Pediatric
Early-Onset Spinal Deformity
Immature pedicles, growth-preservation, and long-construct instability create challenges that conventional fixation was not designed to address.
Explore EOSIntroducing
R-FIX™
Rib-Based Spinal Fixation
A fundamentally new approach to spinal deformity correction that utilizes the thoracic cage as an active load-sharing component.
Clinical Challenges
Engineered to address two of the most challenging problems in spinal deformity surgery.
Adult
Adult Spinal Deformity & PJK Prevention
Long thoracolumbar constructs concentrate load at the upper instrumented vertebra, contributing to proximal junctional failure.
Explore Adult ApplicationsBiomechanical Rationale
Why Engage the Thoracic Cage?
Conventional pedicle-based fixation and rib-based fixation each provide unique biomechanical characteristics. Rib-based fixation utilizes the structural strength of the thoracic cage to supplement spinal fixation, redistribute forces, and address limitations of conventional pedicle-only constructs in selected pediatric and adult deformity patients.
Early-Onset Spinal Deformity
Pediatric Deformity Comparison
Conventional
Pedicle-Based Fixation
Representative Challenges
- High construct stiffness
- Increased autofusion risk
- Pedicle screw pullout
- Rod fracture
- Proximal junctional kyphosis
- Immature pedicles
- Neurological injury risk
Rib-Based Fixation
Thoracic Cage Engagement
Biomechanical Advantages
- Lower construct stiffness
- Growth-friendly fixation
- Increased pullout resistance
- Reduced rod fracture risk
- Reduced proximal junctional kyphosis
- Avoids immature pedicles
- Reduced neurological risk
Adult Spinal Deformity
Adult Deformity Comparison
Conventional
Pedicle-Based Fixation
Representative Challenges
- Abrupt construct transition
- Stress concentration at the UIV
- Damage to posterior ligamentous complex
- Facet joint disruption
- Paraspinal muscle injury
- Pedicle screw pullout
- High PJK/PJF risk
Published studies have reported proximal junctional kyphosis rates approaching 50% in selected high-risk adult spinal deformity populations, depending on patient characteristics, construct design, and clinical definitions.
Rib-Based Fixation
Thoracic Cage Engagement
Biomechanical Advantages
- Establishes a "soft landing"
- Reduces stress concentration
- Limits damage to posterior ligamentous complex
- Eliminates UIV facet joint disruption
- Preserves paraspinal musculature
- Increased pullout resistance
- Designed to address biomechanical factors associated with PJK/PJF
Engineering Principles
“The thoracic cage can function as an active component of the fixation construct rather than simply surrounding the spine.”
Broader Load Sharing
Distribute construct forces across multiple rib attachment points to reduce peak stress at the bone–implant interface.
Gradual Transition Zone
Soften the mechanical transition between instrumented and non-instrumented segments to help mitigate junctional failure.
Extra-Spinal Fixation
Engage anatomy outside the vertebral column to preserve spinal motion and biologic potential where appropriate.
Purpose-Built Design
Engineered around rib anatomy.
Unlike traditional spinal hooks, which were adapted for rib fixation but were not specifically engineered around rib anatomy, R-FIX™ is the first anatomic rib-anchor platform engineered specifically for the correction and stabilization of spinal deformity. Every implant and instrument was designed to improve anatomical conformity, load distribution, and surgical versatility across pediatric and adult applications.
Traditional Spinal Hook
Originally designed for spinal fixation and later adapted for rib fixation, with limited conformity to native rib anatomy.
R-FIX™ Anatomic Rib Anchor
Purpose-designed around rib anatomy for spinal deformity correction.
Technology Platform
The R-FIX platform.
A comprehensive system of anatomic anchors, connectors, and instruments — engineered as one platform.
Swivel Anchor
Multi-axial rib engagement designed for anatomical variability.
Ultra-Low Profile Anchor
Reduced prominence for thin soft-tissue envelopes.
Uniaxial Anchor
Single-plane rib anchor providing predictable engagement with a streamlined footprint.
Monoaxial Anchor
Fixed-angle interface for controlled construct geometry.
Monoaxial Extra Wide Anchor
Extra-wide fixed-angle rib anchor engineered for enhanced load distribution across broader rib anatomy.
Connectors
Modular linkage between rib anchors and the primary construct.
Sliding Connector
Accommodates the spectrum of anatomic distance between rib anchors and primary construct.
Pedicle Screw System
Integrated thoracolumbar anchor set compatible with R-FIX.
Instrumentation
Dedicated instrumentation designed specifically for anatomic rib fixation.
Clinical Applications
One platform. Two distinct clinical arenas.
Pediatric
Early-Onset Spinal Deformity
- Growing Rod Construct
- Hybrid Construct
- Growth-Friendly Fixation
- Reduced Pedicle Dependence
- Reduced Pedicle Screw Pullout, Rod Fracture, PJK, and Neurological Injury Risk
Adult
Adult Spinal Deformity & PJK Prevention
- Soft Landing above UIV
- Preserved Soft-Tissues and Posterior Tension Band
- Load Sharing
- Long Thoracolumbar Constructs
- PJK Prevention
Scientific Validation
Evidence at every stage.
- 01
- 02
- 03
- 04
- 05
Stage 01
Finite Element Analysis
Computational modeling of construct behavior across anatomical variations and loading conditions.
Select a stage above
Learn MoreClinical Evidence
A growing body of preclinical and clinical evidence.
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