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Duo™ Expandable

The Duo system represents the latest advancements in lateral interbody fusion technology. The system minimizes the amount and duration of retraction on the neural structures and surrounding soft tissues, both of which have been linked to neurologic deficits following lateral interbody fusion surgery.1, 2

The Duo implant is the first to combine PEEK, titanium, and graft containment mesh elements. This allows the implant to be placed through a much smaller access window compared to traditional lateral devices. Once placed, the Duo Implant is filled with bone graft in situ and expands to create a large, endplate-conforming, load-sharing graft pack that can reach up to 30 mm in width.

Duo implant before and after filling

Minimal Retraction

The Duo system minimizes the amount of retraction on the neural structures and soft tissues by up to 60%, compared to traditional bladed lateral retractor systems, and reduces or eliminates neurologic deficits commonly associated with the lateral approach.3 

Duo Retraction Requirements

Radical Discectomy

The intuitive design of the Duo discectomy instruments facilitates an efficient, broad discectomy through the straight Portal Tube or our unique Angled Portal Tube, which is designed to provide access to the L4-L5 disc space in the presence of a high iliac crest.

Discectomy Rakes and Curettes 

Maximum Footprint

The Duo mesh component is filled with bone graft in situ and expands in the cephalad/caudal and anterior/posterior planes to create a large, endplate-conforming, load-sharing graft pack. Once filled, Duo provides up to 70% more loaded surface area compared to a 22 mm-wide monolithic PEEK implant4 and is designed to reduce subsidence, maintain spinal correction, and support fusion.

Duo pressure film testing image. Duo has 70 percent more load-sharing surface area.

Duo Postoperative Xrays  


RaDical Clinical Study

The Spineology RaDical Study is being conducted to assess short-term and long-term outcomes in patients treated with the Duo System. This prospective, multi-site evaluation of 200 patients is Institutional Review Board (IRB)-approved and captures both subjective and objective patient data in a real-world, adult population. To view the latest data from the RaDical Post-Market Study, click here

The Duo system is utilized during lateral lumbar interbody fusion (LLIF) procedures. Click here for more information.

Link to Duo LLIF page

1 Aichmair A, Lykissas MG, Girardi FP, et al. An institutional six-year trend analysis of the neurological outcome after lateral lumbar Interbody fusion. Spine 2013;38:E1483-E1490.

2 Rodgers WB, Gerber EJ, Patterson J. Intraoperative and early postoperative complications in extreme lateral interbody fusion. Spine 2010;36:26-33. 

3 Data on file

4 Ferrara L, Nunley P. Abstract 546: Size Matters: A Novel Interbody Fusion Cage Design Increases Contact Area For Bone Exchange And Graft Incorporation. ISASS, 2018.

More Information

Federal law (USA) restricts this device to sale by or on the order of a physician.

Product labeling available upon request.