LISA stands for Lumbar Implant for Stiffness Augmentation and is a novel motion preservation surgical device designed to treat painful lumbar spinal stenosis and chronic low back pain.
What is the clinical problem?
Degenerative disease of the lumbar spine is a significant cause of disability in the world; it encompasses conditions such as spondylolisthesis, disc degeneration, and lumbar spinal stenosis. 403 million (5.5%) individuals worldwide with symptomatic disc degeneration, and 103 million (1.41%) individuals worldwide with spinal stenosis annually.
1.Vijay M. Ravindra, MD, MSPH, Steven S. Senglaub, MS, Abbas Rattani, MBe, Michael C. Dewan, MD, MSCI, Roger Härtl, MD, Erica Bisson, MD, MPH, Kee B. Park, MD, and Mark G. Shrime, MD, MPH, PhD,Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume,Global Spine Journal 8(117):219256821877076, April 2018
How does LISA work?
LISA stabilizes the motion segments by preserving natural mobility, restores spinal sagittal balance through preservation of lumbar lordosis & allows the liberation the neural structures.
LISA resolves the undertreatment / overtreatment dilemma for Stenosis patients by granting an adequate choice to: Decompression alone which may further destabilize the segment & Irreversible fusion procedure, when the lumbar disc is not entirely collapsed.
LISA aims to restore healthy functions for lumbar Stenosis patients, and chronic low back pain, unresponsive to non-surgical treatments, by providing an adequate and reversible solution to treat the root cause of the pathology.
What are the benefits?
LISA is a novel motion preservation surgical device designed to treat painful lumbar spinal stenosis and chronic low back pain.
LISA is CE marked.
LISA is minimally invasive:
- Smaller incisions
- No or little muscle cutting
- Smooth, easy & fast surgery
- Less blood loss
- Reduced infection risk
- Reduced postoperative pain risk
- Less narcotics
- Less rehabilitation
- Faster recovery
LISA restores the natural flexion & extension movements at the operated level & preserves adjacent level kinematics without fusion or access to the pedicle.
LISA maintains foraminal height.
LISA is complementary to the anatomy and does not require any bony purchase.
LISA has a very light footprint in the body.
LISA off loads the disc and the facet joints.
LISA protects adjacent segments from extraordinary stress & degeneration.
LISA is fully & easily reversible.
Benefits vs. Decompression
Decompression is appropriate for many patients. However, the removal of the bony and stabilizing elements along with hyper mobility caused by the decompression may cause the spine to become unstable. In the largest population study of more than 200,000 patients, Castillo et al² found that patients who had previously undergone a lumbar discectomy were roughly three times more likely to undergo a lumbar fusion procedure than a patient with a lumbar diagnosis, but had not undergone a lumbar discectomy.
Benefits vs. Fusion
Fusion is appropriate for many patients. However, motion is irreversibly lost at the treated segment, and has degenerating consequences for the adjacent levels. Saavedra-Pozo et al3 advanced that fusion plus the presence of abnormal end-fusion alignment (usually kyphosis) appears to be a major factor in creating end-fusion stresses that result in ASDeg and ASDis. In a historical cohort study of long-term outcomes of Lumbar fusion among workers’ compensation subjects Nguyen et al4 concludes that Lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a Workers’ Compensation setting is associated with significant increase in disability, opiate use, prolonged work loss, and poor Return To Work status.
Adjacent Segments Relentless Degeneration
- Shi L. L., MD, Michael J. Lee, MD Lumbar discectomy is associated with higher rates of lumbar fusion. The Spine Journal March 2019Volume 19, Issue 3, Pages 487–492
- Saavedra-Pozo F M, MD,1 Deusdara Renato A. M., MD,2 and Benzel E. C., MD3 Adjacent Segment Disease Perspective and Review of the Literature. Ochsner J. 2014 Spring; 14(1): 78–83
- Nguyen, Trang H., MD, PhD*; Randolph, David C., MD, MPH*; Talmage, James, MD†; Succop, Paul, PhD*; Travis, Russell, MD‡. Long-term Outcomes of Lumbar Fusion Among Workers’ Compensation Subjects: A Historical Cohort Study. Spine: February 15, 2011 – Volume 36 – Issue 4 – p 320–331
Why chose LISA?
LISA offers a greater clinical value:
- Leg and back pain relief (immediate & long-term)
- Less time in the operating room (7” – 15” Vs 45” – 90” for Fusion)
- Less blood loss (40cc – 100cc Vs 500cc – 1500cc for Fusion)
- Limits paraspinal musle atrophy
- Shorter hospital stay (Ambulatory Vs 3 – 5 days for Fusion)
- Faster relief of symptoms & quicker recovery (pain & function)
- RoM maintained at both treated & adjacent segments
- Adjacent segment protection