Carevature Medical, Inc. announces a new article that has just been published in PharmacoEconomics, sharing the significant economic impact when Dreal® technology is used to prepare the intervertebral endplates during the common TLIF procedure.

The authors focus upon the intra-operative and post-operative cost drivers for transforaminal lumbar interbody fusion including OR Time, Blood Loss, Length of Stay, Complications, and Revisions, and retrospectively compare two cohorts in search of variance. The two cohorts include patients where the Dreal® device was used to prepare the intervertebral endplates (n=143), and those where conventional tools such as rotating shavers, curettes, rasps, etc. were used (n=65).

Carevature’s curved at the tip, shielded devices offer the capability to efficiently reach into all four endplate quadrants, while the shield protects the dura and the powered cutter removes the cartilaginous endplates. Standard instrumentation (curettes, rasps, rotating shavers, etc.) require multiple passes and forceful maneuvers to reach and remove disc fragments that are adhered to the endplates, and to prepare the intervertebral space for fusion. Gaining access to the dorsal, contralateral quadrant of the disc space with these standard instruments can be challenging and in the absence of effective endplate preparation, the speed and robust nature of the fusion process may suffer.

The authors found that use of Carevature’s Dreal® technology resulted in a statistically significantly shorter procedure (by 23 minutes) and other potentially favorable post-operative elements that in combination led to a statistically significant reduction in costs by just over $2,000.

Says orthopedic spine surgeon and co-author Michael Millgram, MD: “The Dreal® curved high speed drill has proved a valuable addition to my clinical practice. It allows quick and thorough evacuation of disc material in TLIF procedures providing a large clean bony surface for fusion while reducing operating time. My impression is that TLIF procedures performed with the Dreal® exhibit a considerably more robust anterior fusion than those procedures where disc space preparation was performed in the standard manual manner.”

Dennis Farrell, President for Carevature Medical, Inc. comments: “Significant clinical benefits of Carevature technology have been reported from the podium and in the literature across numerous applications, including decompressions, cervical corpectomies, ACDF, and as in this case, intervertebral endplate preparation. This publication introduces another critical element in the evaluation of a new medical device: what is the economic impact of the technology? New medical device technologies are scrutinized for their relative value, and in order for a new device to gain traction, it is necessary to demonstrate both clinical AND economic benefits. We are pleased that this study was able to show an approximate monetary savings of $2,000 per case associated with use of Carevature technology for endplate preparation during a TLIF procedure. Particularly during these times of economic strain, the ability to present a reduced procedural expense profile will continue to be a key driver of our growth.”

Adds Yosi Weitzman, founder and CEO of Carevature Medical: “We are fortunate to work with world-class surgeons that collaborate with us to contribute to this important scientific work as well. The encouraging results of this study are another piece of evidence regarding the viability of the Dreal® technology in the operating room, across different spinal procedures, surgeons’ practices and as in this case, other implant systems. Efficient and safe bone removal capabilities ‘around the corner’ is valuable far beyond decompression-only procedures.”

To date, Carevature Medical’s Dreal® technology has assisted surgeons in over 1,700 cases, both non-fusion and fusion. The company’s highly targeted approach has it working with medical systems and surgeons located across the US in Arizona, Texas, California, Illinois, Michigan, Massachusetts, North Carolina, and Florida, with plans to expand throughout 2021.


Carevature Medical Ltd. a privately held medical device company headquartered in Rehovot, Israel, is dedicated to developing advanced orthopedic surgery solutions that minimize trauma, resulting in long-lasting improved patient outcomes. Carevature Medical, Inc. is a wholly owned subsidiary based in Maryland, USA.