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Dynamic interbody fusion

P Guigui, E Ferrero
Degenerative spondylolisthesis is a common pathology, often causing lumbar canal stenosis. There is, however, no strong consensus regarding the various medical and surgical treatments available. Surgery is indicated mainly for perceived functional impairment; when the indication is accepted, several questions determine the choice of surgical strategy. Improvement in neurological symptoms is one of the main treatment objectives. For this, it is useful to perform radicular decompression. Some authors recommend indirect decompression by interbody fusion (ALIF, TLIF, XLIF), others by means of an interspinous spacer but the most frequent technique is direct posterior decompression...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Man Kyu Choi, Sung Bum Kim, Chang Kyu Park, Hridayesh P Malla, Sung Min Kim
STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate the relationship between trunk muscle cross-sectional area (MCSA) and fusion rate after posterior lumbar interbody fusion using pedicle screw fixation (PLIF-PSF). SUMMARY OF BACKGROUND DATA: Although trunk muscles of the lumbar spine contribute to spinal stability and alignment, effect of trunk muscles on spinal fusion rate and time to fusion is unclear. METHODS: A total of 192 adult patients with degenerative lumbar disease who underwent PLIF-PSF at L3-L4 or L4-L5 were included...
September 10, 2016: Clinical Spine Surgery
Jae Hyup Lee, Chang-Bae Kong, Jae Jun Yang, Hee-Jong Shim, Ki-Hyoung Koo, Jeehyuong Kim, Choon-Ki Lee, Bong-Soon Chang
BACKGROUND CONTEXT: The CaO-SiO2-P2O5-B2O3 glass ceramics spacer generates chemical bonding to adjacent bones with high mechanical stability to produce a union with the endplate and ultimately, stability. PURPOSE: The authors aimed to compare the clinical efficacy and safety of CaO-SiO2-P2O5-B2O3 glass ceramics with a titanium cage that is widely used for PLIF surgery in the clinical field. STUDY DESIGN/SETTING: Prospective, stratified randomized, multi-center, single-blinded, comparator-controlled non-inferiority trial PATIENT SAMPLE: This study was conducted in 4 hospitals and enrolled a total of 86 patients between 30 and 80 years of age who required one-level PLIF due to severe spinal stenosis, spondylolisthesis, or huge disc herniation...
August 3, 2016: Spine Journal: Official Journal of the North American Spine Society
Jiale Qian, Zhao Hua Bao, Xuefeng Li, Jun Zou, Hui-Lin Yang
BACKGROUND: At present, posterior interbody fusion surgery with pedicle internal fixation is the gold standard for the treatment of lumbar degenerative disc diseases. However, an increasing number of studies have shown that because fused lumbar vertebrae lose their physiological activity, the compensatory range of motion (ROM) of the adjacent levels increases. To address this issue, dynamic internal fixation systems have been developed. OBJECTIVE: Our goal was to investigate the short-term therapeutic efficacy of the Isobar TTL dynamic internal fixation system for the treatment of lumbar degenerative disc diseases and its effect on the ROM of the surgical segments...
July 2016: Pain Physician
Sohrab S Virk, Elizabeth Yu
STUDY DESIGN: Bibliometric study of current literature OBJECTIVE.: To catalog the most important minimally invasive spine (MIS) surgery articles using the amount of citations as a marker of relevance. SUMMARY OF BACKGROUND DATA: MIS surgery is a relatively new tool used by spinal surgeons. There is a dynamic and evolving field of research related to MIS techniques, clinical outcomes and basic science research. To date, there is no comprehensive review of the most cited articles related to MIS surgery...
July 19, 2016: Spine
Ahmed Kashkoush, Nitin Agarwal, Erin Paschel, Ezequiel Goldschmidt, Peter C Gerszten
INTRODUCTION: The development of adjacent-segment disease is a recognized consequence of lumbar fusion surgery. Posterior dynamic stabilization, or motion preservation, techniques have been developed which theoretically decrease stress on adjacent segments following fusion. This study presents the experience of using a hybrid dynamic stabilization and fusion construct for degenerative lumbar spine pathology in place of rigid arthrodesis. METHODS: A clinical cohort investigation was conducted of 66 consecutive patients (31 female, 35 male; mean age: 53 years, range: 25 - 76 years) who underwent posterior lumbar instrumentation with the Dynesys Transition Optima (DTO) implant (Zimmer-Biomet Spine, Warsaw, IN) hybrid dynamic stabilization and fusion system over a 10-year period...
2016: Curēus
Majid Reza Farrokhi, Zahra Nikoo, Mehrnaz Gholami, Khadijeh Hosseini
STUDY DESIGN: Prospective, single-blind randomized controlled clinical study. OBJECTIVE: To compare polyetheretherketone (PEEK) cage with a novel Acrylic cage to find out which fusion cage yielded better clinical outcomes following single-level anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is considered a standard neurosurgical treatment for degenerative diseases of cervical intervertebral discs. There are many options, including bone grafts, bone cement, and spacers made of titanium, carbon fiber, and synthetic materials, used to restore physiologic disc height and enhance spinal fusion, but the ideal device, which would provide immediate structural support and subsequent osteo-integration and stability, has not been identified yet...
June 28, 2016: Clinical Spine Surgery
Yu Han, Jianguang Sun, Chenghan Luo, Shilei Huang, Liren Li, Xiang Ji, Xiaozong Duan, Zhenqing Wang, Guofu Pi
OBJECTIVE Pedicle screw-based dynamic spinal stabilization systems (PDSs) were devised to decrease, theoretically, the risk of long-term complications such as adjacent-segment degeneration (ASD) after lumbar fusion surgery. However, to date, there have been few studies that fully proved that a PDS can reduce the risk of ASD. The purpose of this study was to examine whether a PDS can influence the incidence of ASD and to discuss the surgical coping strategy for L5-S1 segmental spondylosis with preexisting L4-5 degeneration with no related symptoms or signs...
December 2016: Journal of Neurosurgery. Spine
Wei Tian, Yun-Feng Xu, Bo Liu, Ya-Jun Liu, Da He, Qiang Yuan, Zhao Lang, Xiao-Guang Han
STUDY DESIGN: This study was a retrospective review of prospectively collected clinical data. OBJECTIVE: To evaluate the clinical and radiological outcomes of computer-assisted minimally invasive spine surgery-transforaminal lumbar interbody fusion (CAMISS-TLIF) and open TLIF for the treatment of one-level degenerative lumbar disease. SUMMARYOF BACKGROUND DATA: Minimally invasive TLIF is becoming increasingly popular; however, the limited space and high rate of hardware complications associated with this method are challenging to surgeons...
June 20, 2016: Clinical Spine Surgery
Sumihisa Orita, Kazuhide Inage, Yawara Eguchi, Go Kubota, Yasuchika Aoki, Junichi Nakamura, Yusuke Matsuura, Takeo Furuya, Masao Koda, Seiji Ohtori
In patients with lower back and leg pain, lumbar foraminal stenosis (LFS) is one of the most important pathologies, especially for predominant radicular symptoms. LFS pathology can develop as a result of progressing spinal degeneration and is characterized by exacerbation with foraminal narrowing caused by lumbar extension (Kemp's sign). However, there is a lack of critical clinical findings for LFS pathology. Therefore, patients with robust and persistent leg pain, which is exacerbated by lumbar extension, should be suspected of LFS...
October 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hironobu Sakaura, Toshitada Miwa, Tomoya Yamashita, Yusuke Kuroda, Tetsuo Ohwada
OBJECTIVE Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation...
May 27, 2016: Journal of Neurosurgery. Spine
Man Kyu Choi, Sung Bum Kim, Bong Jin Park, Chang Kyu Park, Sung Min Kim
OBJECTIVE: Although trunk muscles in the lumbar spine preserve spinal stability and motility, little is known about the relationship between trunk muscles and spinal fusion rate. The aim of the present study is to evaluate the correlation between trunk muscles cross sectional area (MCSA) and fusion rate after posterior lumbar interbody fusion (PLIF) using stand-alone cages. METHODS: A total of 89 adult patients with degenerative lumbar disease who were performed PLIF using stand-alone cages at L4-5 were included in this study...
May 2016: Journal of Korean Neurosurgical Society
Naohiro Tachibana, Naohiro Kawamura, Daiki Kobayashi, Takaki Shimizu, Takeshi Sasagawa, Shigeru Masuyama, Yujiro Hirao, Junichi Kunogi
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To investigate the effects of dynamic stabilization with sublaminar taping (ST) on the upper segment adjacent to posterior lumbar interbody fusion (PLIF). SUMMARY OF BACKGROUND DATA: Hybrid procedures such as dynamic stabilization for adjacent segment in addition to spinal fusion have been developed for reduction of the mechanical stress and prevention of adjacent segment pathology (ASP)...
January 1, 2017: Spine
Chao Zhou, Yong-hao Tian, Yan-ping Zheng, Xin-yu Liu, Hu-hu Wang
OBJECTIVE: To assess the clinical efficacy of mini-invasive transforaminal lumbar interbody fusion (TLIF) through the Wiltse approach for treating lumbar spondylolytic spondylolisthesis. METHODS: In this retrospective controlled study, 69 cases with lumbar spondylolytic spondylolisthesis treated in Qilu hospital from April to November 2014 were randomly assigned to Wiltse approach (31 cases, 16 male, 15 female; mean age 45.1 years) and traditional approach groups (38 cases, 21 male, 17 female; 47...
February 2016: Orthopaedic Surgery
Yang Zhang, Jian-Lin Shan, Xiu-Mei Liu, Fang Li, Kai Guan, Tian-Sheng Sun
BACKGROUND: There have been few studies comparing the clinical and radiographic outcomes between the Dynesys dynamic stabilization system and posterior lumbar interbody fusion (PLIF). The objective of this study is to compare the clinical and radiographic outcomes of Dynesys and PLIF for lumbar degenerative disease. METHODS: Of 96 patients with lumbar degenerative disease included in this retrospectively analysis, 46 were treated with the Dynesys system and 50 underwent PLIF from July 2008 to March 2011...
2016: PloS One
Chang-Hyun Lee, Tae-Ahn Jahng, Seung-Jae Hyun, Chi Heon Kim, Sung-Bae Park, Ki-Jeong Kim, Chun Kee Chung, Hyun-Jib Kim, Soo-Eon Lee
OBJECTIVE The Dynesys, a pedicle-based dynamic stabilization (PDS) system, was introduced to overcome the drawbacks of fusion procedures. Nevertheless, the theoretical advantages of PDS over fusion have not been clearly confirmed. The aim of this study was to compare clinical and radiological outcomes of patients who underwent PDS using the Dynesys system with those who underwent posterior lumbar interbody fusion (PLIF). METHODS The authors searched PubMed, Embase, Web of Science, and the Cochrane Database...
January 2016: Neurosurgical Focus
Soo Eon Lee, Tae-Ahn Jahng, Hyun Jib Kim
OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patients who underwent monosegmental surgery at L4-5 with nonfusion dynamic stabilization using the Dynesys system (Dynesys group) or transforaminal lumbar interbody fusion with pedicle screw fixation (fusion group) were retrospectively compared...
January 2016: Neurosurgical Focus
Chao-Hung Kuo, Peng-Yuan Chang, Jau-Ching Wu, Hsuan-Kan Chang, Li-Yu Fay, Tsung-Hsi Tu, Henrich Cheng, Wen-Cheng Huang
OBJECTIVE In the past decade, dynamic stabilization has been an emerging option of surgical treatment for lumbar spondylosis. However, the application of this dynamic construct for mild spondylolisthesis and its clinical outcomes remain uncertain. This study aimed to compare the outcomes of Dynesys dynamic stabilization (DDS) with minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the management of single-level spondylolisthesis at L4-5. METHODS This study retrospectively reviewed 91 consecutive patients with Meyerding Grade I spondylolisthesis at L4-5 who were managed with surgery...
January 2016: Neurosurgical Focus
Nancy E Epstein
BACKGROUND: Instrumented lumbar spine surgery is associated with an increased risk of adjacent segment disease (ASD). Multiple studies have explored the various risk factors contributing to ASD that include; fusion length (especially, three or more levels), sagittal malalignment, facet injury, advanced age, and prior cephalad degenerative disease. METHODS: In this selective review of ASD, following predominantly instrumented fusions for lumbar degenerative disease, patients typically underwent open versus minimally invasive surgery (MIS), transforaminal lumbar interbody fusions (TLIFs), posterior lumbar interbody fusions (PLIFs), or rarely posterolateral lumbar instrumented or noninstrumented fusions (posterolateral lumbar fusion)...
2015: Surgical Neurology International
David W Allison, Richard T Allen, David D Kohanchi, Collin B Skousen, Yu-Po Lee, Jeffrey H Gertsch
Multi-modal neurophysiologic monitoring consisting of triggered and spontaneous electromyography and transcranial motor-evoked potentials may detect and prevent both acute and slow developing mechanical and vascular nerve injuries in lateral lumbar interbody fusion (LLIF) surgery. In case report 1, a marked reduction in the transcranial motor-evoked potentials on the operative side alerted to a 28% decrease in mean arterial blood pressure in a 54-year-old woman during an L3-4, L4-5 LLIF. After hemodynamic stability was regained, transcranial motor-evoked potentials returned to baseline and the patient suffered no postoperative complications...
December 2015: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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