Shielded Drill Facilitates Thoracic Interbody Fusion Procedures

A novel high-speed curved spinal decompression device with a built-in shield allows safe posterior thoracic discectomy, according to a new study.

The Carevature Medical (Rehovot, Israel) DReal decompression system (DDS) is a minimally invasive, high-speed bone removal instrument with a forward facing drill at the distal end that includes integrated irrigation. The curved tip of the device has a nine mm radius of curvature, seven mm of which are shielded on the underside in order to protect neural elements from multiple angles. The remaining two mm active tip can be used to treat all anatomical segments of the spinal column--cervical, thoracic, and lumber.


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

A new study conducted at Assuta Hospital (Tel Aviv, Israel) shows that introducing the DReal ventrally to the dural sac allows removal of calcified and soft disc fragments during posterior unilateral thoracic discectomy, via a modified approach that obviates forceful manual maneuvers and avoids spinal cord manipulation. The technique has been used to treat pathologies in transforaminal thoracic interbody fusion procedures (TTIF), as well as in common transforaminal lumbar interbody fusion procedures (TLIF). The study was published on January 20, 2020, in The International Journal of Spine Surgery.

“The DReal curved high speed drill has proved a valuable addition to my clinical practice. It allows quick and thorough evacuation of disc material in TLIF procedures providing a large clean bony surface for fusion while reducing operating time,” said lead author orthopedic spine surgeon Michael Millgram, MD. “My impression is that TLIF procedures performed with the DReal exhibit a considerably more robust anterior fusion than those procedures where disc space preparation was performed in the standard manual manner.”

“Our company is laser focused on improving outcomes through novel technology which is designed to safely, efficiently, and effectively remove pathology while retaining structural anatomy and minimizing the collateral damage often associated with spine surgery,” said Dennis Farrell, President of Carevature Medical. “Carevature continues to research, develop, and launch solutions that advance the art of the decompression through our family of sterile packed, single-use, curved at the tip, shielded, and high speed bone cutting technology.”

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Carevature Medical
Assuta Hospital