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Archive for the ‘Minimal Access Spinal Technologies’ Category

About Minimally Invasive TLIF Transforaminal Lumbar Interbody Fusion

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Overview  from

A Transforaminal Lumbar Interbody Fusion (TLIF) is an operation often indicated for patients suffering from back and/or leg pain caused by the natural degeneration of the disc space or some type of traumatic event.

The Minimally Invasive TLIF technique is a less invasive option incorporating the use of specially designed instruments that allow surgeons to achieve the same clinical goals of traditional, “open” TLIF but with much smaller incisions, causing less damage to the surrounding soft tissue.




The technique incorporates use of the II Tubular Retractor System and CD  II Spinal System. The METRx® II System provides minimally invasive access to the spine through tubular portals, while the CD  II Spinal System uses an innovative arc device to percutaneously (without a large skin incision) deliver screws and rods for spinal fusion.

* Through a minimal incision in the patient’s back, the surgeon uses specially designed dilators in the  II Tubular Retractor System to spread the muscle and tissues of the back. A tubular retractor, or “portal”, is then inserted over the dilators to maintain a clear pathway to the spine.

* Accessing the spine through the II Tubular Retractor, the surgeon removes a portion of the bone and the disc material, and places an implant in the disc space between the vertebral bodies. This spacer may serve to restore the natural height of the disc space, “unpinch” the nerves, and act as a scaffold for bone growth or “fusion” between the vertebral bodies.

* Finally, the surgeon may use the  Spinal System to place screws and rods in a minimally invasive fashion. These screws and rods are intended to stabilize the vertebral bodies while the bone fuses or heals.

Your browser may not support display of this image. Traditional, “open” TLIFs may often involve significant blood loss and a lengthy hospital stay. However, the Minimally Invasive TLIF technique may offer many patient benefits, including:

* Decreased intraoperative blood loss2
* Shorter hospital stays1
* Smaller incisions and scars
* Decreased post-operative medication needed while in the hospital1

1 Isaacs. Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion. J. Neurosurg: Spine. 3:98-105, 2005.

2 Park, Won Ha. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. SPINE 32(5):537-543, 2007.


Minimally Invasive Spine surgery These Dallas Doctors perform minimally invasive spine procedures: 

(These surgeons have extensive experience in both neurosurgery and orthopedics)  

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Pain Doctor, Pinnacle Pain, Chronic Pain, Pain Medication, Pain Meds, Dr. Jeffrey Wasserman

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Dr. Jeffrey Wasserman received his B.S. from Lafayette University and his M.D. from Penn State. He completed his Anesthesiology residency at Harvard’s Massachusetts General Hospital where he did fellowships in pain management and cardiac anesthesia. He has been a pioneer, first to bring several advanced interventional therapies to Dallas, and specializes in minimally invasive disc healing therapies. He represents numerous state and national pain committees. Dr. Wasserman is board certified in anesthesiology and a Diplomate of the American Board of Pain Medicine. This Dallas Texas Pain Doctor who prescribes pain medications like hydrocodine and oxycontin etc offers the full services of pain medicine and pain disorders. Pain care and pain injections are part of the ways this doctor treats pain and injuries when you get hurt.

Anesthesiology/Pain management

• Trigger Point Injections
• Botulinum Toxin Type A
• Cervical Epidural Injection
• Thoracic Epidural Injection
• Lumbar Epidural Injection 
• Sacroiliac Joint Injection
• Facet Block
• Kyphoplasty
• Radiofrequency Lesioning (Rhizotomy)
• Sympathetic Nerve Block
• Cervical, Thoracic and Lumbar Discography
• IDET (Intradiscal Electrothermal Therapy)
• DISC Nucleoplasty
• Intrathecal Pain (Pump) Therapy
• Spinal Cord Stimulation
• Epidural Lysis of Adhesions

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Dr. Henrik Mike-Mayer, M.D., Texas Back Institute, Texas Back Institute Fellow, TBI, Rockwall Spine Surgeon, Rockwall Pain Doctor

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Dr. Henrik Mike-Mayer, M.D.

Dr. Mike-Mayer is a fellowship trained Orthopaedic Spine Surgeon specializing in the non-operative and surgical treatment of spinal disorders. He completed his undergraduate degree at Drake University. He earned his medical degree at the University of Medicine and Dentistry – New Jersey Medical School. He received his Orthopaedic training and was Chief Resident at the Seton Hall University School of Graduate Medical Education in New Jersey. He completed a one year spine fellowship in Disorders of the Spine at Texas Back Institute. During this fellowship, he was exposed to the most complex spinal disorders and received training in the newest cutting-edge techniques and equipment. He continues to pursue training in the latest developments in spine surgery and is involved in clinical research including FDA IDE trials.

At doctors group, our commitment to our patients is the highest level of personal and comprehensive attention and care.

To ensure the highest quality of patient care, Dr. Mike-Mayer and his staff carefully and thoroughly evaluate each and every patient’s condition and provide the highest level of non-operative and surgical care necessary to improve spinal health. Dr. Mike-Mayer manages a wide-range of spinal cases from children, adult and geriatric patients, injured workers and sports injuries.


2504 Ridge Road, #206

Rockwall, TX 75087


Listing Details

2504 Ridge Road, #206,RockwallTexasUnited States, 75087

Become Pain Free | Pain Specialist in Texas

Minimally Invasive Stabilization, MIS

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A procedure that relieves certain painful spine conditions

Minimally invasive stabilization (MIS) at is performed in an outpatient environment for patients who are in search of a minimally invasive approach to spine fusion.

When compared to open fusion procedures, the advantages of minimally invasive stabilization performed at hospitals include:


Currently, Laser Spine Institute offers a few types of minimally invasive stabilization surgical procedures to treat problematic discs that other types of endoscopic spine surgery do not treat.

Minimally invasive stabilization commonly treated conditions:

Less than 3 percent of patients that seek endoscopic spine procedures at are recommended for a minimally invasive stabilization procedure. General anesthesia is used for minimally invasive stabilization surgery at Laser Spine Institute, but the recovery time following surgery is fairly quick, resulting in the patient being able to leave the facility within a few hours postoperatively. The minimally invasive stabilization technique used on a patient will depend on the specific character of the patient’s problem.

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Laser spine surgery is a minimally invasive surgery highly acclaimed by surgeons across the nation

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Laser Spine Surgery/Endoscopic Spine Surgery

Laser spine surgery is a minimally invasive surgery highly acclaimed by surgeons across the nation. It was introduced over 30 years ago, and has recently been excessively rising in popularity with evolved technology and knowledge. Laser spine surgery is typically a go-to procedure for patients with neck and back pain. Using lasers, doctors and neurosurgeons can more precisely target soft tissue to help relieve pain and ridding of excess dead tissue surrounding the spine. It is also a procedure used to trim any bulging or herniated discs to ease pressure on the spinal column and nerves.

Laser spine surgery has historically has been done by “going under the knife”, but with laser spine surgery, patients can rest assured that this minimally invasive procedure requires concentrated beams of light to relieve back pain. With laser spine surgery, the effects are safer and much more controlled. The result of the surgery is less blood loss, which results in a faster healing process, and minimal scarring due to it being less invasive. Also, using lasers can greatly decrease the amount of damage to any muscles or spine surrounding tissues because of the increased ability to control the concentrated beam of light, rather than “hand and knife.”

Although laser spine surgery is said to have unproven benefits by the National Institute of Health, doctors everywhere have relied on its usefulness to help relieve back and neck pain in countless patients. Laser spine surgery has become wildly popular in the medical field, and it is continuously and rapidly growing into an effective, helpful, and patient-convenient procedure that will undoubtedly continue to climb the charts.

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Fax #:  (888)238-9155 | E-mail Us

Written by becomepainfree

January 22, 2013 at 5:25 pm

Get relief from chronic neck and back pain with a minimally invasive alternative to open neck or back surgery

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For those suffering from chronic neck and back pain, daily life can be a painful struggle. Even the most enjoyable activities can be difficult to partake in when every movement brings up unbearable pain and discomfort. It’s extremely common for patients to feel helpless, hopeless, depressed, and out of options when short-term remedies fail to provide relief, and pain medications cause unpleasant side effects. But utilizes our Laser Spine Program and it has great news – our advanced endoscopic procedures can help you rediscover your life without neck and back pain. Unlike normal open neck or back surgery, ours require a less than 1-inch incision.

Call Us: (214) 396-3647 | (888) 373-3720
Fax #:  (888)238-9155 | E-mail Us


Laser Spine Surgery

Laser Spine Surgery

This means our procedures involve a much shorter recovery time than traditional back surgery, and in fact, many of our patients are back on their feet within an hour after their procedure.’s medical group performs more minimally invasive spine procedures each month than any other spine facility in the nation, so trust us for proven relief from chronic neck and back pain.

Call Us: (214) 396-3647 | (888) 373-3720
Fax #:  (888)238-9155 | E-mail Us

Robotic Guided Spine Surgery, State Of The Art Spine Surgery Technology, Robotic Spine Surgery, Spine Surgery Robot

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Spinal disorders encompass a spectrum of pathologies which  result in either pain, deformity or paralysis to the patient. Call Us: (214) 396-3647 | (888) 373-3720
Fax #:  (888)238-9155 | E-mail Us

No age is spared and the need for the surgical correction of the problem crosses the barrier of age and gender.

Most of the surgical procedures involve the fusion, stabilization or correction of the deformity or pathology by putting in screws in the individual vertebrae.

Screw placement is fraught with inherent risk of injury to the nerves, spinal cord or blood vessels, as it is a free hand procedure based on the surgeon’s orientation of the anatomy and guided by a radiological device called C arm.

The disadvantage was the lack of accuracy in these machines to detect possible injury to the vital structures in complex anatomical deformities of the spine or in patients who were already oper-ated and needed a revision surgery.

Thus a need for a more accurate and safe guidance device to improve the safety levels in screw placement was increasingly felt.

The concept of a monitoring and navigating device to aid the surgeon in operating on deformed and crooked spines has been developed since the late 1990s.

The early systems rely on the use of reference points on the spine, which are fed into a computer which calculated the path of a safe screw in the vertebra, based on a CT scan reconstruction of the spine.

This system has its own flaws and required the surgeon to navigate the spine, which makes the process cumbersome.

Moreover the accuracy of such systems in large trials was suspect, as it is still a free hand procedure.

This led to the development of a highly advanced state of the art technology, where a small robot aligns itself in the direction of the pedicle, which is a part of the backbone where the screws are put. The robotic arm is moved by a software which matches the preoperative high resolution CT scan of the patient’s spine with the images of the patient’s spine captured by a C-arm, which is a portable X-ray device used to see the bones during orthopedic surgery.

Once the bones are matched and the individual parts are registered on the machine this aligned robotic arm guides the surgeon to place the screws in a very accurate fashion.

The path of the screws is planned by the surgeon on the day prior to the surgery on a computer.

All the details of the surgery including the sizes of the screws and implants, number of implants and the various other angles and distances for the respective screws are programmed by the surgeon.

On the day of the surgery, these details are available to the surgeon at the click of a button. This makes the whole procedure faster, safer and more accurate.

The recent advances in spine surgery has included Minimally Invasive Spine Surgery, also called Keyhole surgery in common parlance.

In these surgeries, the skin is not cut in great lengths on the back.

The entire surgery is done through one or more small incisions the sizes of small keyholes.

This gives the patient the advantage of a faster return to work and easier rehabilitation, lesser blood loss and pain.

For these types of surgeries, a  number of X rays are taken during the surgery to determine the correct level and the exactness of implant placement.

This endangers the patient, surgeon and other operating room personnel to a lot of radiation hazards. The robotic  guided surgery  decreases the amount of radiation exposure by 10 times vis-à-vis a standard keyhole procedure.

Ever since the Spine Surgery Unit headed by Dr Sajan Hegde conceived of getting this technology to India for the first time, it has been followed very keenly in the hospital.

The robotic guidance system called Mazor Rennaisance, is developed by an Israeli company called Mazor Robotics Limited.

The company sent its prog-rammers  and trainers to Chennai to our Hospital to train and instruct the various theoretical and practical intricacies. An instructional course with training was given to the surgeons, OT nurses and all the other involved personnel.

A dry run on bone models was carried out and once it was sure that all the systems necessary were in place, only then Dr Hegde’s team went ahead and performed the surgeries.

Since the whole team was new to this procedure, a few technicians and programmers from the company came down to India along with the machine and helped in the initial few surgeries to avoid any glitches.

Since its launch to date, close to 20 spine surgeries have been operated, some of which were extremely complex deformities and would have been very difficult, if not impossible to perform without guidance.

One young girl, who had been operated many times on her back for her scoliosis with failures at each attempt, came to us with a desire to get operated for the deformity. During the surgery we saw that the whole of the anatomical landmarks necessary for the free hand placement of the implants was lost and there was no way the screws could have been put.

It was at that time we realized the value of the robotic guided system to enable us to place the screw in the bone without any damage to the blood vessels or nerves.

Another patient who was suffering from severe kyphosis (hunch-back) due to a disease called Ankylosing spondylitis was operated with a deformity correction and eventual straightening of the back.

Many of the surgeries which were planned to be done in the minimally invasive way were executed with as less as 10% of the radiation in a standard C arm guided keyhole surgery.

There are patients in whom the robot has been used to obtain tissue for biopsy from an exact preplanned location, as in the case of an elderly woman with breast malignancy and metastases to the spinal column.

Another useful instance has been in a middle aged lady who had a severe scar on her back due to a previous burn. This lady came to us with infection of the backbone  and incomplete paralysis of the lower limbs.

Since the skin of the back did not permit a standard open back surgery, a keyhole stabilization was done beautifully using the robot.

Planning and executing of this project was both technically and logistically  difficult. There  were initial teething problems in getting everything to fall in its place.

The time taken in the initial surgeries was slightly long. But the learning curve became shorter with each case.

Once all the participants in the surgery were familiar with the procedure of the robot, the surg-ical times decreased drastically.

Also the understanding of the system improved and hence a smooth flow was seen in the oper-ation theatre in the subsequent cases. This technology (Rennaissance, Mazor) has helped us to achieve accuracy levels as high as 98% compared to a standard free hand accuracy which rarely exceeds 90 percent.

More so in the scenario of a very complex deformity in young adults or children where the risk of improper and dangerous surgery is high, the robot has assured the surgeon and the patient with the high safety levels it provides.

Though the instrument is expensive and requires the use of a certain amount of disposables each time, the actual cost incurred to the patient rarely exceeds an additional 20 percent on the total expenses for the surgery.

The patient can be comfortable knowing that the surgery planned is a highly accurate one and that there is no scope for any untoward complication. Thus the benefits compared to the extra cost involved are high enough to take this up. With respect to the hospital, we can be proud that we are the first hospital to introduce this technology in Asia (outside of Israel ), beating countries like China , Singapore , Japanand Korea to the mark.

This has helped brand our hospital as a pioneer in the safe management of complex and otherwise dangerous spinal deformities.

As of date, we have patients from other countries too who have been operated using this state of the art technology.

This bears testimonial to our superiority in technology advancement in the field of spine surgery, making our hospital one among the top centers in the world. The operating room personnel too are benefitted as the radiation exposure due to an image intensifier is reduced to miniscule proportions.

The surgeon and his team, at the end of the day, return home with the satisfaction of having done an accurate and safe surgery.

At the same time we would like to also mention that the surgery as such is normal as a conventional surgery, but the robot finds the safest possible path.

In that sense the robot does not replace the surgeon, as is the normal misconception. On the contrary, the surgeon is backed up by the foolproof planning done prior to the surgery on the robotic software.

Our review of all the patients operated has been excellent and we can confidently assert that the robotic guided surgery has made spine surgery a safer proposition, in addition to reducing the stress on the surgeon and his team in the operation theater.

The future of spine surgery is shaping in the direction of minimally invasive surgeries where the stress shall be on earlier return to productive activity to the patient and reduction of the hospital stay and expenses.

From the surgeon’s perspective too, the use of the robotic guiding systems would mean more safety levels, lesser radiation hazards and stress free situations in the operating room.

Technology is ever advancing and it is the duty of the medical fraternity to keep abreast with it as the patient has the right to benefit from every such advancement. Call Us: (214) 396-3647 | (888) 373-3720
Fax #:  (888)238-9155 | E-mail Us

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