Less Exposure Surgery

LES Society Off to a Roaring Start with First Lab of the Year, Baltimore

LES Society Off to a Roaring Start with First Lab of the Year, Baltimore

The LES Society started the year with a spectacular event at Dr. Agha Khan’s impressive Vita Lab in Baltimore. Harvard-trained Dr. Jeffrey Carlson of Newport News, Virginia, stole the show with his instruction on the LES midline technique. Residents and fellows hung on his every word as they crowded around his cadaver to get a closer look at his expert techniques. Dr. Carlson has done more than 100 LES midline approach cases using SpineFrontier’s instruments and implants.

Dr. Carlson, said, “The Baltimore event was an enormous success. We enjoyed the company of a lot of great surgeons and eager fellows who were interested in LES technologies, techniques and of course AxioMed’s total disc replacement technology. It was an enriching day of education and learning for our SpineFrontier team.  All the surgeons who participated were really engaged in the hands-on labs and getting their questions answered.”

The LES Society Lab in Baltimore was the first in its series of labs and journal clubs for residents and fellows from around the country.  New York neurosurgeon, Dr. John Shiau, engaged the crowd with his energetic and passionate insights on the benefits of MIS techniques. Next, Dr. Michael Murray, an orthopedic surgeon also from New York, instructed the audience on case selection and techniques for a cervical standalone using SpineFrontier’s A-CIFT™ SoloFuse. His patience and meticulous instruction was greatly appreciated by the residents and fellows. Wrapping up the lectures, Dr. Khan, the Baltimore-based neurosurgeon, spoke eloquently about the simplicity and benefit of using an interspinous device as part of the LES philosophy.

Less Exposure Surgery (LES®) is based on a new surgical philosophy. Small open incisions are created, through which the surgeon only exposes what needs to be treated for maximum effectiveness. By developing improved technologies and techniques tailored for pinpointing a problem and fixing it without collateral damage, LES® minimizes normal tissue disruption without relying on excessive radiation.

LES® procedures are performed in an outpatient setting and are tailored to the patient’s lifestyle, health status, and body type. This personal attention decreases risk, is simpler for the surgeon to perform, reduces pain and blood loss, and decreases recovery time.

After lectures, the four LES Society surgeons served as proctors at different cadaver stations.

Dr. Carlson ran a station on midline screw trajectories featuring the PedFuse REmind and FacetFuse® Screws.
LES Society Off to a Roaring Start with First Lab of the Year, Baltimore
LES Society Off to a Roaring Start with First Lab of the Year, Baltimore
Dr. Shiau’s station demonstrated the MISquito™ and InSpan™ technologies.
LES Society Off to a Roaring Start with First Lab of the Year, Baltimore
Dr. Murray ran a station on A-CIFT™ SoloFuse-P™, teaching residents about how to get cervical exposure.
LES Society Off to a Roaring Start with First Lab of the Year, Baltimore
Dr. Khan hosted a station on InVue and Inset® Anterior Cervical Plates. He also showcased AxioMed’s Freedom® Cervical Disc.
LES Society Off to a Roaring Start with First Lab of the Year, Baltimore
LES Society Off to a Roaring Start with First Lab of the Year, Baltimore

After cadaver labs, Frank Schnur, the CSO of SpineFrontier and KICVentures, spoke about the compelling opportunity represented by the KICVentures ecosystem and one of its portfolio companies, AxioMed. AxioMed Freedom® total disc replacement is a single piece technology with a viscoelastic polymer core that closely mimics the shock absorption and movement of a human disc. Surgeons enjoyed putting in the AxioMed Freedom® Cervical Total Disc Replacement earlier in the day.

Dr. Carlson, said, “The Baltimore event was an enormous success. We enjoyed the company of a lot of great surgeons and eager fellows who were interested in LES technologies, techniques and of course AxioMed’s total disc replacement technology. It was an enriching day of education and learning for our SpineFrontier team.  All the surgeons who participated were really engaged in the hands-on labs and getting their questions answered.”

SpineFrontier: From Hospital to Ambulatory Surgery Center: Midline Cortical Pedicle Screws Vs. Traditional Pedicle Screws

From Hospital to Ambulatory Surgery Center: Midline Cortical Pedicle Screws Vs. Traditional Pedicle Screws

Kingsley R. Chin, MD1, 2

Fabio J.R. Pencle, MB BS1

André V. Coombs, MB BS3

Mohamed Elsharkawy, MD3

Corrine F. Packer, MB BS3

Elijah A. Hothem, MD3

Jason A. Seale, MB BS1

  1. Less Exposure Surgery Specialists Institute (LESS Institute).
  2. Florida Atlantic University (FAU) & Florida International University (FIU)
  3. Less Exposure Surgery (LES) Society.
Conflicts of interest and sources of funding: We did not seek or receive any funding from the National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI), or others for this work. KRC is a shareholder in and receives other benefits from SpineFrontier Inc., none of the other authors (FJRP, AVC, ME, CFP, EAH or JAS) have any potential conflicts of interest to declare for this work.

Abstract

Introduction

Modern advances in spine surgery including less invasive procedures have propelled the design of instruments and implants to achieve greater posterior spinal fixation, with decreased tissue destruction and higher safety margins.  Static and dynamic biomechanical studies have validated the superior pullout strength of cortical screws versus the traditional pedicle screws and might represent an opportunity to perform safe lumbar fusions in ambulatory surgery centers (ASC).  The authors aim to compare the outcomes of midline cortical pedicle screw surgical technique for posterior lumbar fixation in the ASC compared to traditional pedicle screws in a hospital.

Method

The medical records of 60 patients with prospectively collected data were reviewed. Two matched cohort groups consisting of 30 patients each, midline cortical pedicle screws performed in ASC patients (Group 1) was compared to traditional pedicle screws performed in Hospital patients (Group 2). Outcomes were measured using Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, estimated blood loss (EBL) and Radiologic fusion rate.

Results

33 males and 27 females, age range (28-75), average 58±3 years. Average BMI was 29±1.15 kg/m2. Significant improvement noted in VAS back pain scores in Group 1 from 7.8±0.5 to 2.5±0.7, p=0.001. Comparing VAS back pain scores and ODI scores, significant improvement demonstrated between group 1 and 2, p=0.004 and p=0.027 respectively. Mean EBL in group 1 was significantly less, p=0.025 than group 2. Intergroup fusion rate at two year was similar, p=0.855.

Conclusions

We successfully transitioned our lumbar fusions from hospitals to ambulatory surgery centers using a midline cortical pedicle screw technique. Although traditional pedicle screw placement was effective and may be viable in an ambulatory surgery center we see more advantages to use midline cortical screws over traditional pedicle screws.

SpineFrontier: From Hospital to Ambulatory Surgery Center: Midline Cortical Pedicle Screws Vs. Traditional Pedicle Screws
SpineFrontier: From Hospital to Ambulatory Surgery Center: Midline Cortical Pedicle Screws Vs. Traditional Pedicle Screws
SpineFrontier: From Hospital to Ambulatory Surgery Center: Midline Cortical Pedicle Screws Vs. Traditional Pedicle Screws
100th Less Exposure Surgery Procedure Completed by Industry Leading Surgeon Dr. Jeffrey Carlson

100th Less Exposure Surgery Procedure Completed by Industry Leading Surgeon Dr. Jeffrey Carlson

Newport News, Virginia –Tuesday, June 30, 2015

Orthopaedic & Spine Center announced today that Dr. Jeffrey R. Carlson finished his 100th case using SpineFrontier’s® PedFuse® REmind® Screws. The operation took place on Tues., June 30, 2015, at Bon Secours Mary Immaculate Hospital in Newport News, VA. The procedure was an L5-S1 posterior lumbar interbody fusion on a 69 year old, male patient. Prior to undergoing surgery, the patient suffered constant pain and failed conservative treatments including chiropractic treatments and steroid injections.

Dr. Carlson’s milestone case represents a significant achievement in the innovative, Less Exposure Surgery (LES®) midline approach. Implanting PedFuse REmind screws via the LES midline approach minimizes tissue disruption and results in smaller incisions. It may also reduce blood loss, and surgery time while potentially speeding up the patient’s recovery.

Less Exposure Surgery (LES) is based on a new philosophy of doing surgery. LES is less invasive than MIS. LES incisions are small incisions through which the surgeon only exposes what needs to be treated for maximum effectiveness. By developing innovative technologies and techniques tailored for pinpointing the problem and fixing it without collateral damage, LES minimizes normal tissue disruption without relying on excessive radiation.

Dr. Carlson remarked on the LES technique, “Advancements in spine surgical techniques are now allowing patients to have outpatient lumbar fusions. SpineFrontier continues to lead in techniques that decrease the pain of surgery and provide the same outcomes as standard procedures. Less pain, less blood loss, and quicker recoveries are the driving force behind these new techniques.”

Susan Finkel, a patient of Dr. Carlson’s who underwent an outpatient Less Exposure Surgery midline procedure, emphasized the ease of her recovery. “Having this done was one of the best decisions that I have ever made and being able to go home within a few hours of surgery and being able to return to work so quickly made this the easiest surgery I’ve ever had.”

Dr. Carlson is a board-certified orthopedic surgeon, focused on treating spine disorders. He received his M.D. from George Washington University in 1993 and completed his residency in orthopaedics at the Harvard Medical School Hospitals (Massachusetts General Hospital and Brigham and Women’s Hospital). He also completed an Orthopedic Trauma Surgery Fellowship and a Spine Surgery Fellowship. Dr. Carlson is a managing partner of the Orthopaedic and Spine Center in Newport News, VA and served as Chief of Surgery at Bon Secours Mary Immaculate Hospital.

Dr. Carlson is a long-time supporter of the Arthritis Foundation. As an expert in his field, he has published and lectured extensively on the subject of orthopedics and has appeared on television several times. In 2008, Dr. Carlson was one of the first surgeons in his area to perform a cervical disc replacement.

About the PedFuse REmind Midline Screw Family

SpineFrontier designed the PedFuse REmind Midline Screw Family under the unifying umbrella of LES midline tissue-preserving surgery. The PedFuse Pedicle Screws use CortiCan™ thread technology, which means the wider space between threads at the tip of the screw bonds it to the less dense, cancellous bone interior and threads grow closer together at the proximal head of the screw to grip the harder, cortical shell on the surface of the bone.

About SpineFrontier® Inc.

SpineFrontier Inc. is a growing medical technology company that designs, develops and markets both implants and instruments for spine surgery based on the Less Exposure Surgery (LES®) Philosophy. These technologies are designed to allow for outpatient surgery due to minimal disruption of normal tissues. SpineFrontier believes LESS is MORE: LESS time in treatment and recovery is MORE time in action for patients and surgeons. SpineFrontier is headquartered in Beverly, MA. It was founded in 2006, and released its first products in 2008. SpineFrontier is a KICVentures portfolio company and the leader in LES technologies and instruments.

Jamaica’s First A-CIFT™ SoloFuse-P™ Case LESS Institute Gives Back - SpineFrontier

The LESS Institute Gives Back

On July 3, 2015, Dr. Kingsley R. Chin of the LESS Institute in Florida and Jamaican Neurosurgeon Dr. Franz Pencle performed a Less Exposure Surgery procedure on a middle age, male patient who suffered from severe myelopathy (spinal cord compression) due to a progressive degenerative disorder. The procedure took place at Cornwall Regional Hospital in Montego Bay, Jamaica. Before surgery, the patient was incapacitated. “He was basically quadriplegic,” Dr. Fabio Pencle, a LESS Institute Research Fellow who supported the case says. “On his strength test, he scored a 1/5 throughout all limbs –which means he could barely flicker his digits.” Dr. Fabio Pencle believes that the patient survived because of treatment. “Patients with similar symptoms demised because they didn’t receive timely treatment,” says Dr. Fabio Pencle.

Dr. Chin, Dr. Franz Pencle and Dr. Fabio Pencle donated their time for the case and SpineFrontier, Inc. donated the SoloFuse hardware. The Less Exposure Surgery (LES) procedure was performed through a midline cervical incision, dissection to expose the affected level and a discectomy using rongeurs and burr. A DBM packed A-CIFT SoloFuse was placed and fixed with screws. This was the first case of a standalone implant in Jamaica. It was also the first outpatient spine surgery done at Cornwall Hospital. The patient could sit upright twelve hours after surgery, and he tested 5/5 on a strength test in the upper limbs and 4/5 in the lower limbs –indicating that he had significant improvement in less than 24 hours.

About SpineFrontier’s A-CIFT™ SoloFuse-P™

The A-CIFT SoloFuse-P standalone Less Exposure Surgery system features a simple dual screw construct, a large graft window, large diameter screws, and slim, agile instrumentation. Its zero-profile and all PEEK-OPTIMA Natural design minimizes tissue disruption.

LESS Talk, More Doing: Changing Lives in Jamaica, SpineFrontier Less Exposure Surgery story

LESS Talk, More Doing: Changing Lives in Jamaica

On a late Saturday night in May, an unlikely group of people’s paths crossed in a small operating room in the University Hospital of the West Indies. It was hot, and beads of sweat formed on the doctors’ foreheads above their surgical masks. Outside the O.R., the windows in the hallways were open to catch the breeze that filtered through the open slats. The hallway was quiet, filled only with an empty gurney with a canvas stretcher and wood handles. A clock on the wall covered in a metal casing methodically tracked the passing moments.

Inside the O.R., Dr. Kingsley R. Chin, an orthopaedic surgeon and founder of Less Exposure Surgery Specialists (LESS) Institute in Florida, and Dr. Carl A. Bruce, a consultant neurosurgeon at the University of the West Indies at Mona Jamaica, operated on a fifteen year old young woman. Around them stood Kevin Chappuis, a medical technology engineer from SpineFrontier, Inc, Harisha Buggam, a medical device distributor in the West Indies, and the University’s Chief of Anesthesiology, Dr. Harding. The operation, a high level, scoliosis case, required that surgeons correct a deformity in the patient’s spine.

Shinel Binns, the patient lying on the operating table, was fit and healthy -a normal young woman in every way, except for the severe curve in her spine. Standing up, Shinel’s legs were perpendicular to the ground, but at her waist, her torso and head angled sharply to the left, as if she had to fight gravity from pulling her left shoulder and head to the ground. A lifetime of trying to hold her head and torso upright to counterbalance her lumbar spine’s deformity had begun to create a curve in her thoracic spine.

Shinel lived in Saint Elizabeth Parish –a two hour journey from the hospital she was now being treated at in Kingston, Jamaica. She and her family had waited a long time for this moment. She would never have been able to afford an operation, but the donated time from the doctors, and over $500,000 in donated technology and personnel from SpineFrontier, as well as her community’s donation of $5,000, was making her operation possible.

Dr. Kingsley R. Chin had flown in earlier that day from the United States. Born and raised in Jamaica, he often returned to perform surgeries for people in need. As a pioneer in the Less Exposure Surgery (LES®) approach, Chin has devoted his life to refining and training others in a revolutionary approach to back surgery. The LES Philosophy of surgery pinpoints the problem, fixes it without collateral damage to surrounding tissues, and lets patients go home the same day.

A patient examination and X-Rays had confirmed to the doctors that Shinel’s original spinal deformity was in the lumbar spine. Because the thoracic curve was compensatory to keep her upright, Dr. Chin and Dr. Bruce operated on the most pronounced section of the curve (L1-L4). Dr. Chin used a Less Exposure Surgery (LES) approach, addressing the most pronounced section of the spinal curve (L1-L4) by inserting SpineFrontier’s S-LIFT® Lateral Interbody through a single, three inch incision at those levels to straighten out the spine. The surgeons then placed unilateral MISquito® Percutaneous Pedicle Screws to hold the straightened position.

The LES approach through the small incision on the side of the abdomen was low impact and saved Shinel the trauma of an incision through her stabilizing back muscles that could disrupt her strength. It also minimized the surgical trauma and maximized its effectiveness for a rapid and less painful recovery. This approach was especially important because it would allow a teenage girl to resume her daily activities more quickly. The surgeons expected that the thoracic curve would straighten itself over time. After the operation, Shinel already felt straighter and only had minimal superficial pain.

Harisha Buggum, the medical device distributor, had observed several other scoliosis corrections before through the Scotiabank Scoliosis Programme that provided implants at a greatly reduced cost to teenagers with scoliosis. But she had a renewed sense of excitement when talking about Shinel’s operation.

In this surgery, you could see the technology changing the deformity and you could see the spine literally straightening up through the fluoro imaging. It’s good to know technology has turned in the direction so that someone with scoliosis can actually get a correction from Less Exposure Surgery.”

“I’ve never seen that kind of procedure done,” Harisha said, leaning forward and talking energetically, “This was different for us than our day-to-day [procedures]. In this surgery, you could see the technology changing the deformity and you could see the spine literally straightening up through the fluoro imaging. It’s good to know technology has turned in the direction so that someone with scoliosis can actually get a correction from Less Exposure Surgery.”      

Harisha’s excitement over what she observed in the O.R. was just a small window into the many cases that Dr. Chin and his colleagues at the LESS Institute perform on a daily basis in the United States.

“This case is a perfect example of how Less Exposure Surgery can transform a patient’s life,” Chin commented.

Introducing the SIJ-Fuse Screw: Making Treatment Better through LES Technology

Introducing the SIJ-Fuse Screw: Making Treatment Better through LES Technology

The SIJ-Fuse Screw is a fenestrated, hollow rod used to fuse the sacroiliac joint. Dr. Kingsley R. Chin and SpineFrontier’s Medical Advisory Board developed the concept for an improved sacroiliac joint (SIJ) fusion system to improve patient recovery time and outcomes.

In the past, SIJ fusion procedures required three fusion rods. But the SIJ-Fuse Screw’s innovative design only requires two rods. By offering more surface area per screw, the SIJ-Fuse provides the same strength of fixation as older systems, but with fewer rods – leading to fewer incisions.

The fenestrations, or holes in the rod enable surgeons to fill the implant with bone graft, increasing the likelihood of boney in-growth and fusion. This all leads to less surgical time, making SIJ-Fuse an emblematic Less Exposure Surgery Technology. It is with great pride that the SpineFrontier team introduces SIJ-Fuse to the world as they look forward to FDA approval later this year.

Dr. Mark W. McFarland Successfully Completes Surgery Using SpineFrontier's® Less Exposure Surgery A-CIFT™ SoloFuse-P™

Dr. Mark W. McFarland Successfully Completes Surgery Using SpineFrontier’s® Less Exposure Surgery A-CIFT™ SoloFuse-P™

Check out our latest press release about Dr. McFarland’s A-CIFT SoloFuse-P Case!

Newport News, VA

Orthopaedic & Spine Center announced today that Dr. Mark W. McFarland successfully implanted SpineFrontier’s A-CIFT™ SoloFuse-P™. The operation took place on Thursday, June 4, 2015 at Bon Secours Mary Immaculate Hospital in Newport News, VA. The procedure was an anterior cervical discectomy and fusion on a 57 year old, male patient.  The patient suffered from both neck pain and bilateral shoulder pain as a result of stenosis at the operative level C3-4. Prior to undergoing surgery, the patient failed conservative treatments including physical therapy and anti-inflammatories.

SpineFrontier’s A-CIFT SoloFuse-P is a Less Exposure Surgery (LES®) technology. LES technologies are designed with outpatient surgery in mind and strive for less disruption of the tissues. The A-CIFT SoloFuse-P standalone, intervertebral body fusion device is a Less Exposure Surgery System featuring a simple, dual screw construct, a large graft window, large diameter screws, and slim, agile instrumentation. Its zero-profile and all PEEK-OPTIMA Natural design minimize tissue disruption.

Dr. McFarland remarked on the advantages of SoloFuse-P’s design in the operation: “Today’s case demonstrates an extremely minimally invasive surgical technique to fuse the cervical spine.  The new SoloFuse standalone device eliminates the need for an overly aggressive surgical exposure or removal of previous spinal instrumentation. It serves to minimize our patients’ post-operative discomfort and speed their final recovery.”

SpineFrontier engineer Lucas Diehl explained how A-CIFT SoloFuse-P leverages the familiarity of existing techniques while providing an alternative to cumbersome plating for one-level procedures. “Its standalone design makes implantation easier. The technology was designed with surgeons in mind. It’s easy. It’s simple. It’s consistent,” said Lucas Diehl.

Dr. McFarland currently practices orthopaedic surgery at the Orthopaedic & Spine Center in Newport News, VA where he focuses primarily on the care and treatment of injuries and disorders of the spine. Dr. McFarland graduated from Oklahoma State University Medical School in 1999. He completed his residency in orthopaedic surgery at Ohio University and then went on to complete an Orthopaedic Spine Surgery Fellowship at the Florida Spine Institute in Clearwater, Florida. Dr. McFarland is a member of the American Academy of Orthopaedic Surgeons and the American College of Osteopathic Surgeons. Among other honors, he received the “Graduating Physician Academic Excellence Award.” His research includes studies on vertebral compression fracture outcomes.

Also check it out on PRWeb & Boston.Com.

LES Society Hosts 26 Surgeons at First International Cadaver Course in Montego Bay, Jamaica

Montego Bay, Jamaica – February 3, 2012 – The Less Exposure Surgery LES Society, a non-profit educational organization for spine surgeons, held a hands-on workshop in conjunction with the 10th Annual Caribbean Neurosciences Symposium on January 27 and 28, 2012 at Half Moon, A Rock Resort, in Montego Bay, Jamaica. The cadaveric workshop is a modern fusion technique course that focuses on training spine surgeons on “Less Exposure Surgery for the Young and Aging Spine”.

The Montego Bay course was attended by 26 spine surgeons from the United States and Latin American countries, including eight LES Society surgeon faculty members and Course Directors Carl A.R. Bruce, MD and Adriano Valdez Russo, MD.

The weekend course kicked off with a dinner and lecture series at Half Moon, A Rock Resort, on January 27. The evening featured a lecture from Honorary Guest Norman B. Chutkan, MD, chief of orthopedic spine surgery at the Medical College of Georgia Orthopedic Surgery. The lecture series, presented by LES faculty surgeons, consisted of techniques including facet fixation, SI joint/pars/interbody fixation, interspinous fixation, lateral access, MISquito Percutaneous Pedicle Screws and Endoscopic Extraforaminal Fusion, all within the LES philosophy.

While the LES Society held four similar course workshops in 2011 across the U.S., this was not only the first 2012 event, but also the first international LES event.

“Transforming an empty ballroom into a fully functioning cadaver lab was a tremendous task but worth all the effort to see surgeons from the U.S. and Latin America transfixed on the new techniques they were learning,” said LES Society Course Coordinator Venessa Henry. “At the end of the lab, one surgeon said that he had a patient that would be perfect for one of the LES techniques and would book the case as soon as he got back!”

The LES Society received an unrestricted philanthropic grant to support the lab from SpineFrontier, Inc., a medical device company focused on developing less exposure surgery (LES) technologies who works in conjunction with the LES Society.

“We are committed to working with surgeons in order to develop the newest techniques and technologies for Less Exposure Surgery, and educate other surgeons so that together we can advance spine surgery, said Marwan Aylouche, Director of Global Branding for SpineFrontier, Inc. “We jumped at the invitation to support the LES Society through philanthropy.”

To register for an upcoming LES event, visit www.les-society.org.

About LES Society

The LES Society (www.les-society.org) is a non-profit, tax-exempt, educational organization whose purpose is to protect the health of the patient and to optimize the surgical procedure for the surgeon by promoting the less exposure surgeon philosophy.

LES Society Mission

The Less Exposure Surgery Society seeks to advance research, education and technology for tissue sparing treatments that allow for ease of application for the surgeon with improved outcome for the patient.

About Less Exposure Surgery (LES)

“Less Exposure Surgery Philosophy is to use proportionate surgical exposure for maximal effectiveness, preserve the anatomy, and lessen blood loss, surgical time and exposure to radiation,” said LES Society Course Chairman and Spine Surgeon Kingsley R. Chin, MD.

Thanks to our Philanthropic Supporter SpineFrontier

SpineFrontier Inc. (www.spinefrontier.com) is a growing medical device company that designs, develops and markets implants and instruments used in spine surgery. The SpineFrontier team is focused on developing innovative technologies and techniques for spinal surgery based on the Less Exposure Surgery (LES) philosophy. The company was founded in 2006 and is headquartered in Beverly, MA.

Contact

Media:
info@les-society.org
connecting@spinefrontier.com