TRANSITION® Stabilization System

TRANSITION® is a posterior dynamic stabilization system providing unique biomechanical profiles depending on its application.

Over 4,000 procedures have been performed worldwide.

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Two Level
Figure 1
Long construct
Figure 2
One Level
Figure 3
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Biomechanics Allow Bending Along with Stretching (during Flexion), and Compression (during Extension)


Figure 4

The Bumper compresses when the distance between pedicle screws increases. Intermediate Spools are free to slide along the Cord (← →) when the Bumper compresses.


Figure 5
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Flexion/Extension Video


TRANSITION®
Flexion/Extension Video
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Transitional Stabilization—Short Constructs

When used in combination with rigid rods, TRANSITION® provides an intermediate amount of stiffness, or Transitional Stabilization, between rigidly fused levels and uninstrumented spinal segments (Fig. 6).

Customizable Options for Short Constructs
Figure 6
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Rigid Instrumentation Biomechanics

One-level Rigid Instrumentation

In this single-level rigid construct, notice the abrupt change in motion and adjacent level hypermobility (Fig. 7) at L2-L3 during flexion-extension.

Figure 7
Figure 7
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Rigid Instrumentation Biomechanics

Two-level Rigid Instrumentation

In this two-level rigid construct, notice the abrupt change between L2-L3 and L1-L2 (Fig. 8) during flexion-extension.

Figure 8
Figure 8
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Transitional Stabilization Biomechanics

Transitional Stabilization using TRANSITION® creates gradual change in motion (Fig. 9).

One-level rigid construct — One-level semi-rigid

Figure 9
Figure 9
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Transitional Stabilization—Long Constructs

When used in combination with rigid rods, TRANSITION® provides an intermediate amount of stiffness, or Transitional Stabilization, between rigidly fused levels and uninstrumented spinal segments (Fig. 10).

Long Constructs
Figure 10
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

PJK = Proximal Junctional Kyphosis

Incidence

The incidence of junctional level breakdown is 20% to 40% in long segment thoraco-lumbar constructs.1,2

Screw loosening and breakage rates can be as high as 11.5% in multiple fused levels.

1Glattes CR, Bridwell KH, Lenke LG, et al. Spine 2005. 30(14):1643-1649.
2Kim YJ, Bridwell KH, Lenke LG, et al. Spine 2008. 33(20):2179-2184.
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

PJK Due To Rigid Instrumentation

Example: Progressive Kyphosis

Rigid instrumentation may cause progressive kyphosis (Fig. 11), or degeneration at the Junctional Level3, which may require an extensive revision (Fig. 12) procedure.

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1 Month Post-op

Figure 11
Figure 11

Revision

Figure 12
Figure 12
3Watanabe K, Lenke LG, Bridwell KH, et al. Spine 2010. 35(2):138-145
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

TRANSITION® Option for Long Construct Index and Revision Procedures

Whether the long construct is an index or revision procedure, TRANSITION® may help reduce development of PJK and potential subsequent revision procedures.

Click images to enlarge
Figure 13.
Figure 14.
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Optimized Load Sharing

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Healthy Spine Loading

Figure 15
Figure 15

TRANSITION® Physiologic Anterior Column Loading

Figure 16
Figure 16
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Optimized Load Sharing

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Loading Patterns

Titanium Rod
Loading Patterns

Figure 17
Figure 17

PEEK Rod
Loading Patterns

Figure 18
Figure 18

TRANSITION® Physiologic
Loading Patterns

Figure 19
Figure 19
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

Multiple Implant Options

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Preassembled
Implants


Figure 20

Buildable Implants
Without In Situ Assembly


Figure 21

Instrumentation for
an MIS Approach


Figure 22
Indications for Use
The TRANSITION® Stabilization System is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion in the treatment of the following acute and chronic instabilities or deformities of the thoracic, lumbar and sacral spine in skeletally mature patients: degenerative spondylolisthesis with objective evidence of neurological impairment, kyphosis, and failed previous fusion (pseudoarthrosis).

In addition, the TRANSITION® Stabilization System is indicated for use in patients: who are receiving fusions with autogenous graft only; who are having the device fixed or attached to the lumbar or sacral spine; and who are having the device removed after the development of a solid fusion mass. TRANSITION® is only indicated when fusion with autogenous bone graft is being performed at all instrumented levels.

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