AN INTRODUCTION TO
`
`MAs®
`
`MAXIMUM ACCESS SURGERY
`
`TRANSFORAMINAL LUMBAR
`
`INTERBODY FUSION
`
`This booklet is designed to inform you about the Maximum Access
`
`Surgery (MAS®) Transforaminai Lumbar /nterbody Fusion (TL/F) surgical
`
`procedure. It is not meant to rep/ace any personal conversations that
`
`you might wish to have with your physician or other member of your
`
`hea/thcare team.
`
`/\/ot a// the information here wi// app/y to your individuai treatment or its
`
`outcome. The information is intended to answer some of your questions
`
`and serve as a stimu/us for you to ask appropriate questions about
`
`th
`
`at
`eproce ure
`
`.
`
`MSD1132
`|PR2013—00506
`|PR2013—00508
`
`
`
`MAs®
`
`MAXIMUM ACCESS SURGERY
`
`TRANSFORAMINAL LUMBAR
`
`INTERBODY FUSION
`
`This booklet is designed to inform you about the Maximum Access
`
`Surgery (MAS®) Transforaminai Lumbar /nterbody Fusion (TL/F) surgical
`
`procedure. It is not meant to rep/ace any personal conversations that
`
`you might wish to have with your physician or other member of your
`
`hea/thcare team.
`
`/\/ot a// the information here wi// app/y to your individuai treatment or its
`
`outcome. The information is intended to answer some of your questions
`
`and serve as a stimu/us for you to ask appropriate questions about
`
`th
`
`at
`eproce ure
`
`.
`
`MSD1132
`|PR2013—00506
`|PR2013—00508
`
`
`
`MAXIMUM ACCESS SURGERY
`MAs‘ '|'|_|F TRANSFORAMINAL LUMBAR
`INTERBODY FUSION
`
`About the Lumbar Spine
`
`The area of your spine in your lower
`back is called the lumbar spine.
`It is made up of five bones, called
`
`vertebrae (or vertebral bodies).
`
`These vertebrae are connected by
`
`several joints, which allow you to
`
`bend, twist, and carry loads. The main
`
`joint between two vertebrae is called
`
`a disc. The disc is comprised of two
`
`parts, a tough and fibrous outer
`
`layer (annulus fibrosis), and a soft,
`
`gelatinous center (nucleus pulposus).
`
`These two parts work in conjunction
`
`9
`
`.
`
`V
`
`;
`‘
`
`CERWCAL
`
`to allow the spine to move, and also
`
`-. it
`
`o
`
`provide shock absorption.
`
`SACRUM
`._i_ __
`COCCYX
`
`ZONE OF SPINE
`FOR THE MAS TLIF
`SURGERY
`
`Anterior &
`
`Lateral View
`
`Front and side views of the lumbar spine
`
`
`
`What is causing my pain?
`There are several primary causes of spine problems. The majority of
`
`the symptoms are caused by disc, bone, or ligaments pressing onto
`
`the nerve roots.
`
`DEGENERATIVE DISC DISEASE (DDD)
`
`During the natural aging process, the discs between each vertebral
`
`body can lose their flexibility, height, and elasticity which can cause a
`
`tear in the tough outer layer of the disc, causing the disc to herniate,
`
`bulge or leak the gelatinous core. The bulges or leakages can end up
`
`compressing the nerve roots and/or spinal cord, causing symptoms
`
`including, but not limited to lower back and/or leg pain.
`
`What are my treatment options?
`Many of the symptoms can be treated without surgery with methods
`
`that involve medication, rest, heat, and physical therapy. It is important
`
`that you speak to your physician about the best options for you.
`
`If your symptoms do not improve with other methods, your physician
`
`may suggest spinal surgery. Surgery is reserved for those who do
`
`not gain relief from non—operative forms of treatment, patients whose
`
`symptoms are increasing or worsening, and/or patients that present
`
`with a spinal condition which indicates the need for surgery.
`
`What is a MAS® TLIF procedure?
`Lumbar interbody fusion is a surgical technique that attempts to
`
`eliminate instability in the back. A MAS TLIF achieves this by using
`
`a less invasive approach to fuse one or more vertebrae together to
`
`reduce their motion.
`
`In a l\/IAS TLIF procedure, rather than starting from the middle of the
`
`back and spreading the muscles to the sides like in a traditional back
`
`
`
`surgery, the MAS TLIF approach starts off to one side of the back and
`
`splits (rather than cuts) the back muscles in one direction. This allows
`
`the surgeon to make a smaller incision with less muscle injury, which
`
`may result in less postoperative pain and a quicker recovery.
`
`WHAT ARE THE POTENTIAL ADVANTAGES OF MAS“ TLIF?
`
`- Reduced blood loss and minimal scarring
`
`- Reduced hospital stay
`
`- Faster postoperative recovery time
`
`° Smaller incision
`
`Is a MAS TLIF right for me?
`Your physician might determine a MAS TLIF procedure is a
`
`good option for you if you require a spinal fusion at any lumbar
`
`level between L1 and S1, and you would benefit from a less
`
`disruptive approach.
`
`Conversely, your physician may determine that a MAS TLIF
`
`procedure is not a good option for you. It is important to discuss
`
`this with your physician.
`
`Are there risks involved?
`
`All surgery presents risks and complications that are important to
`
`discuss with your physician prior to your surgery. Listening to your
`
`physician's guidance, both before and after surgery, will help to ensure
`
`the best possible outcomes from your procedure.
`
`Some of the most common complications following MAS TLIF surgery
`
`include: problems with anesthesia, infection, nerve damage, problems
`
`with the graft or hardware, and ongoing pain. This is not intended to be
`
`a complete list of the possible complications.
`
`
`
`What can I expect...?
`
`BEFORE
`
`DURING
`
`Before surgery
`Your physician will review your condition and explain all of
`
`your treatment options, including non—operative treatments,
`
`such as medications and physical therapy. Once you have been
`
`admitted to the hospital, you will be taken to a pre—op room and
`
`prepared for surgery. This may include instruction about the surgery,
`
`cleansing of your surgical site, as well as instruction about the
`
`postoperative period.
`
`
`
`What happens during surgery?
`
`SURGICAL PROCEDURE
`
`After you are positioned on your belly and draped, an x—ray is taken of your
`
`spine to show the location of the operative disc space.
`
`APPROACH
`
`DISC REMOVAL
`
`Typically, your surgeon will
`
`Your surgeon will then remove the
`
`make a small incision
`
`disc to reduce pressure from the
`
`on one side of your back.
`
`symptomatic cord or nerve root.
`
`The size of the incision can
`
`An appropriate implant, chosen by
`
`vary based on the number
`
`your surgeon, will be placed into
`
`of levels and/or complexity
`
`the disc space to restore the proper
`
`of your case.
`
`disc height and provide mechanical
`
`support while bone grows between
`
`the vertebral bodies during the fusion
`
`(bone healing) process. That segment
`
`of your spine will eventually stabilize
`
`once fusion occurs.
`
`What implants are used?
`Below are some examples of implants that may be used during your
`
`l\/lAS® TLIF procedure:
`
`Implant in
`Anatomy
`
`lnterbody
`Implant
`
`
`
`BEFORE
`
`DURING
`
`AFTER
`
`IMPLANT
`
`FIXATION
`
`Screws will be placed into the
`
`The final result will be a
`
`vertebrae to provide stabilization
`
`construct with an interbody
`
`to the spine. Once the screws
`
`implant between the vertebral
`
`have been placed on the MAS®
`
`bodies, where the fusion
`
`TLIF side, screws are also
`
`will occur, and screw and
`
`inserted on the opposite side of
`
`rod fixation on both sides
`
`the vertebrae through one or two
`
`to stabilize.
`
`small skin incisions. These screws
`
`provide additional stability to help
`
`hold everything in place while
`
`fusion occurs. They are inserted
`
`through a small, minimally
`
`disruptive incision.
`
`Postsurgical
`
`View
`
`
`
`BEFORE
`
`DURING
`
`What can I expect...?
`
`After surgery
`Patients usually require a stay of 1-2 days in the hospital.
`
`Your physician will discuss what is right for your particular case.
`
`The day after your surgery, your physician may instruct you to
`
`use a brace for a period of time to assist with the spinal fusion
`
`process. Supervised by trained medical professionals, your
`
`physician may ask you to carefully sit, stand, or walk within
`
`24 hours of the surgery.
`
`Once you are discharged from the hospital it is important to limit
`
`your activities for a period of time (determined by your healthcare
`
`provider) to give your body a chance to heal. Your physician will
`
`provide instructions on wound care, exercises, and limitations to
`
`postoperative activity.
`
`
`
`Frequently asked questions
`
`CAN I SHOWER AFTER SURGERY?
`
`Depending on your surgical incision, you may have showering
`
`restrictions. Ask your physician for appropriate instructions.
`
`WILL I HAVE A SCAR?
`
`Your physician will discuss the incisions that will be made during
`
`your l\/lAS® TLlF surgery. Small scars of approximately one and a
`
`half inches are common.
`
`WHEN CAN I DRIVE?
`
`For a period of time after your surgery, you may be cautioned about
`
`activities such as driving. Your physician will tell you when you may
`
`drive again.
`
`CAN I TRAVEL?
`
`The implants used in the MAS TLIF procedure may activate a metal
`
`detector. Because of increased airport security measures, please
`
`call your local airport authority before traveling to get information
`that might help you pass through security more quickly and easily.
`
`Ask your physician to provide a patient identification card.
`
`
`
`
`
`RESOURCES
`
`For more information about the MAS® TLIF procedure please visit:
`
`WWW.NUVASlVE.COM
`
`/f you have any questions about the l\/IAS TL/F procedure or
`
`spine surgery in general, please call or see your physician, who is
`
`the only one qualified to diagnose and treat your spinal condition.
`
`This patient information brochure is not a replacement for
`
`professional medical advice.
`
`
`
`AN INTRODUCTION TO
`
`MAXIMUM ACCESS SURGERY
`|V|AS® '|'|_|F TRANSFORAMINAL LUMBAR
`INTERBODY FUSION
`
`?\ 1\1U\/A.S4\/E
`
`800.475.9132 9
`7475 Lusk Blvd., San -Diego, CA 92121
`WWW.NUVAS|VE.COM
`
`800.475.9134
`
`©2013. NuVasive, Inc. All rights reserved.
`'\ , NuVasive, Speed of Innovation, and MAS are registered trademarks of Nuvasive, Inc.
`
`9501028 A
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