Can the “Bullet Cage” Decrease Back Pain?

John Asfora, inventor and surgeon, recently received FDA approval on a novel device and the tools and methods used to implant it into patients suffering from spinal cord injuries and back pain. According to the Argus Leader, surgical trials on the device and approach began in 1999, finally culminating in August 2009 with FDA approval.

The device in question is called a “bullet cage,” named such because it looks like a hollow bullet with screw threads around it. In order to relieve pressure between vertebrae, the bullet cage is inserted into a drilled-out space in the bones. The device acts as a replacement for the intervertebral discs, which can become worn over time or damaged in accidents resulting in spinal cord injuries.

One patient, Jackie McNamara, had the bullet cage implanted into her lumbar spine in Autumn of 2006 and reports that her once severe pain has vanished since then.

The prototype for the current bullet cage was developed in Hawaii in the 1940s as a way of relieving soldiers of back pain. Later, veterinarians experimented with similar devices on horses. Since then, the device and techniques used to implant it have come a long way. Asfora’s bullet cage consists of an inch long piece of titanium with screw threads along the outside to keep it secured in the bones.

Previously, back surgeries such as the insertion of a bullet cage would have been attempted by accessing the lower back through the patients’ bellies. Asfora devised a set of tools, combined with the use of a microscope, by which he could accomplish the implant of bullet cages through an inch-long incision in the back. His FDA approved methods and tools promise much less risk of complications, and far less chance of nerve damage to the spinal cord.

While the procedure and necessary hospital care can cost as much as $70,000, patients like McNamara have found that the cost is worth the benefits of a far less painful life. McNamara is currently training to run a marathon, and she hadn’t been a runner at all before her surgery.

Another recipient of the bullet cage, Tom Lambert, was brought to his knees by debilitating back pain. After getting 4 bullet cages and 2 plates inserted into his back by Asfora, Lambert is back to walking 4 miles a day and lifting as much as 150 pounds. He reported that the surgery might have even made him taller.

Brain & Spinal Cord Injury Center