Fusion is often proposed by default
In Canada, the classic decision matrix quickly steers toward fusion as severity rises. Yet alternatives exist: TOPS, IntraSPINE, B-Dyn, disc prostheses. None of these implants is licensed by Health Canada.
INDEPENDENT MEDICAL SECOND OPINION
You were offered a spinal fusion. You deserve a second opinion.
Before permanently fusing a segment of your spine, find out whether a motion-preserving alternative exists for your case. Our partner surgeons review your file — independently, no commitment.
Medical review · CAD 700 · Response within 2 business days
Why it matters
Spinal fusion is not always the only option
Fusion is permanent
Locking a segment irreversibly alters spinal biomechanics and increases load on adjacent vertebrae (adjacent segment disease). There is no undoing that decision.
A second opinion changes decisions
An independent file review by specialised surgeons can surface options your surgeon could not offer — not from neglect, but because those implants are unavailable in their system.
Two phases, two perspectives — for an informed decision
Dr Gilles Dubois
Academician · Neurosurgeon · Clinique de l'Union, Toulouse
First neurosurgeon in France to implant a spinal prosthesis
One question only:
“Does surgery offer a real solution for this patient's condition?”
That is the only question he answers at this stage. If the answer is no, he says so. If yes, the file moves to phase 2.
Specialised surgeons — by technique and implant
Once validated, your file is shared with Franchir surgeons who specialise in the technique most likely indicated for your condition — each with extensive hands-on experience placing the proposed implants:
Dr Doan Cô-Minh → IntraSPINE
Interlaminar stabilisation without fusion. >2,000 procedures · Prospective study >200 patients published.
Dr David Brauge → TOPS
Facet arthroplasty. Clinique des Cèdres, Toulouse — only private French facility with 2 O-Arms.
Dr Jean-Patrick Rakover → Disc prostheses
Lumbar and cervical. Former senior registrar at Pitié-Salpêtrière · International trainer.
Drs Teyssedou & Swennen → Endoscopy / MIS
Institut de Chirurgie Vertébrale de Nouvelle-Aquitaine (Poitiers, 2024).
Outcome: written medical opinion + eligibility confirmation + detailed quote.
Canadian matrix vs Franchir matrix
In Canada, fusion covers nearly all cases as severity rises. In France, your surgeon has three additional option zones.
Canada — Classic matrix
- Early stage: conservative care
- Moderate: fusion
- Advanced: long fusion
France — Franchir matrix
- Early stage: endoscopy / MIS
- Moderate: TOPS, IntraSPINE, B-Dyn
- Advanced: navigated minimally invasive fusion
Eligibility for each technique is assessed case by case by our partner surgeons. Only surgeons determine whether an alternative is indicated.
You may be a candidate for an alternative — without knowing it
| Clinical situation | Often proposed in Canada | Possible alternative in France | Canada implant status |
|---|---|---|---|
| Grade I degenerative spondylolisthesis + stenosis | Decompression + TLIF fusion | Decompression + TOPS | Not licensed (MDALL) |
| Painful lumbar disc disease, 1–2 levels, healthy facets | ALIF or TLIF fusion | Lumbar disc prosthesis (up to 4 levels) | Rarely offered privately |
| Multi-level disc disease | Long fusion | Multi-level prostheses or hybrid | — |
| Early vertebral instability | Conservative or fusion | IntraSPINE or B-Dyn | Not licensed (MDALL) |
| Recurrent herniation, large annular tear | Revision ± fusion | Discectomy + Barricaid | Not licensed (MDALL) |
| Cervical radiculopathy 2–3 levels | Multi-level ACDF | Multi-level prosthesis or hybrid | Cervical available in Canada |
Submit your file — we'll reply within 2 business days
Surgeons who review your file
DG
Dr Gilles Dubois
Neurosurgeon · Medical coordinator
Clinique de l'Union, Toulouse
- Founded the neurosurgery department (1991)
- >3,500 neurosurgical procedures / year
- SFCR, SFN member
Independent Franchir scientific advisor
DD
Dr Doan Cô-Minh
Orthopaedic spine surgeon
Polyclinique Oréliance, Saran
- Former senior registrar, CHU Montpellier
- >2,000 IntraSPINE stabilisations
- Prospective study >200 patients published
DD
Dr David Brauge
Neurosurgeon
Clinique des Cèdres, Toulouse
- TOPS — facet arthroplasty
- Associate INSERM researcher
- Only private French facility with 2 O-Arms
Your questions, our direct answers
ACT BEFORE THE DECISION IS MADE FOR YOU
Your spine, your decision.
Get an independent second opinion before any surgery. CAD 700. Response within 2 business days.
Independent review · No commitment · Board-certified surgeons
Published