The spine experts at Israel-based Expanding Orthopedics Inc. (EOI) are likely celebrating these days, as they have recently received U.S. commercialization clearance for their FLXfit, the world’s first 3D expandable interbody cage.
Expanding Orthopedics: U.S. Clearance for FLXfit

Ofer Bokobza, CEO of Expanding Orthopedics, said in the July 21, 2014 news release, “I am extremely proud of the EOI team and our KOLs worldwide enabling us to reach this significant milestone. The FLXfit is the first TLIF cage available worldwide with the 3D expansion capability. This unique and patented technology combines minimal invasive access, maximum footprint support and large bone graft chamber with unique lordotic expansion for sagittal balance correction.”
Dr. Hansen Yuan, a worldwide recognized spine surgeon and one of the leading industry experts as well as a Director at EOI added, “I don’t know of any other cage commercially available in the U.S. combining this many critical and beneficial features as the FLXfit. Minimal invasive through a single, small port, self-steering articulation for optimal placement, large footprint for best stability and a large plate-to-plate bone graft chamber for solid bone fusion.” Additionally, Dr. Yuan explained that the “real revolution of the FLXfit is the combination of these features with the unique lordotic expansion technology which enables an optimal press fit while restoring the anatomy of the spine and lordotic angle correction.” He added “the FLXfit has the potential to change the way spine surgeons treat their patients today.”
Bokobza stated, “EOI is already in the process of signing distribution agreements with leading U.S. spine distributors and I expect the FLXfit to quickly become a significant player in the fast growing expandable cage segment based on its unique capabilities. This segment shows a steady 30% CAGR with an established reimbursement codes.”
Bokobza, concluded, “As part of our continuous strive to improve spine’s standard of care, the EOI team together with its distinguished advisors is going to execute on our product pipeline and deliver a complete family of expandable cages based our expanding devices IP Platform. The expanding cages’ product family, coupled with the CE Marked XPED Expandable Pedicle Screw System, will reinforce our position as a leading company delivering innovative expanding devices and strengthen our vision as a driver for continuous improvement in spine care solutions.”
Bokobza told OTW, “Our vision is to provide innovative solutions that can improve the standard of care. We are planning to implement this vision in the U.S. starting with this revolutionary product and to continue to introduce additional unique products based on our large IP portfolio. In the next few months, the company will focus on building a U.S. infrastructure to enable smooth introduction of its products.”

Discussion
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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