Dr. Jonathan G. Hobbs is the first surgeon in the United States to combine Carlsmed’s patient-specific 3D-printed TLIF cages with Medtronic’s patient-specific UNiD™ rods across two levels, in a milestone procedure at Northwest Health – Porter
Lakeshore Bone & Joint Institute (LBJI) today announced that Jonathan G. Hobbs, M.D., M.S., a board-certified neurosurgeon specializing in spine surgery, has performed the first two-level lumbar interbody fusion in the United States to combine Carlsmed’s patient-specific aprevo® TLIF interbody cages with Medtronic’s patient-specific UNiD™ rods. Both the cages and the rods were designed and manufactured for this one patient before surgery and anchored with standard pedicle screws.
The procedure, a transforaminal lumbar interbody fusion (TLIF) of the two lowest levels of the spine (L4–S1), was completed at Northwest Health – Porter. The cages and rods were designed from the patient’s own X-rays and CT scans and manufactured to a surgical plan Dr. Hobbs reviewed and approved before the operation. This was the first fully customized posterior spinal fusion.
Traditional spinal fusion relies on cages that come in standard sizes and rods that the surgeon bends by hand in the operating room. With patient-specific technology, the alignment goal is set before surgery and the hardware is built to carry that plan into the operating room.
“This represents an important step toward making spine surgery more precise and more individualized,” Dr. Hobbs said. “Instead of adapting the patient to standard implants during surgery, we can use their imaging to plan the correction in advance and create implants and rods for their specific anatomy. The technology supports what we are always trying to accomplish: the right operation for the right patient, carried out as accurately as possible.”
How a patient-specific fusion works
- The patient’s X-rays and CT scans are used to build a three-dimensional model of the spine and pelvis.
- A specialized planning team proposes alignment targets, cage designs and rod shape. Dr. Hobbs reviews every measurement and approves the plan before anything is manufactured.
- The interbody cages are 3D printed and the rods are produced to the approved specifications.
- In the operating room, the team follows the personalized plan alongside the patient’s imaging and confirms the placement of the cages, rods and screws before the patient leaves the room.
Because the plan considers the pelvis and the rest of the spine, not only the levels being fused, the goal is to restore alignment in a way that reflects the patient’s overall anatomy and may reduce stress on the levels next to the fusion.
Patient-specific technology does not mean surgery is the first or the right treatment for every patient. Dr. Hobbs begins with a complete evaluation and, when appropriate, recommends nonsurgical care such as medication, therapeutic exercise, manual therapy or injections. Spinal fusion is considered when symptoms remain debilitating and interfere with walking, bathing, household tasks or other essential parts of daily life.
“Personalization starts with determining whether surgery is needed at all,” Dr. Hobbs said. “For patients who continue to have significant symptoms after conservative care, this technology gives us another way to tailor the operation to their anatomy and long-term needs. It is a planning tool, not a substitute for clinical judgment.”
Dr. Hobbs completed his neurosurgery residency at the University of Chicago, where he trained in both intracranial and spinal conditions. He practices with LBJI and specializes in spinal tumors, deformity, degenerative conditions, and complex and revision spine surgery. His practice incorporates minimally invasive techniques, robotic navigation and personalized surgical planning when appropriate for the patient.
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