William Tobler, MD

May 21, 2008
FOR IMMEDIATE RELEASE

CONTACT:
Tom Rosenberger, APR
Communications Department
(513) 569-5260

Cindy Starr, MSJ
Communications Department
(513) 569-5321

Illustration of a single-level AxiaLIF procedure. Using long narrow instruments, a working tunnel is created between the bony sacrum and the pelvic organs to access the 5th lumbar vertebra. The diseased disc between L5 and S1 is removed and a screw is inserted to fuse the bones together.

Mayfield Clinic’s William Tobler, MD, reaching milestones
in minimally invasive fusion of the lumbar spine

First two-level AxiaLIF® successfully completed at Cincinnati’s Christ Hospital

CINCINNATI – William Tobler, MD, a Mayfield Clinic neurosurgeon and subspecialist in spinal disorders, marked one milestone on Tuesday and is approaching two others in his successful use of minimally invasive fusion of the lumbar spine.

On Tuesday he performed the region’s first minimally invasive lumbar spinal fusion of two vertebral levels using Axial Lumbar Interbody Fusion, or AxiaLIF®, at the Christ Hospital Spine Institute. The patient was doing well following surgery.   

This summer Dr. Tobler also will mark the third-year anniversary of his first single-level AxiaLIF® case, also performed at Cincinnati’s Christ Hospital, and he expects to perform his 200th case overall.

The procedures are the least invasive approach to the lumbosacral region, which includes two vertebrae (L4 and L5) of the lower (lumbar) spinal column and the first vertebra (S1) of the sacrum (tailbone). The procedures, which require an incision of less than one inch near the top of the buttock and which utilize long, narrow instruments, are designed to fixate the lower spine in patients who suffer from degenerative disc disease or spondylolisthesis.

“What makes this so paradigm-changing is that it can be accomplished without cutting through the abdomen and its muscles or opening the spine from behind and damaging the spinal muscles,” Dr. Tobler says. “Many spinal fusions are performed by opening up the abdomen, with a vascular surgeon standing by to help protect major blood vessels exposed in that approach. With the AxiaLIF® procedure, there is less risk and less cutting. This results in reduced recovery time and discomfort for the patient.”

The single- and two-level procedures were developed by TranS1, Inc., a medical device firm based in Wilmington, N.C. The U.S. Food and Drug Administration approved the single-level procedure for L5-S1 in 2004. In April 2008 TranS1 received clearance to market AxiaLIF 2L™, its two-level percutaneous lumbar fusion system, in the United States. The two-level fusion is designed to treat degenerative disc disease at both the L5-S1 and L4-L5 lumbar discs through a single incision of less than one inch.

Christ Hospital has performed more AxiaLIF® procedures, Dr. Tobler says, than any other hospital in the world. In addition, more than 20 of the cases have been performed on an outpatient basis.

Worldwide, more than 4,000 cases have been performed, with only 18 significant complications, Dr. Tobler says. Most of the complications involved the perforation of the bowel, which, if recognized promptly, is highly treatable. “If it’s not recognized right away an infection could develop, requiring a colostomy,” Dr. Tobler says. “But physicians need to keep in mind that other life-threatening complications can, and occasionally do, occur with traditional approaches to spinal fusion.”

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The Mayfield Clinic is recognized as one of the nation's leading physician organizations for clinical care, education, and research of the spine and brain. With 20 neurosurgeons and two neurointensivists, Mayfield treats 20,000 patients from 35 states and 13 countries in a typical year.  Mayfield's physicians have pioneered surgical procedures and instrumentation that have revolutionized the medical art of neurosurgery for brain tumors and neurovascular diseases and disorders.