METRx ® tubular system for spinal surgery is a less invasive version of traditional spine surgery in which tubular retractor is applied by using microsurgical techniques to achieve nerve and spinal cord decompression and spine stability. For the first time invasive surgeries like microdiscectomy, laminotomy, foraminotomy and inner decompression of the spinal cord can be performed in a less invasive way and without the use of general anesthesia. The METRX system combines the reliability of conventional microsurgical methods with the advantages of a minimally invasive technique. The advantage of METRX system over traditional microsurgical methods is that now the neurosurgeon can perform spine surgery by using segmental dilators and tubular retractors and apply a technique that minimizes the amount of damage to muscle tissue which is the main factor of spine stability. Contact us for more information.

Features and Benefits
With the METRx™ System, spine surgeons are now able to remove herniated or “slipped” discs in the lumbar spine with a minimally invasive technique that significantly decreases the amount of pain felt by the patient after the operation. Over the last 10 years, many of the surgical sub-specialties in Orthopedics and Neurosurgery have used fiberoptic video cameras and specially designed tools to assist them in performing surgery with much smaller incisions, less damage to the surrounding tissue, and faster recovery times. Most people are familiar with this type of technology in the form of “arthroscopic” surgery, which allows orthopedic surgeons to look inside joints like the knee and operate through very small incisions with a minimal amount of pain, scarring, and trauma to the muscles that move the knee. This type of technology has recently been applied to spine surgery, and with the new METRx™ System created by Medtronic Sofamor Danek, surgeons can treat herniated discs in the lumber spine with much less trauma to the muscles that support and protect the spine. Minimally invasive surgical techniques have become the standard of care in the treatment of many conditions that affect the joints, heart, and GI tract. With this new technology, spine surgeons are now able provide their patients with the same benefits of less invasive surgery, less post-operative pain, shorter recovery times, and easier rehabilitation.
What type of Spine Surgery is the METRx™ System Used For?
The METRx™ System was designed in order to provide spine surgeons with a way of removing herniated intervertebral discs in the lumbar spine that are putting pressure on the spinal nerve roots and causing pain. Herniated discs occur because the discs that act as shock absorbers between the bones of the spinal column become stiff and less flexible as we grow older. Discs that lose their flexibility can rupture and cause neck pain and back pain. A part of the inside of the disc can herniate or leak out through a tear in the ligaments that surround the disc, pressing on the spinal cord or on the nerves that travel out to the arms and legs. A herniated disc can be responsible for a pain that is felt in the neck or back, but the pressure that the herniated disc puts on the spinal cord or the nerve roots can cause pain in the arms or legs and sometimes can even cause problems with the way the spinal cord normally functions. If a herniated disc is pinching a nerve in the neck, most people will have persistent neck pain, often with numbness in the arms and hands. If a herniated disc is pinching a nerve in the lower back, then most people will have persistent low back and buttock pain, with numbness and tingling in the legs and feet. When the symptoms of a herniated disc do not respond to physical therapy, medications, or improve with time, then surgery can be an option. This type of spine surgery is called a “discectomy” and it is used to remove the part of the herniated disc that is pinching or putting pressure on the nerve roots in order to relieve the pain and numbness. With traditional disc surgery, spine surgeons make an incision in the center of the back or neck at the same level as the herniated disc and then strip the muscles of the back away from the bones of the spinal column in order to be able to see the area where the disc has herniated. Once the herniated disc has been removed, the muscles are put back in place and the surgeon closes the incision.

How is surgery with the METRx™ System Different?
With the new METRx™ System, surgeons can perform this type of discectomy surgery with a special type of muscle splitting technique that minimizes the amount of muscle damage that is necessary in order to be able to see where the herniated disc is located and safely remove the herniated fragments while protecting the nerve roots and spinal cord. In comparison to a standard discectomy, a micro surgery discectomy performed with the METRx™ System causes much less pain after the surgery, and allows patients to leave the hospital earlier, and return to work and their daily activities sooner. This type of surgery also makes rehabilitation and physical therapy after spine surgery much easier because there has been less damage done to the muscles that move and protect the spine, which leads to less scar tissue formation.
How does the METRx™ System Work?
The main advantage of the METRx™ system in comparison to a tradition discectomy is a smaller incision and less damage to the muscles of the spinal column. This advantage is achieved by allowing the surgeon to expose the area where the herniated disc is located without making a large incision. A discectomy that is done with the METRx™ system begins with the surgeon precisely localizing the level of the herniated disc with a very small needle that is inserted through the muscles of the back down to the area where the disc fragments are located. The correct position of this needle is confirmed with a special type of X-ray machine that is used in an operating room called a flouroscope. After the correct position of the needle has been confirmed with fluoroscopic guidance, a series of soft-tissue dilators are used to create a small tunnel that measures 16mm in diameter (less than ¾ of an inch) through the muscles of the back so that a hollow tube can be inserted down to the level of the spinal column. This tube, which is called a tubular retractor, contains a very special video camera with a magnifying lens and a fiberoptic light source that illuminates the tissues and relays the images to a separate video screen so that the surgeon can operate safely.
Hello Korina. METRx-assisted minimally-invasive surgery, in most cases, is not suitable for low-back pain syndrome. For discogenic low-back pain we have great results with laser disc decompression (for first grades of disc degeneration) and selective endoscopic discectomy (for advanced degenerations).
Thank you for your quick response. I had PLDD, but my situation remains the same. So now doctor proposed discectomy using METRx method. I am confused, because I read, and you also now said that this is not method for my problem. I don’t know what to decide. Why is the SED method better for discogenic pain? What are the chances for adhesions and reherniations after this type of surgery?
It depends on your MRI. Very often, discogenic low-back pain includes no herniation. Because of that, most of doctors don’t know whats wrong with you, and others see a problem, but have no tools to treat it. If doctor sees a herniation on your MRI, he can try to treat it with METRx system and tools, and in that way decrease your low-back pain.
Fascinating article. It’s great to hear about procedures taking the advantage of minimally invasive spine surgery. It is probably preferred now more than ever due to the small incisions and the fast recovery time. Would love to hear more about METRx.
I have had 2 back surgeries over the last 30yrs, iam 68yrs old and my problems started 30yrs ago, i have just had an mri scan which shows a bulge in the disc below the one they just operated on so i am still having leg pain what would you suggest? for me
Dear Katherine. For bulging discs we suggest either laser or endoscopic spine surgery. Do you have MRI on CD, could you send it over for a review? Kind regards from Croatia
Hello. Can you tell me if i need to have an ACDF or would a METRx have a better chance for me, My pain is only neck. c5-6 has herneated and spinal cord space is being invaded.lots of body twitching and arm spasms. and difficulty on flexion movements.50% loss of strength in left arm.Foraminal problems also present. Thanks Chris.
I have lumber Stanosis & it affects my legs, pain in knees & in left thigh Muscle so i can hardly walk.
would this surgery be able to help me walk again?
Hello Jane. We are able to treat spinal stenosis. However, we need to hear more about your case and look at your MRI/CAT to give you more accurate answer. Please contact us via email at info@spine-surgery-croatia.com or call on +385 95 805 67 97.
Please send us your MRI and description of your symptoms via email at info@spine-surgery-croatia.com or call on +385 95 805 67 97.
Had MRI that showed my 3/4 disc has a cyst….I am having serve pain in left leg/numbness in toes….I had 10 years ago surgery left leg 4/5 disc, rerouted nerve and did well. Went to Dr. today with my xrays and MRI, Dr. is going to do METRx System surgery Thursday….Please let me know what you think fast…I have arthritis bad in back, at first Dr. talked about putting in a rod, but I hesitated and wanted to try this first! Fast reply please. Thank you, Myra
According to my MRI report I have spodylolisthesis ,L3-L4.
could you please tell me that METRx surgery can be done for this proble?
thanks.
4:52 pm
Hello, I have a herniated disc on level L5-S1, but have only pain in my lower back, particulary when I sit or walk for some time. I have done provocative discography which shown that the anulus fibrozus is ruptured. Does Metrx discectomy can solve this type of disc problems, or is this method used only for radiated pain in leg? I read about metrx discectomy and always says that is used for herniated disc when people have radicular pain in leg etc., so I’m wondering is it for discogenic pain also, and how you accomplished to seal the anulus, so there are no more tear?