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Interbody fusion device

Christopher J Kleck, Damian Illing, Emily M Lindley, Andriy Noshchenko, Vikas V Patel, Cameron Barton, Todd Baldini, Christopher M J Cain, Evalina L Burger
STUDY DESIGN: Clinically related experimental study. OBJECTIVE: Evaluation of strain in posterior low lumbar and spinopelvic instrumentation for multilevel fusion resulting from the impact of such mechanical factors as physiologic motion, different combinations of posterior and anterior instrumentation, and different techniques of interbody device implantation. SUMMARY OF BACKGROUND DATA: Currently different combinations of posterior and anterior instrumentation as well as surgical techniques are used for multilevel lumbar fusion...
January 2017: Spine Deformity
Hyun W Bae, Vikas V Patel, Zeeshan M Sardar, Jeffrey M Badura, Ben B Pradhan, Howard B Seim, A Simon Turner, Jeffrey M Toth
BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) is a powerful osteoinductive morphogen capable of stimulating the migration of mesenchymal stem cells (MSCs) to the site of implantation and inducing the proliferation and differentiation of these MSCs into osteoblasts. Vertebral end-plate and vertebral body resorption has been reported after interbody fusion with high doses of rhBMP-2. In this study, we investigated the effects of 2 rhBMP-2 doses on peri-implant bone resorption and bone remodeling at 7 time points in an end-plate-sparing ovine interbody fusion model...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
Nancy E Epstein
BACKGROUND: Complications exclusive of new neurological deficits/injuries that follow extreme lateral interbody fusion (XLIF) and related lateral lumbar interbody techniques should be better recognized to determine the safety of these procedures. Unfortunately, a review of the XLIF literature did not accurately reflect the frequency of these "other complications" as few US surgeons publish such adverse events that may lead to medicolegal suits. METHODS: Major complications occurring with XLIF included sympathectomy, major vascular injuries, bowel perforations, sterile seromas, and instrumentation failures...
2016: Surgical Neurology International
Yuanyuan Chen, Yang Liu, Huajiang Chen, Peng Cao, Wen Yuan
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare clinical and radiologic outcomes of 3-level anterior cervical discectomy and fusion between a zero-profile (Zero-P) spacer and a traditional plate in cases of symptomatic cervical spine spondylosis. SUMMARY OF BACKGROUND DATA: Anterior cervical decompression and fusion is indicated for patients with anterior compression or stenosis of the spinal cord. The Zero-P spacers have been used for anterior cervical interbody fusion of 1 or 2 segments...
September 16, 2016: Clinical Spine Surgery
Chang-Hyun Lee, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
AIM: Although conventional posterior lumbar interbody fusion (PLIF) using pedicle screws accomplish successful outcomes, pedicle screw related complications were sometimes noted. SPIRE™ was invented as interspinous fixation device (ISD) to replace pedicle screw. This study is to evaluate the clinical and radiological outcomes in patients underwent unilateral PLIF using SPIRE™ compared with pedicle screw. MATERIAL AND METHODS: All consecutive patients who shows medically intractable lumbar degenerative disease with unilateral radiculopathy and mild instability were enrolled...
November 13, 2015: Turkish Neurosurgery
William R Walsh, Matthew H Pelletier, Nicky Bertollo, Chris Christou, Chris Tan
BACKGROUND: Polyetheretherketone (PEEK) has a wide range of clinical applications but does not directly bond to bone. Bulk incorporation of osteoconductive materials including hydroxyapatite (HA) into the PEEK matrix is a potential solution to address the formation of a fibrous tissue layer between PEEK and bone and has not been tested. QUESTIONS/PURPOSES: Using in vivo ovine animal models, we asked: (1) Does PEEK-HA improve cortical and cancellous bone ongrowth compared with PEEK? (2) Does PEEK-HA improve bone ongrowth and fusion outcome in a more challenging functional ovine cervical fusion model? METHODS: The in vivo responses of PEEK-HA Enhanced and PEEK-OPTIMA(®) Natural were evaluated for bone ongrowth in the form of dowels implanted in the cancellous and cortical bone of adult sheep and examined at 4 and 12 weeks as well as interbody cervical fusion at 6, 12, and 26 weeks...
November 2016: Clinical Orthopaedics and related Research
Fabio Papacci, Luigi Rigante, Eduardo Fernandez, Mario Meglio, Nicola Montano
Few papers have been published about the anterior cervical discectomy and fusion (ACDF) with implant of porous tantalum cages. These studies included patients submitted to operation at a single level. To our knowledge, we report the results of the largest series of ACDF with implant of porous tantalum cages. Our series included patients operated at a single or double level with a long follow-up (FU). We also discuss the pertinent literature. Clinical and outcome data of 99 consecutive patients (47 men, 52 women) submitted to ACDF with implant of porous tantalum cages (Trabecular Metal TM-S Cervical Fusion Device, Zimmer Spine, Minneapolis, MN) from June 2007 to September 2012, were retrospectively reviewed...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jae-Young Park, Ki-Young Choi, Bong Ju Moon, Hyuk Hur, Jae-Won Jang, Jung-Kil Lee
To investigate the risk factors for subsidence in patients treated with stand-alone anterior cervical discectomy and fusion (ACDF) using polyetheretherketone (PEEK) cages for single-level degenerative cervical disease. Seventy-seven consecutive patients who underwent single-level stand-alone ACDF with a PEEK cage between 2005 and 2012 were included. Subsidence was defined as a decrease in the interbody height of more than 3mm on radiographs at the 1-year follow-up compared with that in the immediate post-operative image...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Warren F Neely, Frank Fichtel, Diana Cardenas Del Monaco, Jon E Block
BACKGROUND: Many first generation stand-alone fusion cages required endplate decortication and surgical impaction during the procedure resulting in segmental subsidence, implant migration and loss of lordosis postoperatively. The primary objective of this study was to evaluate radiographically, in a large series of patients, whether engineering and design modifications incorporated in a specific stand-alone, expandable interbody fusion device (VariLift(®)-L) adequately addressed previously recognized deficiencies of stand-alone interbody cages...
2016: International Journal of Spine Surgery
Jörg Franke, Neil Manson, David Buzek, Arkadiusz Kosmala, Ulrich Hubbe, Wout Rosenberg, Paulo Pereira, Roberto Assietti, Frederic Martens, Khai Lam, Giovanni Barbanti Brodano, Peter Durny, Zvi Lidar, Kai Scheufler, Wolfgang Senker
UNLABELLED: The objective of the study is to assess effectiveness and safety of minimally invasive lumbar interbody fusion (MILIF) for degenerative lumbar disorders (DLD) in daily surgical practice and follow up with patients for one year after surgery. A prospective, multicenter, pragmatic, monitored, international outcome study in patients with DLD causing back/leg pain was conducted (19 centers). Two hundred fifty-two patients received standard of care available in the centers. Patients were included if they were aged >18 years, required one- or two-level lumbar fusion for DLD, and met the criteria for approved device indications...
June 13, 2016: Curēus
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
Marco T Reis, Phillip M Reyes, Bse, Idris Altun, Anna G U S Newcomb, Vaneet Singh, Steve W Chang, Brian P Kelly, Neil R Crawford
OBJECTIVE Lateral lumbar interbody fusion (LLIF) has emerged as a popular method for lumbar fusion. In this study the authors aimed to quantify the biomechanical stability of an interbody implant inserted using the LLIF approach with and without various supplemental fixation methods, including an interspinous plate (IP). METHODS Seven human cadaveric L2-5 specimens were tested intact and in 6 instrumented conditions. The interbody implant was intended to be used with supplemental fixation. In this study, however, the interbody was also tested without supplemental fixation for a relative comparison of these conditions...
December 2016: Journal of Neurosurgery. Spine
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
Kevin Phan, Monish Maharaj, Yusuf Assem, Ralph J Mobbs
Lumbar interbody fusion represents an effective surgical intervention for patients with lumbar degenerative diseases, spondylolisthesis, disc herniation, pseudoarthrosis and spinal deformities. Traditionally, conventional open anterior lumbar interbody fusion and posterior/transforaminal lumbar interbody fusion techniques have been employed with excellent results, but each with their own advantages and caveats. Most recently, the antero-oblique trajectory has been introduced, providing yet another corridor to access the lumbar spine...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Gurpreet S Gandhoke, Manish K Kasliwal, Justin S Smith, JoAnne Nieto, David Ibrahimi, Paul Park, Frank Lamarca, Christopher Shaffrey, David O Okonkwo, Adam S Kanter
OBJECTIVE: A retrospective review of the clinical and radiographic outcomes from a multi-center study of surgical treatment for high-grade spondylolisthesis (HGS) in adults. The objective was to assess the safety of surgical reduction, its ability to correct regional deformity, and its clinical effectiveness. METHODS: Retrospective, multi-center review of adults (age >18 y) with lumbo-sacral HGS (Meyerding grade 3-5) treated surgically with open decompression, attempted reduction, posterior instrumentation and interbody fusion...
June 20, 2016: Clinical Spine Surgery
Jeremy P Morgan, Ashley L Miller, Paul A Thompson, Wilson T Asfora
BACKGROUND: Low back pain and degeneration of the intervertebral disc are an integrated malady that affects millions of Americans. Cage devices used in association with posterior lumbar interbody fusion (PLIF) have been shown to be an effective approach in the treatment of a number of lower spine disorders attributed to degenerative disc disease (DDD). OBJECTIVE: This study was undertaken as part of a U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE) study and compares the effectiveness of the Asfora Bullet Cage System (ABCS) to successfully fuse vertebra at one or two levels between L2 and S1 in patients with DDD to an FDA approved comparison device, the Medtronic-Sofamor Danek Inter Fix Threaded Fusion Device (MSDIFD)...
April 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Byung Jo Victor Yoon, Fred Xavier, Brendon R Walker, Samuel Grinberg, Frank P Cammisa, Celeste Abjornson
BACKGROUND: Titanium plasma spray coating on polyetheretherketone (PEEK) is a recent innovation to interbody spacer technology. The inherent hydrophobic properties of standard, uncoated PEEK implants can hamper cell attachment and bone healing during fusion. The addition of Ti coating not only offers initial stability due to increased surface roughness, but long term stability due to bony ongrowth created from osteoconductive microenvironment on the device surface. The previously established hydrophilic and osteophilic properties of commercially pure titanium (CPTi) can potentially provide an ideal environment promoting cell attachment and bony ingrowth when applied at the endplate level of the fusion site...
May 27, 2016: Spine Journal: Official Journal of the North American Spine Society
Christopher C Gillis, Megan C Kaszuba, Vincent C Traynelis
OBJECTIVE Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spine procedures. It can be used to correct cervical kyphotic deformity, which is the most common cervical deformity, and is often performed using lordotic interbody devices. Worsening of the cervical sagittal parameters is associated with decreased health-related quality of life. The study hypothesis is that through the use of machined lordotic allografts in ACDF, segmental and overall cervical lordosis can be maintained or increased, which will have a positive impact on overall cervical sagittal alignment...
May 6, 2016: Journal of Neurosurgery. Spine
Richard D Guyer, Jean-Jacques Abitbol, Donna D Ohnmeiss, Chang Yao
STUDY DESIGN: This was a biomechanical push-out testing study using a porcine model. OBJECTIVE: The purpose was to evaluate the strength of implant-bone interface of a porous titanium scaffold by comparing it to polyetheretherketone (PEEK) and allograft. SUMMARY OF BACKGROUND DATA: Osseointegration is important for achieving maximal stability of spinal fusion implants and it is desirable to achieve as quickly as possible. Common PEEK interbody fusion implants appear to have limited osseointegration potential because of the formation of fibrous tissue along the implant-bone interface...
October 1, 2016: Spine
Louis Chenin, Johann Peltier, Michel Lefranc
BACKGROUND: Circumferential arthrodesis is commonly used to treat degenerative lumbar diseases. Minimally invasive techniques may enable faster recovery and reduce the incidence of postoperative infections. METHODS: We report on the surgical technique of a transforaminal lumbar interbody fusion (TLIF) procedure performed with the assistance of a new robotic device (ROSA(TM) Spine) and intraoperative flat-panel CT guidance. CONCLUSIONS: The combined use of this new robotic device and intraoperative CT enables accurate and safe arthrodesis in the treatment of degenerative lumbar disc diseases...
June 2016: Acta Neurochirurgica
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