar disc has been designed to replicate the natural motion

of the spine. With its silicone nucleus and polycarbonate urethane annulus, the LP-ESP disc is non- surface bearing with an adaptive centre of rotation. The unique manufacturing process mitigates against any chance of wear debris. With 10 years of research and design behind it, and more than 10 years of follow up, the LP-ESP disc has proved it is a safe and clinically effective solution to a challenging problem.

LP-ESP Lumbar Disc

Lumbar disc replacement is indicated for patients with mechanical low back pain primarily in the absence of radiculopathy. The LP-ESP lumbar disc has been designed to replicate the natural motion

of the spine. With its silicone nucleus and polycarbonate urethane annulus, the LP-ESP disc is non- surface bearing with an adaptive centre of rotation. The unique manufacturing process mitigates against any chance of wear debris. With 10 years of research and design behind it, and more than 10 years of follow up, the LP-ESP disc has proved it is a safe and clinically effective solution to a challenging problem.