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Dynamic interbody fusion

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
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
Hiroyuki Aono, Shota Takenaka, Yukitaka Nagamoto, Hidekazu Tobimatsu, Tomoya Yamashita, Masayuki Furuya, Motoki Iwasaki
BACKGROUND: Posterior lumbar interbody fusion (PLIF) has become a general surgical method for degenerative lumbar diseases. Although many reports have focused on single-level PLIF, few have focused on 2-level PLIF, and no report has covered the fusion status of 2-level PLIF. The purpose of this study is to investigate clinical outcomes and fusion for 2-level PLIF by using a combination of dynamic radiographs and multiplanar-reconstruction computed tomography scans. METHODS: This study consists of 48 consecutive patients who underwent 2-level PLIF for degenerative lumbar diseases...
January 17, 2018: World Neurosurgery
Manuel Segura-Trepichio, David Candela-Zaplana, José Manuel Montoza-Nuñez, Antonio Martin-Benlloch, Andreu Nolasco
Background: The number of lumbar spine surgeries has been increasing during the last 20 years, which also leads to an increase in hospital costs and complications related to surgery. Therefore, there is a greater concern about the costs and safety of the techniques and implants used. Methods: Patients (aged from 18 to 50 years) presenting with lumbago /sciatica (ICD-10-CM M54.3, M54.4) due to lumbar disc herniation lasting more than 12 weeks, were included. Patients with disc herniation larger than size-2 or size-3 according to the MSU Classification were eligible for participation...
2017: Patient Safety in Surgery
Fon-Yih Tsuang, Yueh-Ying Hsieh, Yi-Jie Kuo, Chia-Hsien Chen, Feng-Huei Lin, Chen-Sheng Chen, Chang-Jung Chiang
Interbody fusion with posterior instrumentation is a common method for treating lumbar degenerative disc diseases. However, the high rigidity of the fusion construct may produce abnormal stresses at the adjacent segment and lead to adjacent segment degeneration (ASD). As such, biodegradable implants are becoming more popular for use in orthopaedic surgery. These implants offer sufficient stability for fusion but at a reduced stiffness. Tailored to degrade over a specific timeframe, biodegradable implants could potentially mitigate the drawbacks of conventional stiff constructs and reduce the loading on adjacent segments...
2017: PloS One
Hironobu Sakaura, Toshitada Miwa, Tomoya Yamashita, Yusuke Kuroda, Tetsuo Ohwada
OBJECTIVE The cortical bone trajectory (CBT) screw technique is a new nontraditional pedicle screw (PS) insertion method. However, the biomechanical behavior of multilevel CBT screw/rod fixation remains unclear, and surgical outcomes in patients after 2-level posterior lumbar interbody fusion (PLIF) using CBT screw fixation have not been reported. Thus, the purposes of this study were to examine the clinical and radiological outcomes after 2-level PLIF using CBT screw fixation for 2-level degenerative lumbar spondylolisthesis (DS) and to compare these outcomes with those after 2-level PLIF using traditional PS fixation...
November 10, 2017: Journal of Neurosurgery. Spine
Gun Woo Lee, Myun-Whan Ahn
OBJECTIVE: The aim of this study was to report 2-year follow-up outcomes of posterior lumbar interbody fusion (PLIF) with cortical bone trajectory-pedicle screw (CS), in terms of fusion rates, clinical outcomes, surgical outcomes, and complications, and to compare these outcomes with outcomes for PLIF with conventional pedicle screw (PS). METHODS: We enrolled 79 patients and randomly assigned them to 2 groups (group A with PS, 39 patients; group B with CS, 40 patients), and finally 37 and 35 in group A and B were analyzed in the study...
January 2018: World Neurosurgery
Parmenion P Tsitsopoulos, Leonard I Voronov, Michael R Zindrick, Gerard Carandang, Robert M Havey, Alexander J Ghanayem, Avinash G Patwardhan
OBJECTIVE: To test the following hypotheses: (i) anterior cervical discetomy and fusion (ACDF) using stand-alone interbody spacers will significantly reduce the range of motion from intact spine; and (ii) the use of a static or a rotational-dynamic plate will significantly augment the stability of stand-alone interbody spacers, with similar beneficial effect when compared to each other. METHODS: Eleven human cadaveric subaxial cervical spines (age: 48.2 ± 5.4 years) were tested under the following sequence: (i) intact spine; (ii) ACDF at C4 -C5 using a stand-alone interbody spacer; (iii) ACDF at C5 -C6 and insertion of an interbody spacer (two-level construct); and (iv) randomized placement of either a two-level locking static plate or a rotational-dynamic plate...
August 2017: Orthopaedic Surgery
Hasan Serdar Işik, Özerk Okutan, Timur Yildirim, Elif Akpinar, Ali Yilmaz
AIM: There are some recognized treatment modalities in the literature for the treatment of lumbar degenerative diseases,which cause pain and avoidance of daily life activities for the patients.The most widely accepted algorithm in the literature is medical treatment,physical therapy and minimally invasive pain-relieving therapies,if necessary,followed by surgical interventions.The common procedure used in neurosurgery practice is the decompression of neural elements followed by fusion...
July 30, 2017: Turkish Neurosurgery
Gun Woo Lee, Han Seok Yang, Jin S Yeom, Myun-Whan Ahn
BACKGROUND: Vitamin C has critical features relavant to postoperative pain management and functional improvement; however, no study has yet evaluated the effectiveness of vitamin C on improving the surgical outcomes for spine pathologies. Thus, this study aimed to explore the impact of vitamin C on postoperative outcomes after single-level posterior lumbar interbody fusion (PLIF) for lumbar spinal stenosis in prospectively randomized design. We conducted a 1-year prospective, randomized, placebo-controlled, double-blind study to evaluate the impact of vitamin C on the postoperative outcomes after PLIF surgery...
September 2017: Clinics in Orthopedic Surgery
Sung-Soo Chung, Kyung-Joon Lee, Yoo-Beom Kwon, Kyung-Chung Kang
This study evaluated the characteristics of a newly developed 3-dimensional printed mesh structure titanium spacer and its efficacy for posterior lumbar interbody fusion. Posterior lumbar interbody fusion with this spacer was performed at 53 segments (40 patients; mean age, 64 years; range, 51-73 years). Data were collected prospectively. Radiographic characteristics were analyzed with changes in interbody height, instability of the segments, formation of bone bridges around the implants, and pseudarthrosis, as determined by dynamic radiographs and postoperative computed tomography scans...
September 1, 2017: Orthopedics
Peng Huang, Yiguo Wang, Jiao Xu, Bo Xiao, Jianheng Liu, Luyang Che, Keya Mao
BACKGROUND: Conventional open transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws and a translaminar facet screw has been performed for many years with good results. The outcomes of minimally invasive TLIF (MIS TLIF) are similar to the good outcomes of open TLIF, with the additional benefits of reducing iatrogenic injury, shortening hospital stays, and reducing the recovery duration. Instead of using small cuts on both sides, we performed MIS TLIF through a single cut using unilateral pedicle screws and a translaminar facet screw...
July 20, 2017: Journal of Orthopaedic Surgery and Research
Haiting Wu, Qingjiang Pang, Guoqiang Jiang
Objective To compare the medium-term clinical and radiographic outcomes of Dynesys dynamic stabilization and posterior lumbar interbody fusion (PLIF) for treatment of multisegmental lumbar degenerative disease. Methods Fifty-seven patients with multisegmental lumbar degenerative disease underwent Dynesys stabilization (n = 26) or PLIF (n = 31) from December 2008 to February 2010. The mean follow-up period was 50.3 (range, 46-65) months. Clinical outcomes were evaluated using a visual analogue scale (VAS) and the Oswestry disability index (ODI)...
October 2017: Journal of International Medical Research
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 radiologic outcomes of computer-assisted minimally invasive spine surgery transforaminal lumbar interbody fusion (CAMISS-TLIF) and open TLIF for the treatment of 1-level degenerative lumbar disease. SUMMARY OF 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...
July 2017: Clinical Spine Surgery
Félix Tomé-Bermejo, Julián A Morales-Valencia, Javier Moreno-Pérez, Juan Marfil-Pérez, Elena Díaz-Dominguez, Angel R Piñera, Luis Alvarez
STUDY DESIGN: A retrospective, observational study of prospectively collected outcomes. OBJECTIVE: To investigate the long-term clinical course of anterior cervical discectomy and fusion with interbody fusion cages (ACDF-IFC) with lordotic tantalum implants and to correlate the radiologic findings with the clinical outcomes, with special emphasis on the significance and the influence of implant subsidence. SUMMARY OF BACKGROUND DATA: Cage subsidence is the most frequently reported complication after ACDF-IFC...
June 2017: Clinical Spine Surgery
Timothy A Peppers, Dennis E Bullard, Jed S Vanichkachorn, Scott K Stanley, Paul M Arnold, Erik I Waldorff, Rebekah Hahn, Brent L Atkinson, James T Ryaby, Raymond J Linovitz
BACKGROUND: Trinity Evolution® (TE), a viable cellular bone allograft, previously demonstrated high fusion rates and no safety-related concerns after single-level anterior cervical discectomy and fusion (ACDF) procedures. This prospective multicenter clinical study was performed to assess the radiographic and clinical outcomes of TE in subjects undergoing two-level ACDF procedures. METHODS: In a prospective, multicenter study, 40 subjects that presented with symptomatic cervical degeneration at two adjacent vertebral levels underwent instrumented ACDF using TE autograft substitute in a polyetherethereketone (PEEK) cage...
April 26, 2017: Journal of Orthopaedic Surgery and Research
Gun Woo Lee, Ji-Hoon Shin, Seung Min Ryu, Myun-Whan Ahn
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To determine the impact of L5 sacralization on fusion rates and clinical outcomes after single-level posterior lumbar interbody fusion (PLIF) surgery at the L4-L5 level. SUMMARY OF BACKGROUND DATA: L5 sacralization can produce greater stress concentration at the adjacent segment (L4-L5); therefore, L4-L5 PLIF surgery in patients with L5 sacralization may negatively affect fusion rate and be associated with poor clinical outcomes...
April 7, 2017: Clinical Spine Surgery
Mark P Arts, Jasper F C Wolfs, Terry P Corbin
PURPOSE: Anterior cervical discectomy with fusion is a common procedure for treating radicular arm pain. Polyetheretherketone (PEEK) plastic is a frequently used material in cages for interbody fusion. Silicon nitride is a new alternative with desirable bone compatibility and imaging characteristics. The aim of the present study is to compare silicon nitride implants with PEEK cages filled with autograft harvested from osteophytes. METHODS: The study is a prospective, randomized, blinded study of 100 patients with 2 years follow-up...
April 5, 2017: European Spine Journal
Shigeto Ebata, Jun Takahashi, Tomohiko Hasegawa, Keijiro Mukaiyama, Yukihiro Isogai, Tetsuro Ohba, Yosuke Shibata, Toshiyuki Ojima, Zentaro Yamagata, Yukihiro Matsuyama, Hirotaka Haro
BACKGROUND: For elderly patients, posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) is usually performed to treat lumbar degenerative diseases. However, some patients exhibit pseudarthrosis following such procedures. The anabolic agent teriparatide is an approved treatment for promoting bone formation in osteoporotic patients. Our multicenter, prospective randomized study assessed the role of once-weekly teriparatide administration on patient outcomes following interbody fusion...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
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