Canada–France pathwayFRANCHIRNeurothérapie Montréal

WHAT CANADA CANNOT OFFER YOU

Why France offers more than fusion

TOPS, IntraSPINE, B-Dyn, viscoelastic disc prostheses — techniques that preserve the motion of your spine. None is licensed by Health Canada. All are performed by our partner surgeons.

Which option for my case?See comparison table

What Canada offers

  • Discectomy / decompression: available, CAD 10,000–20,000 privately
  • Cervical disc prosthesis: available privately (CAD 28,000–45,000+)
  • Lumbar prosthesis (ProDisc-L): licensed, but rarely offered privately (single active model in Health Canada database)
  • Fusion: CAD 40,000–80,000 privately
  • Private wait: 3–12 months even when paying

What France offers in addition

Expanded
  • TOPS — facet arthroplasty (FDA June 2023, superiority vs fusion)
  • IntraSPINE — interlaminar stabilisation without fusion (>2,000 patients, Dr Doan Cô-Minh)
  • B-Dyn — dynamic pedicle rod (convertible to fusion with same screws)
  • Barricaid — annular closure post-discectomy (reduces reherniation risk)
  • LP-ESP / CP-ESP — French viscoelastic disc prostheses (6 DOF, EU since 2005)
  • 4K biportal endoscopic surgery
  • O-Arm / Loop-X navigation (intraoperative 3D CT)

Source: official Health Canada device licences (MDALL), verified 29 September 2026. An unlicensed device may exceptionally be obtained via Health Canada's Special Access Programme (SAP). MDALL

Comparison: what is available, where

Green = available. Red = not licensed by Health Canada (MDALL, Sept 2026).

ProcedureAvailable Canada (private)Available FranceFrance timeline
Decompression / discectomy✅ CAD 10–20k✅3–8 wks
Cervical disc prosthesis✅ CAD 28–45k+✅3–8 wks
Lumbar disc prosthesis⚠️ Rarely offered✅ (multi-level)3–8 wks
Fusion / arthrodesis✅ CAD 40–80k✅ (minimally invasive)3–8 wks
TOPS (facet arthroplasty)❌ Not licensed✅3–8 wks
IntraSPINE (dynamic, no fusion)❌ Not licensed✅3–8 wks
B-Dyn (dynamic rod)❌ Not licensed✅3–8 wks
Barricaid (annular closure)❌ Not licensed✅3–8 wks
LP-ESP (viscoelastic prosthesis)❌ Not licensed✅3–8 wks
4K biportal endoscopy⚠️ Very limited✅—
O-Arm / Loop-X navigation⚠️ Variable✅ Cèdres, Poitiers—

Four motion-preserving techniques in the Franchir network

None is licensed by Health Canada. All are routinely performed by our partner surgeons in France.

Not licensed in Canada · MDALL 2026

TOPS — Lumbar facet arthroplasty

  • Stabilises after decompression without fusion
  • Main indication: Grade I degenerative spondylolisthesis + lumbar stenosis
  • FDA June 2023 — PMA P200012 — superiority to fusion (Cleveland Clinic)
  • Dr David Brauge · Clinique des Cèdres (2 O-Arms)
Not licensed in Canada · MDALL 2026

IntraSPINE — Interlaminar stabilisation without fusion

  • Soft interlaminar spacer · CE-marked · Reversible
  • Dr Doan Cô-Minh: >2,000 procedures · Prospective study >200 patients
Not licensed in Canada · MDALL 2026

B-Dyn — Dynamic pedicle rod

  • Pedicle screws with a dynamic rod · S14 Implants, Pessac
  • Key advantage: convertible to fusion with the same screws if needed
Not licensed in Canada · MDALL 2026

LP-ESP — Viscoelastic lumbar disc prosthesis

  • 6-DOF viscoelastic prosthesis · EU-authorised since 2005
  • Up to 4 lumbar discs in one operation
  • Dr Rakover · Clinique du Pré, Le Mans

TECHNOLOGY & PRECISION

Operating theatres at another level

Choosing a surgeon also means choosing the equipment they use. Procedure precision depends directly on tools available in the OR.

Intraoperative 3D Scanner (O-Arm)

Real-time 3D scan during surgery. Verifies exact screw and implant positioning before closure. Clinique des Cèdres is the only private French clinic with 2 simultaneous O-Arms.

Clinique des Cèdres — Dr David Brauge

Mobile intraoperative imaging (Loop-X, Brainlab)

Next-gen robotic imaging. Real-time 2D/3D with low radiation. Direct navigation integration. Available at very few French facilities.

Polyclinique de Poitiers — ICV NoA

Surgical navigation (spinal GPS)

GPS-like guidance during screw and implant placement. Replaces fluoroscopy, drastically reducing radiation exposure.

Clinique de l'Union — Dr Gilles Dubois

4K biportal endoscopic spine surgery

Two 1–2 cm portals only. 4K camera. No significant muscle damage. Mobility on day 1 for selected cases.

Clinique d'Occitanie · Clinique de l'Union

EOS edge (low-dose standing spine X-ray)

Full spine imaging in standing position — 8× lower radiation than CT. Gold standard for alignment assessment.

Polyclinique Oréliance — Dr Doan Cô-Minh

Intraoperative neurophysiological monitoring (PEV/PESS)

Continuous nerve activity monitoring throughout surgery. Immediate alert if an anomaly is detected. Standard at all Franchir partner centres.

Polyclinique de Poitiers — ICV NoA

These technologies are not uniformly available across French or Canadian facilities. Franchir verifies equipment availability at each partner centre before directing a patient.

Which option for your case?

Submit your file. Our surgeons determine whether a fusion alternative is indicated for you.

Which option for your case?

Do you have a recent MRI or CT (< 12 months)? *
I was offered a spinal fusion *

Your file is reviewed by an independent scientific advisor and our partner surgeons. No surgical commitment at this stage.

Find the option suited to your condition

Medical review CAD 700. Reply within 2 business days. No surgical commitment.

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