Karlsruhe (GER) – joimax^® and Trang Thi are pleased to announce their partnership in bringing the joimax^® full-endoscopic and minimally invasive spinal surgery technology to the Southern Provinces of Vietnam including Da Nang market.  joimax^® a German-based company is a recognised market leader in these technologies and training methods with a history of innovation in endoscopic spine surgery since 2001.

Endoscopic Spine Surgery has been growing steadily in popularity since the late 1990’s and there has been exponential growth in the technique in the past 10 years. The distributor Trang Thi and joimax^® are pursuing a long term corporation to provide a broader surgical choice for patients considering spinal surgery. “joimax^® is looking forward to working with a partner as strong as Trang Thi, says joimax^® Founder and CEO Wolfgang Ries and adds, “a company that has the necessary personnel, expertise, as well as the corresponding specialization and penetration of the market”.

“We’re very pleased to collaborate with joimax^®,” comments Trang Thi Medical Co., Ltd Director Dieu Linh Nguyen. “Endoscopic spine surgery is a technique that enables patients to have access to truly minimally invasive surgical procedures of the spine.” Thus, joimax^® strengthens its sales activities in Southern Provinces of Vietnam including Da Nang and enters into another important partnership across APAC.

About Trang Thi Medical Co. Ltd
Trang Thi Medical Co., Ltd (TRANG THI) is one among key players in Vietnam market, providing complete solutions for neuro and spine surgery. During the nine years of operation, TRANG THI has cooperated with many well-known manufacturers, transfering advanced and innovative technology to hospitals and healthcare centers. With the mission of community health, Trang Thi always strive to make a real difference to people’s lives.

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During a special joimax^® faculty meeting which was held at the institute of anatomy at the University of Mainz, Germany on June 20-21, joimax^® honored three surgeons with the Parviz Kambin Award. Dr. Albert Telfeian, Rhode Island Hospital, Brown University, RI, US and Dr. Gabriele Jasper, Center for Pain Control, NJ, US received the award in recognition of their outstanding scientific and educational dedication to transforaminal surgery. The two surgeons tremendously contributed to this field with numerous high quality publications. Also they are treading new paths for spinal endoscopy. Just recently Dr. Telfeian did the first awake surgery to remove a thoracic spinal tumor. Dr. Menno Iprenburg, Iprenburg Herniakliniek, NL received the award for his lifetime achievement. Dr. Iprenburg is applying joimax techniques, especially TESSYS, since 2004. In his private clinic, he successfully treated more than 2000 patients suffering from disc herniations.

The award is named after Dr. Parviz Kambin who identified a workspace within the intervertebral foramen, through which the spinal canal can be accessed safely. Because this safe zone is somewhat triangular shaped, it was named the „Kambin triangle“.

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Spine specialists take part at the joimax® endoscopy workshop with live spinal surgeries

Karlsruhe, 14 March 2011: On 17 and 18 March 2011, the Medical University as well as the Institute for Anatomy in Graz, Austria, were the sites of a two-day international joimax® Workshop focused on the endoscopic resection of herniated discs utilizing the TESSYS® method. The first day, Dr. Wolfgang Kreil and Univ. Doz. Dr. med. Sandro Eustacchio of the Medical University Graz will operate on two patients with herniated discs using the TESSYS® method. The participating orthopaedic surgeons and neurosurgeons from Germany, Austria, Greece, Bulgary, Italy and Macedonia will experience the surgery procedure firsthand. While operating on the patients, one of the operating surgeons will explain each step of the TESSYS® surgery and answer questions of the workshop attendees. Afterwards Dr. Wolfgang Kreil and Dr. Sandro Eustacchio will lead scientific presentations and panel discussions on how the transforaminal endoscopic technique works and what their experiences have been, while discussing several case examples.

On the second day, joimax® hosts an intensive cadaver training course at the Institute for Anatomy Graz. The practical training and hands-on learning experience gained at cadaver workshops such as this one is an important first step in the three-step joimax® CM3 Education Program. In this comprehensive program, experienced surgeons and application specialists train each workshop member to use the TESSYS® Method. The subsequent steps of the Education Program are visitations, followed by live surgeries accompanied by joimax® Medical Trainers and application specialists.

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Minimally invasive treatment methods and their successes from the patient’s perspective were the focus of the congress. The very latest surgical possibilities and techniques were presented in symposia, workshops, and numerous lectures to a very high scientific standard. joimax® GmbH trainer, Dr. med. Ralf Wagner from Frankfurt, Germany, notably introduced TESSYS® in his presentation “Endoscopy of the lumbar spine in degenerative diseases.” This technique provides transforaminal access to the lumbar spine for treatment of herniated discs and stenosis – an osseous narrowing of the spinal canal.

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“In the context of the annual NASS meetings’ we aim to share the latest information, innovative techniques and best practices with renowned spine care professionals from around the world. These joimax^® activities will satisfy the requirements of spine specialists to take advantage of the latest innovations and technologies in endoscopic minimally-invasive spine surgery,” says Wolfgang Ries, CEO and founder of joimax^®.

“With our existing product range as well as with our newly launched products – the MultiZYTE^® SI endoscopic sacroiliac joint therapy set, MultiZYTE^® RT for endoscopic minimally-invasive treatment of the facet joint and the new Intracs^® Intraoperative Navigation Tracking & Control System, joimax^® uniquely enhances its endoscopic minimally-invasive product portfolio to fully meet users’ needs,” he continues.

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Minimally Invasive Surgery Was Huge at ISASS12

ISASS12 in Barcelona was a remarkable venue for numerous presentations related to minimally invasive spine surgery. Great interest both in the US and abroad continues to grow in this area of spine surgery: MIS made up the content for one-third of all the general sessions, with a sprinkling of individual presentations in other general sessions.

The range and complexity of the MIS topics proved broad. One of the most striking findings emerging in the literature is the marked decrease in infections when minimally invasive surgery is performed. Pfandistiener et al. from the Clinic for Spine Surgery with Scoliosis Center in Germany reported on infection rates between open and MIS posterior instrumentation. In 284 open surgeries, deep infections were seen in 2.46%. In contrast, 199 patients underwent percutaneous posterior instrumentation procedures without a single infection.

The use of minimally invasive strategies to treat ever more complex conditions were highlighted. Phillips and co-workers presented the prospective, multi-center results of 107 adult degenerative scoliosis with 24 month follow-up. Excellent clinical results and a low complications were encountered in this this challenging group of patients with advanced age and co-morbidities. Anand showed similar results in 33 patients from a single site.

The fusion rates of minimally invasive interbody fusion remains high. As shown in a meta-analysis by Gwinn et al. from Walter Reed Medical Center, the MIS TLIF technique enjoys a greater than 95% fusion rate.

Topics in endoscopic surgery continue to generate interest, as well–Nagahama et al. (Hokkaido University) and Schubert (Munich, Germany) showed continued success of this promising procedure in the hands of experienced endoscopic spinal surgeons.

Lingering questions regarding MIS were also addressed: Lee et al. (University of California, San Diego) quantitatively examined hip flexion strength after the popular transpsoas lateral lumbar interbody fusion (XLIF/DLIF/LLIF). As experienced by many surgeons, hip flexion strength decreased in most patients immediately postoperation, but returned to baseline within 2 weeks of surgery.

Cost effectiveness of open versus MIS TLIF was assessed by Phillips et al. on worker’s compensation patients; the cost of overall inpatient care was slightly less for MIS than for open.

Pimenta et al. advised appropriate caution when he described low fusion success rates of 2-level AxiaLIF procedures. In their review of 27 patients undergoing L4-S1 2-level AxiaLIF, only 22% of patients were considered to have solid fusion at 2 year follow-up.

Emerging MIS technologies were presented by a wide variety of groups. Regev et al. from Tel Aviv Sourasky Medical Center described the minimally invasive transforaminal, thoracic microscopic discectomy; Husain et al. from Loma Linda University described a percutaneous cervical transfacet fixation technique; Araghi et al. showed the results of the first 40 Guyer Lumbar Interbody Fusion (GLIF) procedures; MacMillan described a novel all transosseous approach to the L5-S1 disc, and both Julien (West Virginia University) and Sharma et al. (Manassas, VA) described the use of percutaneous stabilization for thoracolumbar fractures. It is heartening to see so many attempts to make the best of minimally invasive technology in this still pioneering area of spine surgery.

Santos et al. (University of Minnesota) showed that 3-D navigation may be used to improve safety and accuracy of percutaneous pedicle screw placement. Finally, the potential changes in healthcare delivery were highlighted by Smith and Christian (Las Vegas, NV) when they showed that selected MIS fusions may be performed in the ambulatory setting.

The diversity of topics was matched only by the excitement surrounding them. I’m looking forward to even more fascinating research by my colleagues at ISASS13 in Vancouver.

Choll Kim, MD, PhD
Spine Institute of San Diego

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Karlsruhe (GER) — Founded 2001 in Germany, joimax^®, the leading manufacturer of medical devices for endoscopic minimally invasive spine surgery, celebrates its 20^th anniversary this year. In tandem with this milestone, the company expanded their educational program, ESPINEA^®, furthering their global reach.

Despite COVID-19, ESPINEA^® (Endoscopic Spine Academy) training programs, which are held in cooperation with the Royal College of Surgeons Edinburgh (RCSEd) and joimax^®, were conducted all over the world in 2020, and continue to roll out in 2021. Due to travel restrictions, the programs were adapted to webinars, and remote support and training, totaling 60 sessions last year. By pivoting to online learning, approximately 3000 surgeons were reached in 2020, and 700 surgeons so far in 2021. ESPINEA^® was founded by joimax® CEO and Founder Wolfgang Ries in 2019, and was accredited by the RCSEd last year. 

“Our goal is to be globally present online, as well as to provide direct local support,” says Ries. “Regardless of lockdowns in many countries, under the ESPINEA^® platform, more than 120 surgeons were trained in onsite workshops this quarter, with 70 in the USA and Mexico, 35 in Europe, 15 in Asia, and many more through the joimax^® CME-program partnership in China.

ESPINEA^® Board Member Alastair Gibson, FRCSEd states: “These efforts demonstrate that joimax^® and ESPINEA^® can achieve anything together. I’m proud to be part of this impressive blend of online, on-site, and remote events, enabling a strong ESPINEA^® community.”

To support the roll out, additional Coronavirus-compliant labs were integrated into the local, onsite education programs. In addition to the company’s existing labs in Karlsruhe and Irvine, California, more labs throughout the USA, including Houston, Minneapolis, New York City, Dallas, and Indianapolis, as well as the Surgical Skills Lab in Mexico City and ORSI Academy in Melle, Belgium, have been added.  Also, joimax^® opened a branch office in Singapore; the Hong Kong office was opened in spring 2019.

“It is becoming increasingly important to have a personal, on-site presence in order to teach globally-valid learning content,” adds Ries. 

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iLESSYS^® Delta, an advanced development of the joimax iLESSYS^® technology, is suitable for dorsal and dorso lateral treatment of central spinal canal stenosis. The iLESSYS^® Delta system enables a large area to be decompressed by means of the interlaminar access, guided by endoscopic-assisted vision.

“Since the access to the spine is the same as with the already well-established iLESSYS^® technique, usage is very straightforward.” said Dr. Guntram Krzok, orthopedic surgeon from Waltershausen, Germany after testing the new system at a joimax workshop early this year. “I was impressed by the new scope which delivers outstanding image quality. With the specialized instrument set, it is finally possible to achieve decompression of central spinal canal stenosis.”

The iLESSYS^® Delta instrument set includes specially developed tools that enable extensive, yet gentle, tissue-sparing decompression. The 6 mm working channel of the new endoscope allows for the use of large shaver blades designed for bone resection and endo-kerrisons. An additional option is the plastic (PPSU) working tube for unimpaired X-ray examination.

“iLESSYS^® Delta is a logical addition to our portfolio. Not only is the system suitable for endoscopic decompression, but it also allows the parallel implantation of cages. This way we can achieve dorsal decompression and stabilization in one step,” comments Wolfgang Ries, CEO and founder of joimax.

About joimax

Founded in Karlsruhe, Germany, in 2001, joimax^® is one of the leading medical device companies in minimally invasive spinal surgery („joined minimal access“). The company’s U.S. subsidiary was established in Irvine, California, in 2005. The company is primarily focused on the development, production and marketing of technologies and methods for minimally invasive endoscopic spinal surgery. joimax is active in 40 countries around the globe and its methods have been successfully employed in approximately 130,000 surgeries. With a special focus on education, the company provides surgeons with specialized technique training through the three-step joimax CM3 education program. This program includes visitations, cadaver workshops and live-surgery support.

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Karlsruhe, December 2010: The 5th German Spine Congress (5. Jahrestagung der Deutschen Wirbelsäulengesellschaft (DWG) will take place from 16 to 18 December 2010 at the Congress Centre in Bremen. joimax^® is proud to present the innovative HD 5-in-1 complete system at their booth no.20: The C-Camsource^®HD Twister offers state-of-the-art HD technology and works with both the joimax^® HD endoscopes and HD flat screens producing an extremely precise and sharp picture and video imaging for endoscopic spinal surgery.

This is convincing technology for spinal surgery experts like Dr. Michael Schubert, Apex-Spine Center, Munich, Germany or Dr. Ralf Wagner, Frankfurt, Germany: „High resolution like this allows very precise working and provides the necessary safety required when operating – especially in the field of endoscopic spinal surgery.“ With this integrated combination of HD camera technique, HD endoscopes and HD flat screen monitors joimax^® is the first manufacturer to offer a completely tuned and expandable HD system of highest imaging quality and picture resolution.

Both surgeons value the C-Camsource^® HD Twister as a 5-in-1 system with its integrated xenon light source and picture rotation function; “There is optimal lighting at all times and with the Twister, image details can be zoomed in and rotated”, “and thanks to the imaging function and the diaphragm and mask function, optimal orientation in the operation area is possible.”
The HD 5-in-1 complete system has also a text generator in order to document each step of the surgery and it offers direct and simple data storage on a USB data carrier. “It was important for us to offer the surgeon a perfectly coordinated as well as a safe complete system“, says Wolfgang Ries, CEO and founder of joimax^®, “for the best possible treatment of patients – without any compromises.”

Advantages of the C-Camsource^® HD-Twister complete system and the joimax^® HD endoscopes

– Best possible resolution due to High-Definition-Technology
– First-class brightness, brilliance of the pictures due to optimal co-ordination of the endoscope,
camera and screen as tuned system
– Unique image rotation, zoom and picture movement function
– As much system integration as sensible, possible and necessary
– Functions for intuitive orientation, marking and documentation

Advantages of the HD flat screen monitors by joimax^®

– HD flat screen monitors in either 24“ or 42“ with an angle of
178 degrees for an exceptionally good view and safe operating
– Brilliant images in high resolution: 1.920 x 1.080 pixels
– Picture in picture function; size and position adjustable
– Touch Control Panel, multi-language menu navigation

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