Spinal Stabilization Technologies™ is pioneering what may be a radically less invasive surgical treatment when compared to spinal fusion or total disc replacement: The PerQdisc™ Nucleus Replacement System. The PerQdisc surgical procedure requires a small portion of the outer part of the disc to be exposed in order to access the nucleus and also to create a cavity to implant a patient specific, form fitting, custom implant. This technology replaces the diseased and dysfunctional nucleus pulposus in an effort to recreate physiological motion and redistribute the disc’s weight-bearing forces and mechanical properties in a more natural fashion.
PerQdisc™ Nucleus Replacement System
The SST PerQdisc Nucleus Replacement System is intended to replace the nucleus pulposus of the intervertebral disc in the L1-S1 spinal region in patients with single-level discogenic pain. The patient may have single or multi-level degenerative disc changes but the discogenic pain must be limited to a single level. The patient must be skeletally mature, at least 21 years of age, presenting with moderate to severe low back pain (with or without leg pain) that is unresponsive to non-surgical conservative treatments. The patient should not have a history of prior lumbar spine surgery, however, the patient should have a minimum disc height of 6 mm. Click below for complete lists of Patient Qualifications and Risks Associated with the PerQdisc Nucleus Replacement:
Degenerative Disc Disease
The PerQdisc Implant (Figure 1), a malleable elastic device, consists of a shaped membrane as an outer chamber with an additional internal chamber. Each chamber is independently inflatable. Once the device is placed inside of the prepared disc space, the inner chamber is filled with radiopaque contrast media, thus allowing the surgeon to visualize and to verify the position of the implant, the outer chamber of the implant is then filled with a silicone polymer. The liquid polymer cures in situ within 10 minutes at body temperature. Once cured, the implant the delivery system is withdrawn.
Figure 1. PerQdisc Implant – L3/4
Video: PerQdisc™ Technology
Video: A 3D Animation of the PerQdisc™ Future Technology
PerQdisc™ Mechanism of Action
The PerQdisc (Figure 2) acts by replacing the physical space of the nucleus with an implant that aims to behave in a similar fashion to a healthy native nucleus. The PerQdisc™ is comprised of an incompressible material which, when contained by the annulus helps recreate physiological motion and redistribute the weight bearing forces and mechanical properties of the disc in a more natural fashion.
Figure 2. PerQdisc™
The PerQdisc™ is designed for implantation using a lateral transpsoas or retroperitoneal (i.e., anterolateral) surgical approach to access the disc space. Access through the annulus can be achieved using the PerQdisc™ Disc Access System (Figure 3). Once nuclear access is achieved, a nuclectomy (removal of nucleus material) is performed through the disc access using various tools to remove most of the nucleus material.
Figure 3. PerQdisc™ Disc Access System
The PerQdisc™ Implant Delivery Device (Figure 4) is then inserted through the Access Cannula into
the enucleated disc space. Contrast is injected into the inner chamber of the implant. This aids in visualization and provides real-time monitoring of the fill pressure. The outer chamber of the implant is then filled under pressure control with an in-situ curing silicone polymer containing barium sulfate. The polymer cures in situ within 10 minutes at body temperature. Once cured, the contrast media is removed from the inner chamber of the implant and the delivery system is withdrawn.
Figure 4. Implant Delivery Device