TranS1 Spinal Fusion

The collapsed, degenerated, painful disc remains a true surgical challenge. Most often treated with lumber fusion, the patients have had to undergo major surgery and success rates were often poor. Select patients may now be treated with a minimally invasive technique, called TranS1, where the disc is removed through a tiny incision. The bone screws, that once took hours to install, can be placed in minutes. Hospitalization is not required.

The image to the right shows a collapsed disc at the L5-S1 level. This type of disc damage can cause severe pain.

TranS1 is a newly available lumbar fusion system. The device is inserted through a tiny incision near the coccyx. It uses one screw in the midline. It can be done with our without pedicle screws. A hospital stay is often not needed, there is little pain, and it does not require a long recovery period. It is not for everyone, but when it is appropriate it offers all of the advantages of a major fusion without many of the risks. Patients can return to work in as little as two weeks. It can only be used at the L5-S1 spinal segment.


  • Degenerative Disc Disease (DDD) , with or without radicular (leg) symptoms
  • Pseudoarthrosis (unsuccessful previous fusion)
  • Spondylolisthesis (low grade only)  
A blunt probe is passed along the sacrum toward the bottom of the S1 body. The probe is then inserted into the bone and is used as a guide for the rest of the procedure.
Once the probe is attached to the bone, a hole is drilled to the L5-S1 disc space. Special instruments are inserted to remove as much of the disc as possible. Once this is done, bone and a special bone growth hormone are inserted to replace the disc.
The drill is next advanced along the same line and a second, smaller hole is made in the L5 vertebral body.
Once the hole is finished, the fusion screw is inserted and the operation is complete. The procedure takes under one hour in most cases. The final appearance is similar to the x-ray below.

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Last modified: 07/27/08