As a neurosurgeon specializing in spinal procedures, Dr. Eric Oberlander has seen a lot of new technologies and medical advancements come and go in his 17 years of practice. He notes that most of these “fads” don’t live up to their promise and can end up causing patients more problems in the long run, instead of offering the pain relief they were seeking. Therefore, it’s important not to jump on a surgical bandwagon too early.
The area where there is meaningful advancement is the field of biologics—materials that promote bone formation and fusion. Nobody really wants a root canal, but sometimes it is necessary. Spinal fusions are similar in that no one really wants to have one, but sometimes they are necessary to properly fix the spine. If you have a disc that has totally collapsed, with bone grinding on bone, the best way to f ix it is to remove the damaged disc, separate the bones, and replace the disc with a biologic spacer— the essence of most fusion surgeries.
But one new biologic material called PEKK has already proven itself a winner, Oberlander says. PEKK, which stands for polyetherketoneke tone, is a polymer that can be used in spinal fusion surgeries to replace degenerated and rotten discs and rebuild new spinal segments.
PEKK’s chemistry is slightly different from its predecessor, a material called PEEK, allowing it to promote better bone growth.
“Bone will not grow into PEEK because of its chemistry,” Oberlander explains. “But PEKK has a unique chemistry, which allows molecules to attach to it and allows bone to grow into it.”
Oberlander has been using PEKK in spinal fusion surgeries for about a year and calls the results fantastic.
“We had good fusion rates before, but our ‘failed fusion’ rate has dropped to almost zero, even in high-risk patients, like those with diabetes and tobacco use” he says. “The reason that’s important is because the No. 1 complication from fusion surgery is failure to fuse. If you don’t fuse, it means the bone didn’t grow properly, and you end up with chronic pain and often loose or broken hardware.”
Over the past 17 years, Oberlander has built the nation’s largest neurosurgical practice focused on spinal surgery. He has performed more than 10,000 spine surgeries and his team sees about 8,000 patients a year, including some from as far away as Virginia and Alaska.
“That volume of surgery and patients gives us vast experience and know-how to fix almost any spinal issue,” he says. “During surgery, I use tricks of the trade that can only be learned from a large body of experience.”
Oberlander also has a background in engineering and spinal implant design, which helps him identify implants — such as PEKK — that offer the best solutions to his patients’ issues. He emphasizes that simple solutions usually work best and are the most durable — making it important not to get caught up in the excitement over new “implant gadgets and widgets” that may introduce more complications into surgeries.
Spinal surgery is tricky and can be difficult to get right, he says. He likes to think of it as “spinal carpentry” — stabilizing and rebuilding a stronger, healthier spine by working with bone, discs and un-pinching nerves.
“It’s a combination of carpentry mixed with a delicate surgery that, much like woodworking, requires very precise instrumentation and skill,” he says.
Oberlander enjoys using his extensive experience to help patients. And with PEKK now in his arsenal of options, he is looking forward to improving patient outcomes even further.
“We’re seeing really good results,” Oberlander says. “The whole point of surgery is for patients to heal with good results, and we’re actually seeing them heal quicker with better results using advanced biologics, like PEKK.”
Learn more at droberlander.com
