BACK SURGERY
Decompression without an implant, motion-preserving implants, and fusion when a segment has to be stabilised. Franchir connects patients from Québec with French spine surgeons — after a file review, never by default.
Informational page. Only the surgeon, after reviewing your imaging and clinical history, decides whether an operation is indicated and which one. No outcome is guaranteed.
On this page, back surgery covers the lumbar spine and the cervical indications the network already treats. The level changes the approach, the implant and the length of stay — not the rule: confirm first that surgery actually solves the problem.
Cervical herniation, cervicobrachial neuralgia, disc disease. In France, cervical disc prostheses (including viscoelastic CP-ESP devices, EU-authorised since 2005) are widely performed. A posterior endoscopic foraminotomy is described for selected cases. A cervical prosthesis is also available privately in Canada (CAD 28,000–45,000+).
Stenosis, herniation with sciatica, spondylolisthesis, disc disease. The surgical-options page sets out what Canadian private care offers (discectomy, fusion, a lumbar prosthesis that is rarely proposed) and what partner surgeons add: TOPS, IntraSPINE, B-Dyn, Barricaid, LP-ESP, 4K biportal endoscopy.
Fusion is not the only category. Franchir guides distinguish three families: simple release without an implant, motion preservation with an implant, and fusion. In Canada, the decision matrix often steers toward fusion. In France, Dr Gilles Dubois first assesses whether a motion-preserving option is realistic. The decision stays surgical.
NO IMPLANT
When instability is minimal and the main problem is a localised nerve compression (herniation, foraminal stenosis, moderate lumbar stenosis), decompression alone targets the mechanical cause without locking the level. The instability page places it before fusion when the segment is still stable.
Microsurgery or endoscopy to free a nerve root or remove the disc fragment causing symptoms. The Franchir video shows a nerve-release procedure narrated in the OR by three surgeons, focused on anatomical integrity and mobility.
Two 1–2 cm portals, a 4K camera, and no significant muscle stripping. Same-day mobilisation for selected cases. No Franchir video films this gesture specifically: the still is the one already used on the site.
Incisions of 2–4 cm and tubular instruments. Microscopic or endoscopic laminectomy through a small midline incision targets the responsible segment while aiming to preserve stability.
A wide exposure, the reference approach for complex cases. It remains indicated for some deformities and multi-level fusions, when endoscopy or MIS cannot do the job.
DYNAMIC IMPLANT
These implants stabilise without a classic fusion. TOPS, IntraSPINE, B-Dyn, Barricaid and LP-ESP hold no active Health Canada licence (MDALL, September 2026). ProDisc-L and ProDisc-C prostheses are licensed. An unlicensed device can, in Canada, go through the Special Access Programme — that is not the usual route.
A posterior implant that stabilises after decompression without fusion. The video is filmed in the OR with Dr David Brauge at Clinique des Cèdres.
with Dr Brauge
A soft interlaminar silicone spacer (CE-marked, Cousin Biotech), without fusion, described as reversible and with limited muscle disruption. No Franchir video shows the implantation.
Pedicle screws and a dynamic rod (S14 Implants, Pessac) for controlled micromotion. No Franchir video shows the implantation.
A 6-degrees-of-freedom prosthesis (FH Orthopedics / Spineway), EU-authorised since 2005. Anterior approach, 5–8 cm incision, up to 4 levels. The two Franchir videos illustrate L5-S1 disc replacement and the muscle-sparing anterior approach.
Same ESP family as LP-ESP: a viscoelastic prosthesis, 6 degrees of freedom, EU authorisation since 2005. The site does not name a specific surgeon or operative time for CP-ESP, and the Franchir channel has no dedicated video.
An annular closure device after discectomy, for large annular defects of 6–10 mm. The options page states that it reduces the risk of recurrence. No Franchir image or video for this procedure.
FUSION
Fusion removes pathological motion at one or more levels. It is discussed when slip progresses, instability is mechanical, or a dynamic option is not realistic. It is permanent at the fused segment. Adjacent-level degeneration exists; the instability page notes that its impact is often overestimated when sagittal balance is preserved, disc height is restored and the fusion is kept short.
Anterior lumbar interbody fusion through the abdomen. The anterior route is also used for lumbar disc prostheses; this card is the fusion. The site's anterior-approach video illustrates muscle preservation for a prosthesis, not an ALIF, so it sits above with LP-ESP.
Interbody fusion from the back, with pedicle screws. TLIF is the posterior fusion most often named in Franchir guides (decompression plus TLIF, or ALIF / TLIF depending on the case).
An approach through the flank rather than the back or the abdomen. The spine FAQ groups XLIF with lateral routes, alongside some endoscopic techniques. OLIF is named with TLIF and ALIF on the instability page, without a separate technique sheet.
Three columns. Public waits and Canadian private orders of magnitude reuse figures already published. The Franchir timeline is this page's own figure. No Franchir surgical package price on this page: the quote comes after the medical review.
| Criterion | Québec — public | Canadian private (indicative) | Franchir — France |
|---|---|---|---|
| Time to surgery | Often 12–18 months (patients Franchir has accompanied) | Fraser Institute 2024: 30-week median, 57 weeks for orthopaedic surgery | 6 to 8 weeks in total, from file validation to surgery |
| Decompression / discectomy | Covered if the public pathway proceeds | CAD 10,000–20,000 | Performed. Quote after review. |
| Cervical disc prosthesis | Depends on the centre | CAD 28,000–45,000+ | Performed, including CP-ESP. Quote after review. |
| Lumbar disc prosthesis | Limited access depending on the centre | ProDisc-L licensed, rarely offered | LP-ESP and other models, including multi-level. Quote after review. |
| Fusion | Public pathway | CAD 40,000–80,000 | Including minimally invasive. Quote after review. |
| TOPS, IntraSPINE, B-Dyn, Barricaid, LP-ESP | Not licensed (MDALL, Sept 2026) | Not licensed | Performed by partner surgeons. Quote after review. |
| First step | Referrals inside the public system | Depends on the clinic | Medical file review, about CAD 700 |
| RAMQ | Local public care covered | Outside RAMQ | Planned care abroad is not covered. Private insurance may apply. |
The 12-to-18-month waits reflect the experience of patients Franchir has accompanied. The 6-to-8-week figure is the total time from file validation to surgery, subject to eligibility, recent imaging and theatre slots. Total cost in France (surgery, stay, coordination) is often equivalent to or lower than Canadian private care — with no price published before the quote. The medical quote has no hidden fees; travel and lodging remain yours to cover, with help organising them.
Eligibility form, about 3 minutes. Attach the imaging you have, or say if you do not have it yet. No commitment at this stage.
Neurothérapie Montréal calls back: complete file, questions, next steps. A bilingual Canadian contact.
Review by partner surgeons and a documented opinion. From file validation to surgery, the wait is 6 to 8 weeks in total, if you are eligible and accept the quote. Imaging required: MRI or CT under 12 months old.
Operative report, prescription, follow-up calendar. Video visits with the French surgeon, rehabilitation in Québec, a link to your family doctor.
The same pathway as the Québec hub. The patient-pathway page spells out a five-step version, length of stay by technique, and the centres. Detailed patient pathway
Marcel Mazaltarim (Neurothérapie Montréal) and Benoit Dubuc look back on a Quebec-to-France pathway: first contact, the stay in Poitiers, surgery, follow-up and the return home.
Franchir is not tied to one facility. The centre follows the condition and the technique. Partner surgeons Franchir works with perform an average of 320 operations a year per surgeon, with sub-specialisation, in accredited private clinics (Ramsay Santé, Elsan, HAS certification).
TOPS, complex spine surgery
2 O-Arms — the only private French facility cited with that dual setup
Dr David Brauge
24 operating rooms · 1,200 m² rehabilitation floor
Neurosurgery, endoscopy
Neuronavigation, fluorescence microscopes, laser, electrophysiology
Dr Gilles Dubois
More than 3,500 neurosurgical procedures a year (centre figure)
IntraSPINE, dynamic stabilisation
EOS edge
Dr Doan Cô-Minh
IntraSPINE since 2007
ICV NoA (created 2024)
Loop-X, endoscopy, PEV monitoring, EOS
Drs Teyssedou and Swennen
LP-ESP, disc prostheses
Spine unit, 4 surgeons
Dr Jean-Patrick Rakover
Former chief resident, Pitié-Salpêtrière
According to condition and technique
Other French facilities are used depending on the indication.
Franchir network
The pathway page refers to more than 15 partner centres.
Franchir does not publish long biographies here. The points below repeat only the centres, techniques and roles already written in the guides. Surgeons are independent specialists: Franchir is paid for coordination, not for the clinical decision. You meet the surgeon by secure video before you fly; the decision to operate is made with you.
Neurosurgery, endoscopy
Clinique de l'Union, Toulouse
TOPS, complex spine
Clinique des Cèdres, Toulouse
IntraSPINE, dynamic stabilisation
Polyclinique Oréliance, Saran
LP-ESP disc prostheses
Clinique du Pré, Le Mans
Franchir interviews: Dr Gilles Dubois, and Dr Doan Cô-Minh on innovative surgery and the patient pathway.
with Dr Gilles Dubois
with Dr Doan Co Minh
Each page describes the signs, what is discussed before surgery, and the link with France. Surgery is not the automatic conclusion.
Narrowing of the canal, claudication, microscopic or endoscopic laminectomy when the responsible segment is identified.
Read the pageNerve-root compression. Endoscopic or microsurgical discectomy, sometimes with annular closure if the defect justifies it.
Read the pageVertebral slip. Rehabilitation, decompression alone, or TLIF / ALIF / OLIF fusion depending on stability.
Read the pageDisc wear and acute low-back crises. The Québec lumbago page describes the step toward a spine surgeon when crises repeat or imaging shows a structural cause.
Read the pageCervicobrachial neuralgia, cervical herniation. Foraminal injection, posterior endoscopic foraminotomy in some cases, prosthesis or fusion depending on the file.
Read the pageAdult curves. Correction under 3D navigation, discussed when deformity and pain justify it. Jean-François's video, below, is a revision after previous scoliosis surgery.
Read the pagePain that continues despite treatment already tried. The file review says whether an operation has a role, or not.
Read the pageThese situations are assessed case by case. If surgery is not the best option, the file review says so. The CAD 700 is still due; you keep a documented opinion. If surgery later proceeds through Franchir, that amount is deducted from the procedure.
Three videos from the @franchir_tv channel. They are individual accounts, not typical results. More stories are on the dedicated page.
FAQ
NO SURGICAL COMMITMENT
About CAD 700. A reply within 2 business days of the form. The full quote follows if the surgeons retain an indication.
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