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Interbody fusion

Matthias A König, Bronek M Boszczyk
OBJECTIVE: 360 degrees in-situ fusion for high-grade spondylolisthesis showed satisfying clinical long-term results. Combining anterior with posterior surgery increases fusion rates. Anteriorly inserted transvertebral HMA screws could be an alternative to strut graft constructs or cages, avoiding donor site complications. In addition, complete posterior muscle detachment is avoided and the injury risk of neural structures is minimized. This study investigates the use of HMA screws in this context...
March 22, 2018: British Journal of Neurosurgery
Ovidiu Palea, Michelle Granville, Robert E Jacobson
The clinical effectiveness of percutaneous and transforaminal endoscopic discectomy procedures has been evaluated by the system used or compared to open laminectomy or micro-discectomy but are not evaluated based on the location and characteristics of the abnormal disc. This review proposes that outcomes are primarily related to disc size, biomechanics, location, and associated segmental fibrotic and bone changes as well as the surgeon's skill in using various systems rather than the specific system used...
January 20, 2018: Curēus
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
Heeren Makanji, Andrew J Schoenfeld, Amandeep Bhalla, Christopher M Bono
PURPOSE: Lumbar fusion for degenerative disorders is among the most common spine surgical procedures performed. The purpose of this study was to analyze fusion, complications, and clinical success for lumbar fusion performed with various surgical techniques as reported in the literature from 2000 to 2015 and compare with previous critical analysis of outcomes from 1980 to 2000. METHODS: A systematic review of the literature to identify all studies of adult lumbar fusion for degenerative disorders published between January 1, 2000, and August 31, 2015, was performed adhering to PRISMA guidelines...
March 15, 2018: European Spine Journal
Oliver P Gautschi, Martin N Stienen, Marco V Corniola, Granit Molliqaj, Enrico Tessitore
No abstract text is available yet for this article.
April 2018: Journal of Neurosurgical Sciences
Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
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
John P Kleimeyer, Ivan Cheng, Todd F Alamin, Serena S Hu, Thomas Cha, Vijay Yanamadala, Kirkham B Wood
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes of selective one- to two-level anterior lumbar interbody fusions (ALIFs) in the lower lumbar spine versus continued nonsurgical management. SUMMARY OF BACKGROUND DATA: Low back pain associated with lumbar intervertebral disc degeneration is common with substantial economic impact, yet treatment remains controversial. Surgical fusion has previously provided mixed results with limited durable improvement of pain and function...
March 9, 2018: Spine
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
Xi Chen, Liang Xu, Yong Qiu, Zhong-Hui Chen, Qing-Shuang Zhou, Song Li, Xu Sun
No abstract text is available yet for this article.
March 7, 2018: World Neurosurgery
Zhenjun Zhang, Guy R Fogel, Zhenhua Liao, Yitao Sun, Weiqiang Liu
Inappropriate lordotic angle of lumbar fusion cage could be associated with cage damage or subsidence. The biomechanical influence of cage lordotic angle on lumbar spine has not been fully investigated. Four surgical finite element models were constructed by inserting cages with various lordotic angles at L3-L4 disc space. The four motion modes were simulated. The range of motion (ROM) decreased with increased lordotic angle of cage in flexion, extension, and rotation, whereas it was not substantially changed in bending...
March 7, 2018: Computer Methods in Biomechanics and Biomedical Engineering
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
Michael R Riley, Adam T Doan, Richard W Vogel, Alexander O Aguirre, Kayla S Pieri, Edward H Scheid
Background Context Intraoperative neurophysiological monitoring (IONM) has gained rather wide-spread acceptance as a method to mitigate risk to the lumbar plexus during Lateral Lumbar Interbody Fusion (LLIF) surgery. The most common approach to IONM involves using only electromyography (EMG) monitoring, and the rate of postoperative deficit remains unacceptably high. Other test modalities, such as transcranial electric motor-evoked potentials (tcMEPs) and somatosensory-evoked potentials (SSEPs), may be more suitable for monitoring neural integrity but they have not been widely adopted during LLIF...
March 2, 2018: Spine Journal: Official Journal of the North American Spine Society
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
Marko Tomov, Kevin Tou, Rose Winkel, Ross Puffer, Mohamad Bydon, Ahmad Nassr, Paul Huddleston, Michael Yaszemski, Bradford Currier, Brett Freedman
Study Design: Retrospective case-control study using prospectively collected data. Purpose: Evaluate the impact of liposomal bupivacaine (LB) on postoperative pain management and narcotic use following standardized single-level low lumbar transforaminal lumbar interbody fusion (TLIF). Overview of Literature: Poor pain control after surgery has been linked with decreased pain satisfaction and increased economic burden. Unfortunately, opioids have many limitations and side effects despite being the primary treatment of postoperative pain...
February 2018: Asian Spine Journal
Dong-Yeong Lee, Young-Jin Park, Sang-Youn Song, Soon-Taek Jeong, Dong-Hee Kim
Study Design: A retrospective clinical case series. Purpose: To determine the strength of association between cage retropulsion and its related factors. Overview of Literature: Lumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging...
February 2018: Asian Spine Journal
Arvind G Kulkarni, Shashidhar Bangalore Kantharajanna, Abhilash N Dhruv
Study Design: Retrospective case series. Purpose: To compare minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) outcomes in primary and revision surgeries. Overview of Literature: Revision spinal fusion is often associated with an increased risk of approach-related complications. Patients can potentially benefit from the decreased approach-related morbidity associated with MI-TLIF. Methods: Sixty consecutive MI-TLIF patients (20 failed back [Fa group], 40 primary [Pr group]) who underwent surgery between January 2011 and May 2012 were reviewed after Institutional Review Board approval to compare operative times, blood loss, complications, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores for back and leg pain before surgery and at the last follow-up...
February 2018: Asian Spine Journal
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