A new cervical spinal implant designed by Fred Geisler M.D., Ph.D. of the Chicago Back Institute at Swedish Covenant Hospital, has been introduced by Aesculap Implant Systems, LLC.
Dr. Geisler’s New Cervical Device
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The PL-AGE system is a stand-alone device intended for use in anterior cervical spinal fusion procedures at one level from C3-C7.
Dr. Geisler, according to a March 7, 2013, press release from the company, was the first physician in the U.S. to adopt anterior cervical plating.
“The PL-AGE implant is the only truly dynamic translational stand-alone cervical stabilization device that incorporates the superior mechanical benefits of dynamic stabilization, learned from clinical experience with dynamic cervical plates, ” said Dr. Geisler. “Contact between the rough textured titanium surface of the PL-AGE implant cage and the endplates, along with the generous bone graft window, provides an optimal osteogenic environment.”
The rough textured surface, according to Dr. Geisler, also provides immediate mechanical stability, making screw insertion safe, fast and accurate. “Furthermore, the PL-AGE screw insertion does not damage the vertebral endplates with screw holes, as occurs with other stand-alone devices, since the PL-AGE screws are inserted in standard ACDF plate trajectories through dynamic slots in two small tabs lying on the anterior vertebral body cortex. These two small tabs also effectively block the PL-AGE from rotation and angled subluxation during the normal healing of the arthrodesis into a mature cervical fusion. Thus, the PL-AGE incorporates the best mechanical and osteogenic features learned over the last 25 years for efficacy, speed and safety—all combined in one implant.”
According to the company statement, the PL-AGE offers an integrated plate-cage design featuring a one-piece titanium housing for strength, slotted screw holes for translational functionality and a textured surface that promotes fusion. The system is available in a comprehensive size range with a wide selection of instrumentation for intra-operative flexibility to accommodate varying patient anatomy. Self-drilling/self-tapping and self-tapping screws are available in two sizes and four lengths.
Click here to see a two-minute animation video of the system.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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