Spinal Decompression Drill Reduces Risk of Dural Tear

A unique surgical drill is both powerful enough to efficiently cut bone, and small enough for use in all sections of the spine.

The Carevature Medical (Rehovot, Israel) DReal Decompression System (DDS) is a minimally invasive, high-speed bone removal device with a curved active tip and a forward facing drill positioned at its distal end, shielded on the underside in order to protect neural elements from multiple angles. Feature include integrated irrigation, a nine mm radius of curvature, and a small, two mm active tip that covers all anatomical segments of the spine (cervical, thoracic, and lumber).


The system comes with a range of single use drill tips, including a 45 degree angle regular tip, a 75 degree extended tip, tips with front or rear facing shields, and fluted drills or diamond burr cutters available in two or three mm diameter sizes. The DReal system is powered by a range of recommended electric or pneumatic motors compatible with a micro connection, or by using appropriate adaptors; the motor system is not included and not part of the device.

“I've been deeply impressed with the design and function of these devices. I don't believe any other device on the market can provide these results. Furthermore, it increases the efficiency and safety with which I can perform multiple, dissimilar spinal procedures,” said neurosurgeon Scott Kutz, MD, of the Texas Back Institute (Plano, TX, USA). “In particular, these devices are extremely helpful in minimally invasive spine surgery, a market segment that's expanding relative to standard spine surgery. I expect that use of the Dreal system will grow exponentially over the next few years, in step with the demand for minimally invasive spinal techniques.”

The dura mater encloses the brain, spinal cord, cauda equina, nerve roots, and cerebrospinal fluid (CSF). A durotomy, or dural tear, can occur during spinal surgery, requiring a water-tight closure in order to prevent a CSF leak, as without adequate treatment, it can lead to various clinical complications, such as pseudomeningocele, meningitis, and re-operation. In addition, dural tears can often lead to longer hospitalization and increased costs.

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