MINIMALLY SPINE

INVASIVE SPINE
SURGERY
Solution with Plasma Ablation System

Precision out of passion

BEIJING JESWIS TECHNOLOGY LTD
http://cs.jxhzmed.com
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Based on the unique square waveform, our ablation i
technology : c

Generates plasma discharges more rapidly, delivering time-efficient

e
soft tissue ablation
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a Controlled soft tissue
t removal for intervertebral
i disc treatment.
o
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RFS-100A
Figure 1. 100 kHz Square
Our unique square waveform
excites plasma Low
Waveform
discharges in shorter time period,
allowing

more time for effiecient tisssue

Temperatur
e Plasma
ablation during
each working cycle.

time/
Ablation
Voltage

System
5 10 15 20 (μs)

time/
Current

5 10 15 20 (μs)

To address the need for an

alternative to major back surgery,
we offer the Low
Temperature Plasma Ablation
System using low thermal
plasma-mediated
ablation technology to precisely
cope with lesions of soft-tissue
types.

Functional Features:
Universal utilities in ENT,
Spinal and Arthroscopic
procedures
Performing gentle, precise soft
tissue removal at low
temperatures (between
 40° and 70°C) in the well defined area with low operating hemostasis capabilities allows
frequency(100kHz) for efficient procedure
Multiple functions: ablation, cutting, coagulation and Foot Control maximizes user
hemostasis efficiency and OR flexibility
Bipolar energy delivery provides enhanced control and Unique square waveform
precision delivers ablation energy more
Multi-electrode technology rapidly

A wide selection of Plasma Wands: available in different sizes Easy set-up procedure
and guarantees OR efficiency
configurations to meet different anatomical needs of specific PFC circuit helps reduce
surgical environmental risks
procedures
Versatile Wand combining integrated ablation, suction, saline
irrigation, and

Leading Technology
01
G31S21
Spine Wands Diameter: 1.07mm Working length: 220mm

Collection
For symptomatic patients with
Lumbar Spine Wand I
contained herniated discs. Cannula

Cervical Spine Wand

G31S11
Diameter: 0.9mm Working Length: 105mm

Cervical Spine Wand Introducer Cannula

Lumbar Spine Wand

 e
Clinical Application: r
m
a
Percutaneous Disc l
l
Decompression ( PDD ) y

A minimally invasive outpatient approach s

to disc decompression. a
f
e
Percutaneous Disc Decompression:
w
by creating multiple tissue ablation channels, i
relieves intradiscal pressure and reduces t
pressure applied by the disc to adjacent h
nerves.
n
o
PDD using plasma-mediated ablation
technique features numerous benefits: t
Controlled removal of nucleus tissue with no i
damage to the adjacent structures s
Immediate reduction in intradiscal pressure s
u
Performed on an outpatient basis
e
Requires only local anesthesia
n
Less invasive and less traumatic than open
e
procedure
c
Promises shorter recuperation time with no r
bracing needed o
Sustained reduction in VAS pin score s
i
Simple and safe procedure with low risk of
s
complication
Promotes positive intradiscal biochemical effect
I
s

t
h
02 Minimally Invasive Spine Surgery Solution with Plasma Ablation System 03
e d
Duel to the
precision and p h
control ensured by a e
the low i r
temperature n n
plasma-mediated f i
ablation u a
technology, our l t
Spine Wands are i
proven to enable a d o
thermally safe, i n
much less s s
traumatic c
alternative to a i
traditional major l n
back surgery.
p t
r h
Cervical Spine Wand o e
D t
e r c
s u e
i s r
g i v
n o i
e n c
d a
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i
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 Wan
d Patient selection
Tip criteria:
P
Cervical Spine Wand a
i
Luer-Lock
n

i
n

t
h
e

u
Flange
p
p
e
r

l
Intro i
duc m
er b
Can
＞
nula
Skin p
Prop Prop
Mark er er a
er cann cann
i
ula ula
place place n
ment ment
from from
Can the the
i
nula later anter
al ior n
Hub view view

t
Stylet h
Hub e

n
e
c
 k Failed conservative po Wand under fluoroscopic
treatment siti guidance. Monitor the
on insertion of the plasma
MRI evidence of contained in device to the tip of the
cervical disc herniation g cannula using lateral
Discography positive of fluoroscopy. Once in
th position, keep the
Failed selective nerve root block
e Wand stationary
sty with one hand and
Surgical Approach: let pull back the
tip cannula with the
Anterior-lateral surgical approach
usi other hand to
ng expose the tip of
Procedure Illustration of A/ the Wand. Secure
Percutaneous Cervical P the cannula hub
Decompression: an onto the luer lock
d by rotating the
Patient Preparation:
lat cannula onto the
Before actual procedure, prepare the patient plasma device, while
er
in the supine position, with the his/her neck keeping the device
slightly overstretching. Identify the target disc al
vie
stationary.
under C-arm fluoroscope, then mark the
position on the patient’s skin. ws 3. Monitor the
. deployment of the device
Insert the Cervical Spine Wand: beyond the edge of the
2. Withdr
1. Insert the introducer cannula through the space introducer cannula in
aw the
between the arterial sheath and the carotid sheath lateral fluoroscopy.
stylet
using a standard anterior-lateral surgical approach Confirm the position of
from the
under fluoroscopic imaging. the device tip using
introduce
During insertion of the introducer cannula, target fluoroscopic A/P and
r cannula
the tip of the stylet to the centre of the nucleus. lateral views.
and insert
(Note: Proper needle placement should be at the
the 4. Verify the proper
centre of the nucleus, as is proved from both the
Cervical placement of the device
anterior view and the lateral view.) Confirm proper tip.
Spine

04 Minimally Invasive Spine Surgery Solution with Plasma Ablation System 05

3. Hold the
Ablation: cannula hub securely with one hand, while
1. Set the Controller at grasping the flange with the other hand.
power level 2. 4. Depress
2. Depress the the ablation paddle (paddle in the yellow
coagulation paddle (paddle in the blue color) on the color) while rotating the flange in a slow,
Foot Control for one-half second. Caution: the steady 180 degree rotation for about 8
device needs to be stopped and re-positioned if seconds to create the ablation area.
neural stimulation is observed.
 Additional t
Ablation ( if r
desired ) : o
d
1. Retract the cannula
u
and the device 2mm, using fluoroscopic guidance to
c
confirm correct Wand deployment.
e
2. Confirm new r
position of the device tip using A/P and lateral
views. c
a
3. Repeat the n
aforementioned Ablation procedure. n
u
l
a

Special Notes: w
D i
O t
h
N
O t
T h
e
m
a S
n p
e i
u n
v e
e
r W
a
o n
r d

a i
d n
v s
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d
t .
h
T
e
h
e
i
n
p
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o t
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y
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e
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e
r
U h
s i
e l
e
a
n a
t p
i p
b l
i y
o i
t n
i g
c
s d
e
w h
i y
t d
h r
a
d n
i t
s
c f
r o
e r
t
i 3
o
n d
a
( y
a s
t .

Wearing of
m
a Schanz
o
s Collar for 2
t weeks is
recommen
1 ded.

t
i
m
e
)
,

w
 l
Lumbar Spine Wand u
m
S b
ol a
ut r
io
n d
fo i
r s
p c
ai
nf
ul
di
s
Wand Tip
c
al
p
r Lumbar Spine Wand
ot
r
u Reference Mark
si
o
n
a
n Depth
d Gauge
c
o
nt
ai
n
e
d
h
e
r
ni
at
io Intr
n odu
s cer
in Can
th
nula
e
 Skin
Marke
r
Cannul
a Hub
Stylet
Hub
P
a
t
i
e
n
t
s
e
l
e
c
t
i
o
n

c
r
i
t
e
r
i
a
:
Failed
Pain in the upper limb ＞ pain in conservative
the waist therapy
MRI evidence of contained Failed selective
cervical disc protrusion nerve root block

06 Minimally Invasive Spine Surgery Solution with Plasma Ablation System 07

Deco should verify Spine
Procedure mpres Wand/Cannula placement:
Illustration sion: 1. Prior to inserting the introducer
of
First time cannula into the patient, the stylet should be
Percutaneo users removed and the Plasma Wand inserted.
us Lumbar
2. Advance the Spine of surgically active section of the Spine Wand is
Wand through the cannula important bony deployed into the nucleus.
until the distal end of the structure.
reference mark is
3. Note: During
positioned at the proximal
the insertion of the
edge of the cannula hub.
introducer cannula,
At this, the active section
target the center of
of the Plasma Wand tip will
the disc in both
be outside of the tip of the
coronal and sagittal
cannula.
planes. Using
3. Remove the Spine fluoroscopic
Wand from the cannula imaging, confirm
and reinsert the stylet. proper cannula
placement using
Patient
A/P and lateral
preparation:
view. In the A/P
Prior to the actual view, the cannula
procedure, should be in the
prepare the center of the
patient in the lumbar vertebra,
prone position on while in the lateral
the OR table. view, the needle
Identify the target should be in the
disc under middle of the
fluoroscopic intervertebral
guidance, then space.
mark the position
Introduce
on the patient’s
the Spine
skin.
Wand
Insert the
1. Withdraw
introducer
the stylet from the
cannula
introducer cannula.
1. Insert the
2. Insert the
introducer cannula using
Plasma Wand into
fluoroscopic imaging.
the introducer
During the insertion, the
cannula is supposed to tilt cannula under
towards the patient’s skin fluoroscopic image.
in a 35-45 degree 8-10cm Monitor the
from the center line of insertion of the
the target disc. Wand using
fluoroscopic
2. Introduce the imaging. Advance
cannula through the the reference mark
physical area known as to the cannula hub,
“Kambin triangle”, where then stop. This
there is the posterior assures that the
lateral part of the annulus
fibrosus with no presence
 e edge of the
3. Retract the introducer
cannula and the cannula
Spine Wand because this
approximately makes sure
2mm. Remember that the active
that the section of the
W Spine Wand
a will be
n working
d without
touching the
t edge of the
i cannula.
p
4. Note the location of the reference mark
i on the shaft of the Spine Wand. Gently
s advance the Plasma Wand, until the
reference mark reaches the cannula hub.
s At this, the starting point of the ablation
u treatment can be identified. Secure the
p cannula hub onto the Wand’s locking
p device, then withdraw the introducer
o cannula back to the annulus fibrosus.
s
e 5. Advance the Wand tip into the targeted
d tissue in a gentle manner, until it reaches
the interior wall of the contralateral
t annulus fibrosus. Squeeze the wings of the
o depth gauge on the Wand shaft, and
advance the depth gauge down to the
e shaft to the proximal end of the cannula
x hub. This is the distal limit for creating the
t ablation channels.
e
6. Withdraw the Wand to the reference
n
mark. You are now ready to begin ablation
d
channeling.
Position of the Position of the 5
introducer introducer
Create ablation channels in the
cannula in cannula in m following sequence:
the A/P view the lateral view m
1. Set the Controller at power level 2.
b 2. As soon as ablation begins, orient the dot
e on the Wand’s handle to the “12 o’clock”
y position. Step on the ablation paddle(paddle in
o the yellow color) on the foot control, while
n advancing the Wand from the starting point to
d the distal limit. Then withdraw the Wand while
stepping on the coagulation paddle(paddle in
t
the blue color), until the Wand tip reaches the
h
starting point. At this, an r r the
ablation channel is created. e dorsolateral
e intervertebral
3. Re-orient the dot on
- disc of the
the Wand shaft to the “2
d lumbar spine.
o’clock”, “4 o’clock”, “6
i This area has
o’clock”, “8 o’clock”, and
m been
“12 o’clock” position.
e considered a
Then repeat the above-
mentioned procedures to n safe site for
create additional ablation s convenient
channels. i access to the
o intervertebral
n disc space, for
a there is no
Special notes:
l traversing
K neural,
a a vascular, or
m n visceral
b a structures of
i t critical
n o importance.
’ m
s The introducer cannula should be
i
parallel with the intervertebral space.
c
T a As the Wand is deployed into the
r l annulus fibrosus, the patient may
i report pain in the waist without
a s signs of radiating pain down to the
n t lower limb.
g r
l When performing ablation with the
u
plasma device, stop the procedure
e c if the patient complains of sudden
t onset of radiating pain down to the
i u lower limb.
s r
e The insertion of the introducer
a cannula turns out to be more
o difficult to perform in the
t v intervertebral space of the L5-S1
h lumbar discs.
e

08 Minimally Invasive Spine Surgery Solution with Plasma Ablation System 09

Technical Specifications
Total Shaft Metal in
Catalog Tip Shaft Recommended
Intended Use Length Diameter the Active
Number Appearance Angle Controller Settings
(mm) Φ (mm) Electrode

Percutaneous
Cutting: 3
G31S11 Cervical 105 Φ0.9 0 Tungsten
Coagulation: 1
Decompression

Percutaneous
Cutting: 3
G31S21 Lumbar 220 Φ1.07 0 Tungsten
Coagulation: 1
Decompression

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