Featured Case: MAS Midline Versatility with Bilateral TLX 20°


In our Featured Case series, NuVasive showcases innovative cases and how our technologies are integrated to create a cohesive system to address key patient pathologies. Our mission at NuVasive is to transform surgery, advance care, and change lives and we are constantly focused on how to deliver improved patient outcomes, increase OR safety and efficiency, and extend our technology to future applications.

In this Featured Case, we present a 66-year-old male with L4-L5 DDD, facet hypertrophy and lateral stenosis resulting in back pain and right leg radiculopathy not responsive to extensive nonsurgical care.

The patient connected with Dr. Pinakin R. Jethwa of Altair Health in Neptune, NJ. Based on the patient’s diagnosis, Dr. Jethwa performed a less invasive PLIF approach at L4-L5 utilizing the MAS Midline System. Utilizing his direct visualization of both facets, Dr. Jethwa, performed a bilateral facetectomy and laminotomy, he then implanted TLX 20° with Osteocel Pro and Reline Open cortical screws; providing segmental stabilization, restoration of spinal alignment, direct and indirect decompression.

“The goals of lumbar spinal fusion surgery are threefold: (1) complete decompression of all neural elements, (2) fixation of the affected spinal segments with adequate surface area for bony fusion, and (3) maintenance or restoration of spinal alignment.”

Dr. Pinakin R. Jethwa

Through the use of the MAS Midline system, Dr. Jethwa was able to decompress, implant bilateral TLX 20° cages (26mm in length) and cortical screws all from the prone position with a standard laminectomy incision; reducing operative time, tissue trauma, blood loss, radiation exposure and anesthesia exposure time.

“The NuVasive MAS Midline approach using cortical screws and TLX 20° expandable cages allows me the achieve all of these goals with a much less invasive approach than traditional open PLIF or TLIF. The incision and muscle dissection is no larger than I would use for a standard laminectomy. The minimal exposure leads to less blood loss, faster operative times, and enhanced patient satisfaction and recovery after surgery.” 

Dr. Pinakin R. Jethwa

The case was completed in 90 minutes and the patient was able to go home the next day. At the two-week follow-up visit, the patient reported feeling great and eager to return normal activities. Since then, the patient has required; no rehabilitation, no pain medications, no muscle relaxers, and has had no complications. As of the last patient visit everything was stable and decompressed.

Note: Osteocel Pro is not available for sale to the EU market.

An individual’s surgical procedure and recovery may deviate from what is described herein. Each case is unique and has its own independent considerations.  It is the surgeon’s responsibility to discuss all relevant risks with the patient prior to surgery.

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