As minimally invasive spine surgery continues to gain prominence in the operating room, surgeons are adopting new technologies. These expandable devices, like Benvenue Medical's Luna 3D and Kiva Systems, create substantial footprints through minimal access points.
In a webinar titled, "Integrating new expandable technologies into a minimally invasive spine practice," Michael Wang, MD, of the University of Miami, Miller School of Medicine, and Laurent Schaller, founder and CTO of Benvenue Medical, discussed minimally invasive technology for spinal procedures.
Luna 3D Interbody Fusion System
"There's been a tremendous growth in interbody fusion for a lot of reasons," said Dr. Wang. "Interbody allows a more robust bone growth environment."
Designed for spinal fusion procedures with symptomatic degenerative disc disease from L2 to S1, the Benvenue Medical Luna 3D Interbody Fusion System is composed of PEEK with metallic components. The Luna 3D implant is ideal for patients with six months prior nonoperative treatment and used with autogenous bone graft and supplemental fixation.
"[Luna] is designed for open and MIS TLIF, and I've used it in both indications," said Dr. Wang. "I think that it performs well in both, obviously the real advantage of this is going to be the minimally invasive space."
Delivered through a 6 to 8 mm cannula, the Luna 3D implant expands to a circular footprint of about 25 mm in diameter. The device is constructed with three stacked rails and the top and bottom rails enter first; the third, middle rail exits the cannula last. The cannula is intended to execute a controlled delivery with reduced nerve retraction.
The third middle segment provides the distraction and indirect decompression, expanding the implant vertically in-situ. Luna 3D has the ability to restore disc height up to 13 mm.
"The good thing about the Luna is it allows expansion in multiple planes. It allows us to get both vertical as well as surface area contact expansion," explained Dr. Wang.
Once securely placed and expanded in multiple directions, the Luna 3D system offers a large opening for graft insertion. The system is designed to lock itself in place.
"We know that the fusion is partially dependent on the contact area and how well you do your discectomy," said Dr. Wang. "This cage will not deploy unless you get that area clean."
During the discectomy, standard instrumentation will suffice for clearing out zone one, the straight-on area. Cleaning out zone two and zone three prove more challenging and require specialized curved tools.
"Initially, I thought this was a disadvantage, but now I find it to be quite an advantage in terms of enforcing some discipline in my technique," said Dr. Wang.
Kiva VCF
Osteoporotic fractures plague more Americans than heart attacks or strokes, according to the American Heart Association. There are available systems to treat osteoporotic fractures of the spine, but Mr. Schaller cited subsequent fractures and limited fracture reduction as pitfalls of existing vertebral compression fracture treatments.
The Kiva VCF Treatment System is intended for the reduction and treatment of spinal fractures in thoracic and lumbar spine from T6 to L5. The system is used with the Benvenue Medical Vertebral Augmentation Cement Kit.
The implant-based Kiva VCF Treatment uses less bone cement than other systems on the market and offers a single-pedicle approach. It's designed for permanent kyphotic angle reduction and can lower subsequent fracture rate.
The Kiva system can have other advantages over similar systems, including:
- More pain relief
- A reduced cement volume
- Less cement extravasation
- Cobb angle correction
- Subsequent fracture reduction
- A shorter procedure time
- Elimination of serious adverse complications
Setting itself apart, Kiva VCF expands to 15 mm in height and is composed of PEEK-Optima. The implant is inserted over a guide wire and has a cross-sectional area of about 20 mm in diameter. The system is designed to restore sagittal alignment, craft a more flexible construct than only cement and offers a large surface to support the endplate.
The Kiva VCF is designed to relieve pain and restore function and height. It's equipped with the broadest labeling of any compression fracture treatment system on the market.
For more information access the webinar slides here.