Spinal Stabilization Technologies™ introduces a potentially less invasive surgical treatment when compared to spinal fusion or total disc replacement: The PerQdisc™ Nucleus Replacement System. A technique where only a small portion of the outer disc needs to be exposed, the PerQdisc system replaces the diseased and dysfunctional nucleus pulposus in an effort to recreate physiological motion and redistribute the weight bearing forces and mechanical properties of the disc 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. The patient should have a minimum disc height of 6 mm.
The PerQdisc Implant (Figure 1) 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 to verify the position of the implant, the outer chamber of the implant is then filled with a polymer. The liquid polymer cures in situ within 10 minutes at body temperature. Once cured the delivery system is withdrawn.
Figure 1. PerQdisc Implant – L3/4
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 provides 50% of the load bearing requirements of the motion segment.
Figure 2. PerQdisc™
The PerQdisc™ is designed for use using a lateral traspsoas or retroperitoneal (i.e., anterolateral) surgical approach to access disc space. Access through the annulus can be achieved using the PerQdisc™ Disc Access System (Figure 3). Once annular 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 as well as provides real-time monitoring of fill pressure. The outer chamber of the implant is then filled under pressure control with a curable, 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