Our Adaptive Geometry™ technology is designed to respect each and every patient’s unique anatomy. We are committed to providing products that help surgeon’s address the patient’s clinical needs, as well as the surgeon’s approach and surgery preferences. The following case studies demonstrate the clinical application of Adaptive Geometry in the FlareHawk® expandable cage.
Spondylolisthesis in Former U.S. Marine Para Jumper
Rohit Vasan, M.D.
The patient is a U.S. Armed Forces veteran with three previous disc intervention procedures, one at L4-5 and two at L5-S1. The patient maintains an extremely active lifestyle.
For the past two years, the patient had progressively increasing severe L5 and S1 left leg radiculopathy, as well as severe axial back pain, and refractory to nonoperative therapy including physical therapy and pain management.
Patient presented with a large left-centric disc herniationat L5-S1 along with significant loss of disc and foraminal height.
Two Accelus TiHawk11™ Interbody Fusion Devices. (The combined width of the two implants is 34mm)
- 10mm height
- 17mm width
- 25mm length
- 6° of lordosis
Given the patient required a third intervention, and he had significant loss of disc height and advanced solitary DDD at the L5-S1 level, Dr. Vasan recommended fusion of the segment. Ponte osteotomies were performed at L5-S1 to allow for greater lordosis correction. A foraminotomy was performed at L4-L5 and a facetectomy at L5-S1 to decompress the L5 nerve root both above and below. To create the best fusion bed possible, a bi-portal discectomy was performed.
To maximize interbody stability in this very active patient, Dr. Vasan performed a bi-lateral PLIF, implanting two 17mm-wide, endplate-conforming TiHawk11 implants to create the largest footprint possible. Since the patient was in normal sagittal balance with all other lumbar levels healthy, targeted deformity correction was not required at L5-S1.
The TiHawk system provided Dr. Vasan with intraoperative implant selection flexibility to give the patient the largest footprint possible based upon the neural and bony anatomy at the level. He had the option to choose between two insertion profiles: 9mm or 11mm wide. The patient’s large Kambin’s triangles facilitated insertion of the wider implant that expands from 11mm to 17mm.
The patient reported a marked reduction in back and leg pain in the immediate post-operative period.