TriALTIS™ Spine System

Back to search

TriALTIS™ Spine System

Christian Mazel, Naresh Kumar, Firoz Miyanji, Yu-Mi Ryang, Kevin Seex

Fig 1: The TriALTIS™ Spine System

The TriALTIS™ Spine System is a next generation posterior thoracolumbar spine implant system with a clinical focus on open surgery for degenerative, tumor, trauma and deformity pathologies in adults. Combining a new portfolio of implants with digital enabling technology, the TriALTIS™ Spine System aims to address unmet clinical needs and help surgeons achieve more consistent outcomes in treating complex spine conditions. Novel implants include polyaxial screws, favored angle screws, set screws, rods, and instruments.

Leveraging design features of the EXPEDIUM^™5.5, VIPER^™Spine, and MATRIX^™ Spine Systems, the TriALTIS^™ Spine System delivers a consistent user experience and improved implant performance in terms of set screw clamping force, set screw loosening torque, resistance to pullout, and gripping capacity. Other innovations include improved instrument design to indicate actuation points, consolidated instrument sets, and a modular case and tray design.

The TriALTIS™ system affords efficient integration with cement augmentation, power, navigation and robotic-assisted solutions, while decreasing costs to healthcare systems and addressing the needs of more patients. The TriALTIS™ Spine System is the foundational element of a wider comprehensive system (coming soon) that will allow for a consistent surgeon user experience across all indicated pathologies.

Clinical Cases
Disclaimer

Case 1

A 17-year-old woman presented to the spine clinic with significant lower back pain. X-ray imaging (Figs 2-4) showed evidence of spondylolisthesis. Upon clinical examination of spinal alignment, the patient was found to have a pelvic incidence of 78°, a lumbar lordosis of 54° and a pelvic tilt of 51°.

Fig 2a-b: Preoperative x-rays showing full-length lateral (a) and posteroanterior (PA) (b) views of the spine. X-rays demonstrate a Myerding Grade 2/3 L5-S1 spondylolisthesis with significant disc space narrowing.

Fig 2 (c-d) Preoperative x-rays showing spot posteroanterior (c) and lateral (d) views of the lumbosacral spine. X-rays demonstrate a Myerding Grade 2/3 L5-S1 spondylolisthesis with significant disc space narrowing.

Fig 3a-c: CT images of the lumbosacral spine (a-b lateral view and (c) transverse view) showing elongation, sclerosis, and thickening of the pars interarticularis. Loss of disc height is again noted with significant foraminal narrowing at L5-S1.

Fig 4: Mid-sagittal MRI image of the lumbosacral spine showing significant degeneration of the L5-S1 disc and continued evidence of L5-S1 spondylolisthesis (not fully reduced).

Posterior Spinal Instrumentation and Fusion (PSIF) was undertaken with an interbody fusion at L5-S1. L5 laminectomy and sacral dome osteotomy followed by pedicle screw instrumentation using TriAltis™ implants helped reduce the lumbosacral kyphosis and translation of L5-S1 and promote fusion across this level (Fig 5).

Fig 5: Post operative images showing TriAltis™ pedicle screws and rods at L5-S1 with reduction of the lumbosacral kyphosis and translation of L5 on S1.

Case 2

A 19 year-old man with colon cancer was admitted to the spine clinic with pain and progressive kyphosis (Fig 6a). Preoperative CT imaging (Fig 6b) showed a residual mass abutting the superior mesenteric artery.

Surgery was undertaken with TriAltis™ posterior spinal instrumentation system from T5 – L1 to correct and support the kyphotic deformity (Fig 7). The upper and lower instrumented vertebrae were selected to allow symmetry of fixation above and below the apex of the kyphotic curve. Care was taken not to overcorrect the hyperkyphosis given the abdominal mass abutting the superior mesenteric artery. During surgery, multiple sequential reducers were used to achieve cantilever reduction of the deformity (Fig 8).

Fig 6 a-b: Preoperative x-ray showing kyphosis in the thoracic spine (a) and preoperative CT imaging showing a residual mass abutting the superior mesenteric artery (b).

Fig 7a-b Preoperative (a) and postoperative (b) x-rays showing correction of the kyphotic deformity and symmetry of fixation.

Fig 8: Multiple sequential reducers were used in the surgical procedure to allow cantilever reduction of the kyphotic deformity.

Hazards and labeling

Due to varying countries’ legal and regulatory approval requirements, consult the appropriate local product labeling for approved intended use of the products described on this website. All devices on this website are approved by the AO Technical Commission. For logistical reasons, these devices may not be available in all countries worldwide at the date of publication.

Legal restrictions

Any use, exploitation or commercialization outside the narrow limits set forth by copyright legislation and the restrictions on use laid out below, without the publisher‘s consent, is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, scanning or duplication of any kind, translation, preparation of microfilms, electronic data processing, and storage such as making this publication available on Intranet or Internet.

Some of the products, names, instruments, treatments, logos, designs, etc referred to in this publication are also protected by patents, trademarks or by other intellectual property protection laws (eg, “AO” and the AO logo are subject to trademark applications/registrations) even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name, instrument, etc without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain.

Restrictions on use: The rightful owner of an authorized copy of this work may use it for educational and research purposes only. Single images or illustrations may be copied for research or educational purposes only. The images or illustrations may not be altered in any way and need to carry the following statement of origin “Copyright by AO Foundation, Switzerland”.

Check www.aofoundation.org/disclaimer for more information.

If you have any comments or questions on the articles or the new devices, please do not hesitate to contact us.

“approved by AO Technical Commission” and “approved by AO”
The brands and labels “approved by AO Technical Commission” and “approved by AO”, particularly "AO" and the AO logo, are AO Foundation's intellectual property and subject to trademark applications and registrations, respectively. The use of these brands and labels is regulated by licensing agreements between AO Foundation and the producers of innovation products obliged to use such labels to declare the products as AO Technical Commission or AO Foundation approved solutions. Any unauthorized or inadequate use of these trademarks may be subject to legal action.