While most spinal conditions don’t require surgery, there are times when surgery is considered the best option. Implant systems utilizing specially designed spinal instrumentation are used in these surgical procedures. The orthopedic implants are used to correct deformities, facilitate fusion, and stabilize and strengthen the spine. Siora Surgicals is one of the top trauma implants manufacturers in India.
Conditions that usually require instrumented fusion surgery include slippage of the spine (spondylolisthesis), traumatic fracture, chronic degenerative disc disease, and other forms of spinal instability including scoliosis.
Implants: What are they?
Most spinal implants are made of metals such as titanium alloy, titanium or stainless steel; some may be made of non-metallic compounds. They are available in several different sizes and shapes to accommodate patients of all ages and of different anatomy.
Surgeons and scientists around the world are constantly working to develop and refine implants to improve patient comfort and safety. In recent years there have been great advances, including the advent of the hook, rod and screw systems that enable surgeons to correct spinal deformities three-dimensionally; the development of special cages and bone plates that help promote spinal fusion; and the creation of small but strong implants for children.
Spinal implants can be summarized in many groups:
The Rods are one of the unique implants used in the spine. Rods are used, along with screws and hooks, to immobilize and to contour the spine into correct alignment. The rods are strong yet have some flexibility so that the surgeon can shape the rod to match the contours of the patient’s spine.
These specially designed bone screws are carefully implanted into the pedicles of the spinal vertebrae. They have traditionally been used in the lumbar spine, and with recent advances in technique and technology, surgeons are now using them in the thoracic spine too. Screws provide strong points of “Anchorage” to which rods can be attached. Rods can then be contoured to facilitate fusion and correct deformities.
Hooks are used with rods and other orthopedic implants to anchor them to vertebrae.
Plates are often used in the cervical spine. Plates are made to conform to the contour of the spine and are held in place by screws set into adjacent vertebrae. When the plate needs adjustment, a contouring tool is used to customize the fit to the patient’s anatomy.
Cages are usually called interbody cages because they are most often placed between two vertebrae. Cages are small hollow devices with perforated walls. Bone graft or BMP is usually packed into the cage to promote bone growth between the adjacent vertebrae. Cages are used to restore lost disc height resulting from a collapsed disc and to release pressure on nerve roots.
What we Use
We choose orthopaedic implants (implantes ortopedicos) very carefully to ensure they are the best choice for the specific patient. For example, for patients who are slim, we select “low profile” implants so they are not visible through the skin. We also use “low volume” implants because they cause less post-operative pain and reduce muscle irritation. Moreover, we tend to use titanium implants, which unlike stainless steel, are light, strong and, can be used with MRIs. When appropriate, we use radiolucent materials such as carbon fiber cages. Carbon-fiber implants can’t be seen on a scan but allow us to see if the bone is forming and fusion is taking place.
Now, scientists are developing bio-resorbable implants. Like another implant, these are used to facilitate fusion. However, after a year or so (when fusion should be done) most implants are no longer required but are left in the body. Bio- resorbable implants are designed to break down when they meet water (such as in the body). In a year, most reduce in size by 50% and are completely gone in 2-3 years. Therefore, the implant is present in the body while it is required to promote fusion, and then it simply “fades-away” over a 12 to 36-month period. While few bio-resorbable implants are available yet, it is hoped that their advancement will be a significant step-forward in the coming few years.
In the last 20 years, there have been major breakthroughs in the development of spinal implants. The result is better treatment for patients.