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Interbody Bone Fusion

Hung-Wei Hsu, Maxim Bashkuev, Matthias Pumberger, Hendrik Schmidt
Lumbar interbody fusion is currently the gold standard in treating patients with disc degeneration or segmental instability. Despite it having been used for several decades, the non-union rate remains high. A failed fusion is frequently attributed to an inadequate mechanical environment after instrumentation. Finite element (FE) models can provide insights into the mechanics of the fusion process. Previous fusion simulations using FE models showed that the geometries and material of the cage can greatly influence the fusion outcome...
March 15, 2018: Journal of Biomechanics
Joshua M Peterson, Carolyn Chlebek, Ashley M Clough, Alexandra K Wells, Kathleen E Batzinger, John M Houston, Katerina Kradinova, Joseph C Glennon, Darryl J DiRisio, Eric H Ledet
STUDY DESIGN: Real time in vivo measurement of forces in the cervical spine of goats following anterior cervical discectomy and fusion (ACDF). OBJECTIVE: To measure interbody forces in the cervical spine during the time course of fusion following ACDF with plates of different stiffnesses. SUMMARY OF BACKGROUND DATA: Following ACDF, the biomechanics of the arthrodesis is largely dictated by the plate. The properties of the plate prescribe the extent of load-sharing through the disc space versus the extent of stress-shielding...
March 19, 2018: Spine
Shengtao Zhang, Conglin Ye, Qi Lai, Xiaolong Yu, Xuqiang Liu, Tao Nie, Haibo Zhan, Min Dai, Bin Zhang
BACKGROUND: Lumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition. METHODS: Of 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery...
March 16, 2018: Journal of Orthopaedic Surgery and Research
Joshua M Peterson, Carolyn Chlebek, Ashley M Clough, Alexandra K Wells, Eric H Ledet
STUDY DESIGN: In vitro biomechanical testing of human cadaveric cervical and goat cervical motion segments. OBJECTIVE: To measure the effects of plate stiffness on load-sharing, instantaneous axis of rotation (IAR), and posterior element loading after anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is intended to create an environment which facilitates sufficient stability and biomechanical conditions to promote bone formation...
March 15, 2018: Spine
Sven Hoppe, Christoph E Albers, Tarek Elfiky, Moritz C Deml, Helena Milavec, Sebastian F Bigdon, Lorin M Benneker
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient's satisfaction, and complications were followed up for two years...
March 14, 2018: Journal of Functional Biomaterials
Ron N Alkalay, Robert Adamson, Michael W Groff
BACKGROUND CONTEXT: In the lumbar spine, end plate preparation for the interbody fusion cages may critically affect the cage's long term performance. This study investigated the effect of the interbody cage design on the compliance and cage subsidence of instrumented spines under cyclic compression. PURPOSE: To quantify the role of cage geometry and bone density on the stability of the spinal construct in response to cyclic compressive loads. STUDY DESIGN: Changes in the cage-bone interface and the effect of bone density on these changes were evaluated in a human cadaveric model for three intervertebral cage designs...
March 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Gilles Norotte, Carlos Barrios
OBJECTIVE: Recent improvements in cage designs with integral fixation and screw attachments have made stand-alone ALIF a viable option with several possible advantages. The aim of this study was to confirm the efficacy and safety of a PEEK cage filled with hydroxyapatite nanoparticles without adding a bone graft for stand-alone ALIF in the treatment of L5-S1 isolated degenerative disc discopathy (DDD). PATIENTS AND METHODS: Sixty-five patients who required surgery for DDD were evaluated...
January 31, 2018: Clinical Neurology and Neurosurgery
Go Kubota, Hiroto Kamoda, Sumihisa Orita, Kazuhidee Inage, Michihiro Ito, Masaomi Yamashita, Takeo Furuya, Tsutomu Akazawa, Yasuhiro Shiga, Seiji Ohtori
Study Design: Retrospective case series. Purpose: To examine the efficacy of platelet-rich plasma (PRP) for bone fusion in transforaminal lumbar interbody fusion (TLIF) using local bone grafting. Overview of Literature: Several authors have reported the efficacy of PRP for bone union in animal models. However, the use of PRP for bone fusion in TLIF surgery has not been fully explored. Methods: Twenty patients underwent single-level TLIF surgery because of L4 spondylolisthesis...
February 2018: Asian Spine Journal
Zhenjun Zhang, Hui Li, Guy R Fogel, Dingding Xiang, Zhenhua Liao, Weiqiang Liu
In lumbar interbody fusion, a porous additive manufactured (AM) cage can provide more desirable stiffness, and may be beneficial to bone ingrowth. The biomechanical influence of porous cages on stability, subsidence, and facet contact force has not been fully described. The aim of this study was to verify biomechanical effects of porous cages. Surgical finite element (FE) model of transforaminal lumbar interbody fusion (TLIF) was constructed. The partially porous (PP) cages and fully porous (FP) cages were applied...
February 23, 2018: Computers in Biology and Medicine
W R Walsh, M Pelletier, C Christou, J He, F Vizesi, S D Boden
BACKGROUND: Context: Increasing bone ongrowth and ingrowth of PEEK interbody fusion devices has the potential to improve clinical outcomes. PURPOSE: This study evaluated the in vivo response of promoting new bone growth and bone apposition with NM compared to PEEK alone in a cancellous implantation site with an empty aperture. STUDY DESIGN: This is a randomized control animal study METHODS: Implants and funding for this study were provided by SeaSpine (60,000 USD)...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Kirk McGilvray, Jeremiah Easley, Howard B Seim, Daniel Regan, Sigurd H Berven, Wellington K Hsu, Thomas E Mroz, Christian M Puttlitz
BACKGROUND CONTEXT: There is significant variability in the materials commonly used for interbody cages in spine surgery. It is theorized that 3-D printed interbody cages utilizing porous titanium material can provide more consistent bone ingrowth and biological fixation. PURPOSE: The purpose of this study was to provide an evidence-based approach to decision making regarding interbody materials for spinal fusion. STUDY DESIGN: Comparative animal study...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Michael A Bohl, Randy J Hlubek, U Kumar Kakarla, Steve W Chang
BACKGROUND: A major drawback to the use of cortical bone trajectory pedicle screws (CBTPS) with traditional posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) grafts is that traditional graft insertion trajectories require a wider posterior exposure. This wider exposure, beyond the limits otherwise required for CBTPS placement, negates a primary benefit of CBTPS fixation. OBJECTIVE: To define an alternative surgical technique for interbody graft placement that, when used in conjunction with CBTPS fixation, permits both minimal soft tissue dissection and optimal graft placement...
February 17, 2018: World Neurosurgery
Brittany E Haws, Benjamin Khechen, Ankur S Narain, Fady Y Hijji, Kaitlyn L Cardinal, Jordan A Guntin, Kern Singh
STUDY DESIGN: Retrospective Analysis OBJECTIVE.: The aim of this study was to determine whether an association between increased acute pain, postoperative time, and direct hospital costs exists between the use of iliac crest bone grafting (ICBG) and bone morphogenic protein (BMP)-2 following a primary, single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: ICBG has been associated with enhanced fusion rates...
February 16, 2018: Spine
Vinaysagar Sharma, Shashwat Kumar Singh
Introduction: Anterior cervical discectomy is a surgical procedure performed to treat a herniated/degenerated disc in the cervical region. There have been various studies comparing arthrodesis rates among various procedures. Our patients belonged to varied socioeconomic background and underwent anterior cervical microdiscectomy without/with instrumentation. Aim: The present study was performed to study and compare the arthrodesis rates in the patients operated for anterior cervical microdiscectomy with and without fusion/instrumentation procedures at our institution...
January 2018: Journal of Neurosciences in Rural Practice
Eric H Ledet, Glenn P Sanders, Darryl J DiRisio, Joseph C Glennon
BACKGROUND: Context: Achieving a successful spinal fusion requires the proper biologic and biomechanical environment. Optimizing load-sharing in the interbody space can enhance bone formation. For anterior cervical discectomy and fusion (ACDF), loading and motion are largely dictated by the stiffness of the plate which can facilitate a balance between stability and load-sharing. The advantages of load-sharing may be substantial for patients with comorbidities and in multi-level procedures where pseudarthrosis rates are significant...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
Charles D Rosen, P Douglas Kiester, Thay Q Lee
We conducted a study to determine the common characteristics of patients who developed radiculopathy symptoms and corresponding heterotopic ossification (HO) from transforaminal lumbar interbody fusions (TLIF) using recombinant human bone morphogenetic protein 2 (rhBMP-2). HO can arise from a disk space with rhBMP-2 use in TLIF. Formation of bone around nerve roots or the thecal sac can cause a radiculopathy with a consistent pattern of symptoms. We identified 38 patients (26 males, 12 females) with a mean (SD) age of 50...
January 2018: American Journal of Orthopedics
Haiping Zhang, Yonghong Jiang, Biao Wang, Qinpeng Zhao, Simin He, Dingjun Hao
Despite the diverse designs for the lumbar interbody fusion cage, there is no consensus on the optimal design to date. The current study aimed to compare the efficacy and complications associated with the direction-changeable and traditional lumbar cages for treating lumbar spondylolisthesis.We conducted a retrospective study including 109 patients with lumbar spondylolisthesis, who were admitted to our hospital from January 2013 to December 2014. The patients were divided into the direction-changeable (group A) and traditional (group B) lumbar cage group...
February 2018: Medicine (Baltimore)
Jason P Caffrey, Eloy Alonso, Koichi Masuda, Jessee P Hunt, Cameron N Carmody, Timothy M Ganey, Robert L Sah
Titanium cages with 3-D printed trussed open-space architectures may provide an opportunity to deliver targeted mechanical behavior in spine interbody fusion devices. The ability to control mechanical strain, at levels known to stimulate an osteogenic response, to the fusion site could lead to development of optimized therapeutic implants that improve clinical outcomes. In this study, cages of varying design (1.00 mm or 0.75 mm diameter struts) were mechanically characterized and compared for multiple compressive load magnitudes in order to determine what impact certain design variables had on localized strain...
February 3, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Kentaro Yamane, Nobuo Kai
INTRODUCTION: Osteopetrosis is a clinical syndrome characterized by the failure of osteoclasts to resorb bone. Affected patients usually suffer from repetitive fractures due to this pathological state. Surgical treatment of these fractures is often complicated by the difficulty of working with the extremely hard and brittle bones. The purpose of this study was to report a case of chronic hangman's fracture in a patient with osteopetrosis who underwent surgery for cervical anterior interbody fusion...
February 10, 2018: Archives of Orthopaedic and Trauma Surgery
Lin Chen, Jun Cheng, Bo Li, Fang-Biao Zhan, You Zhang, Shi-Long Feng
OBJECTIVE: To evaluate the clinical effects of posterior debridement, interbody fusion with internal fixation in the treatment of lumbar discitis. METHODS: The clinical data of 13 patients with lumbar discitis treated from January 2005 to June 2012 was retrospectively analyzed. There were 9 males and 4 females, aged from 31 to 68 years old with an average of 56 years old. There were 2 cases on L3, 4, 4 cases on L4, 5, and 7 cases on L5S1. Two cases complicated with diabetes, 4 cases with hypertension, and 1 case with obsolete pulmonary tuberculosis...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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