New implant helps ease spinal lumbar fusion surgeryJul. 14, 2022, 9:24 AM
by Emily Stembridge
Raymond Gardocki, MD, associate professor of Orthopaedic Surgery, played an instrumental role in developing and implanting the Flarehawk 9 — a first-of-its-kind interbody implant that can be placed endoscopically during spinal lumbar fusion surgery.
The patient Gardocki cared for had previously undergone a traditional open fusion — using a bone graft to join two vertebrae into one long bone — eight years ago. This time, due to the new device’s ultra-minimally invasive nature, she was able to recover and return to her normal activities much sooner than her previous experience with open surgery. The lumbar fusion performed by Gardocki was done on an outpatient basis without an inpatient hospital stay.
“The Flarehawk 9 is an expandable cage, but unlike some that only expand on height upon insertion, this one can expand in both height and width,” Gardocki said. “You can use a smaller corridor with less nerve retraction to place it.”
Gardocki’s extensive experience in endoscopic surgery meant he was well-equipped to help develop the instruments for endoscopic insertion of the new device when he was asked to join the effort to develop it.
Gardocki built the preliminary endoscopic insertion cannula, which can now be inserted through a 13 millimeter diameter before expanding to 14 millimeters tall and 14 millimeters wide. For perspective, a dime measures 18.5 millimeters in diameter.
Gardocki is also able to perform the implantations on patients under conscious sedation without the need for intubation — often on elderly patients who may not be able to tolerate general anesthesia.
Since the new implant can expand farther than previous iterations, it is particularly useful for large-framed people who need to undergo spinal lumbar fusion. For people of larger stature, previous implants were often too small for optimal support.
“I compare this work to building a ship in a bottle,” Gardocki said. “It’s become so minimally invasive that I’m now able to do these as an outpatient procedure.”
The most common conditions Gardocki treats with endoscopic interbody implants are degenerative spondylolisthesis, a disorder that causes the slip of one vertebra over the one below due to degenerative changes in the spine, and lumbar spondylosis, a condition that causes abnormal wear on the cartilage and bones of the lumbar spine.