Artificial Implant Prosthesis Could Replace Spinal Fusion

A novel artificial spinal joint restores function to the posterior spinal column in people suffering from spinal stenosis.

The Total Posterior Solution (TOPS) system is a titanium-sandwiched implant that effectively replaces anatomical structures removed from the vertebrae during the spinal decompression treatment to alleviate pain, such as the lamina or the facet joint. Thus, the boot and internal components of the implant take the place of the supraspinous ligament, interspinous ligament, and ligamentum flavum in their ability to help control flexion. The internal metal stoppers replace the natural bony elements that served as stoppers during axial rotation.


The implant thus allows axial rotation, lateral bending, extension, and flexion, facilitating bending, twisting, and straightening movements at the affected segment of the spine, while blocking excessive posterior and anterior sagittal translation. Once a controlled range of movement is reestablished, patients regain their ability to bend, flex, walk, and enjoy the normal activities of life, while at the same time experiencing immediate and sustained pain relief. The system also protects adjacent levels of the spine from similar degeneration, a common unwanted side effect of fusion surgery.

As with most spinal fusion devices, the TOPS System is anchored to the spine with four standard polyaxial pedicle screws, and is implanted via a traditional posterior surgical approach. The system is intended for adult patients following decompression surgery to alleviate pain stemming from spinal stenosis and/or degenerative spondylolisthesis affecting the L3-L5 lumbar region of the spine, when nonsurgical treatments have failed to provide relief. The TOPS System is a product of Premia Spine (Netanya, Israel), and can be used in conjunction with Premia Spine's Versalink Fixation System to address multilevel diseases of the spine.

“We’ve developed an implant that recreates all functions of the posterior spinal column, where there are important joints, ligaments, and bony structures that provide control over twisting, bending, and flexing,” said Ron Sacher, CEO of Premia Spine. “With the TOPS System, instead of immobilizing we replace the diseased segment with an artificial joint.”

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Premia Spine