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Anterior Lumbar Intervertebral Fusion

William F Lavelle, Nathaniel R Ordway, Ali Araghi, Rudolph A Buckley, Amir H Fayyazi
OBJECTIVE This purpose of this study was to objectively evaluate and assess the efficacy and efficiency of discectomy and endplate preparation during transforaminal lumbar interbody fusion (TLIF) using traditional manual instrumentation versus a novel suction discectomy curette. Transforaminal lumbar interbody fusion is the most widely used approach for lumbar arthrodesis, and its success depends on the ability to achieve fusion. Complete preparation of intervertebral disc space (removal of the nucleus, endplate cartilage, and margin of inner annulus) is the surgical goal...
January 27, 2017: Journal of Neurosurgery. Spine
Richard Bostelmann, Hans Jakob Steiger, Armin O Scholz
BACKGROUND: Spontaneous infectious spondylodiscitis is a rare, but serious disease with the risk of progressive neurological impairment. The surgical approach to spontaneous infectious spondylodiscitis is in most cases an anterior debridement and fusion, often in staged surgeries. Here we report a case of single-stage posterior debridement and posterior instrumented fusion in combination with an injectable calcium sulfate/hydroxyapatite composite eluting gentamicin. CASE PRESENTATION: A 59-year-old Caucasian man presented with a 6-week history of lumbar pain without sensory or motor disorders of his lower extremities...
December 12, 2016: Journal of Medical Case Reports
Qiyou Wang, Yichun Xu, Ruiqiang Chen, Jianwen Dong, Bin Liu, Limin Rong
RATIONALE: To describe a novel indication for a method through minimally invasive extreme lateral interbody fusion (XLIF) in combination with percutaneous pedicle screwsfixation in the treatment of lumbar tuberculosis (TB) in an elderly patient, and its clinical efficacy and feasibility. Lumbar TB is a destructive form of TB. Antituberculous treatment should be started as early as possible. In some circumstances, however, surgical debridement with or without stabilization of the spine appears to be beneficial and may be recommended...
November 2016: Medicine (Baltimore)
Qing Yue, Tyson Hale, Aaron Knecht, Jennifer Laidacker
BACKGROUND: Footdrop secondary to L5 root injury is a rare complication associated with lumbar surgery. It is unclear whether intraoperative neuromonitoring can detect such an injury. CASE DESCRIPTION: A 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During surgery, the patient lost transcranial electrical motor evoked potentials (tceMEPs) from the left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement...
January 2017: World Neurosurgery
Sebastien Pesenti, Benjamin Blondel, Alice Faure, Emilie Peltier, Franck Launay, Jean-Luc Jouve
Paediatric Chance fracture are rare lesions but often associated with abdominal injuries. We herein present the case of a seven years old patient who sustained an entrapment of small bowel and an ureteropelvic disruption associated with a Chance fracture and spine dislocation following a traffic accident. Initial X-rays and computed tomographic (CT) scan showed a Chance fracture with dislocation of L3 vertebra, with an incarceration of a small bowel loop in the spinal canal and a complete section of the left lumbar ureter...
September 16, 2016: World Journal of Clinical Cases
Calisir Bunyamin, Ulutas Murat, Boyaci Suat, Aksoy Kaya
AIM: Fusion development is the primary objective in spinal surgeries that are conducted for the treatment of vertebra corpus related pathologies such as trauma, tumor and infection. Stabilization using metal plate screws together either with autograft, allograft or xenografts methods are used. Fusion development in stabilizations that are carried out with xenograft (XG) with XG plate-screw (XPS) and XG with metal plate-screw (MPS) systems in dogs' lumbar vertebra (L5-7 segment) was examined in terms of radiology, biomechanics and histopathologic aspects...
June 24, 2016: Turkish Neurosurgery
Gregory D Schroeder, Dessislava Z Markova, John D Koerner, Jeffery A Rihn, Alan S Hilibrand, Alexander R Vaccaro, D Greg Anderson, Christopher K Kepler
BACKGROUND CONTEXT: Degenerative changes including Modic changes (MCs) are commonly observed in patients with chronic low back pain. Although intervertebral disc (IVD) cytokine expression has been shown to be associated with low back pain, the cytokine profile for degenerative IVD with and without MC has not been compared. PURPOSE: This study aimed to evaluate the potential association between IVD cytokine expression and MCs. STUDY DESIGN: A laboratory study was carried out...
January 2017: Spine Journal: Official Journal of the North American Spine Society
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
Sumihisa Orita, Kazuhide Inage, Takeshi Sainoh, Kazuki Fujimoto, Jun Sato, Yasuhiro Shiga, Hirohito Kanamoto, Koki Abe, Kazuyo Yamauchi, Yasuchika Aoki, Junichi Nakamura, Yusuke Matsuura, Takane Suzuki, Go Kubota, Yawara Eguchi, Atsushi Terakado, Kazuhisa Takahashi, Seiji Ohtori
STUDY DESIGN: A retrospective radiological study on vascular anatomy. OBJECTIVE: The aim of this study was to evaluate the anatomical and radiological features of lumbar segmental arteries with respect to the surgical field of the oblique lateral interbody fusion (OLIF) approach by using magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA: OLIF surgery restores disc height and enables indirect decompression of narrowed spinal canals through an oblique lateral approach to the spine, by using a specially designed retractor...
February 2017: Spine
Patrick Strube, Berit M Pfitzner, Florian Streitparth, Tony Hartwig, Michael Putzier
OBJECTIVES: The aim of the present study was to histologically compare chondrotoxicity in surgically harvested intervertebral discs (IVDs) of patients following discoblock, discography, or no preoperative intervention. METHODS: Thirty patients (IVD degeneration Modic ≥ 2°, Pfirrmann 3° or 4°) at L4/5 or L5/S1 who were planned for anterior lumbar interbody fusion were randomly assigned to three groups (open MRI: group DG - discography with gadobutrol; group DB - discoblock with bupivacaine at 4 weeks prior to surgery; group C - no intervention)...
January 2017: European Radiology
Sean Molloy, Joseph S Butler, Adam Benton, Karan Malhotra, Susanne Selvadurai, Obiekezie Agu
BACKGROUND CONTEXT: A variety of surgical approaches have been used for cage insertion in lumbar interbody fusion surgery. The direct anterior approach requires mobilization of the great vessels to access the intervertebral disc spaces cranial to L5/S1. With the lateral retroperitoneal transpsoas approach, it is difficult to access the L4/L5 intervertebral disc space due to the lumbar plexus and iliac crest, and L5/S1 is inaccessible. We describe a new anterolateral retroperitoneal approach, which is safe and reproducible to access the disc spaces from L1 to S1 inclusive, obviating the need for a separate direct anterior approach to access L5/S1...
June 2016: Spine Journal: Official Journal of the North American Spine Society
Nicholas B Abt, Rafael De la Garza-Ramos, Israel O Olorundare, Brandon A McCutcheon, Ali Bydon, Jeremy Fogelson, Ahmad Nassr, Mohamad Bydon
OBJECTIVE: Anterior lumbar interbody fusion (ALIF) is a common procedure used to treat various lumbar degenerative pathologies. The purpose of this study is to describe 30-day postoperative outcomes following ALIF on a national scale. METHODS: The American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) was searched for ALIF patients between 2005 and 2011. The top preoperative diagnoses were determined using ICD-9 codes. All available 30-day complications were grouped as overall composite morbidity and were compared between preoperative diagnosis groups by univariable and multivariable analyses...
April 2016: Clinical Neurology and Neurosurgery
Yung-Heng Lee, Chi-Jen Chung, Chih-Wei Wang, Yao-Te Peng, Chih-Han Chang, Chih-Hsien Chen, Yen-Nien Chen, Chun-Ting Li
This study investigated the biomechanical response of porous cages and lumbar spine segments immediately after surgery and after bone fusion, in addition to the long-term effects of various posterior lumbar interbody fusion (PLIF) techniques, by using the finite element method. Lumbar L3-L4 models based on three PLIF techniques (a single cage at the center of the intervertebral space, a single cage half-anterior to the intervertebral space, and two cages bilateral to the intervertebral space) with and without bone ingrowth were used to determine the biomechanical response of porous cages and lumbar segments instrumented with porous titanium cages (cage porosity=50%, pore diameter=1mm)...
April 1, 2016: Computers in Biology and Medicine
Julien Rigal, Thomas Thelen, Fergus Byrne, Arnaud Cogniet, Louis Boissière, Stephane Aunoble, Jean-Charles Le Huec
INTRODUCTION: The modern literature is producing a rapidly growing number of articles which highlight the relationship between infection and lumbar disc degeneration. However, the means by which samples are collected is questionable. Posterior approach surgery is not free from skin contamination. The possibility of intraoperative contamination of disc biopsies cannot be excluded. OBJECTIVE: The objective of this study was to determine if an association existed between lumbar disc degeneration and chronic infection of the intervertebral disc...
April 2016: European Spine Journal
Hiroshi Taneichi
Update on pathologies of adult spinal deformity (ASD): With advancement of aging society, ASD has become one of the most notable topics of spinal disorders owing to its significant impact on health related quality of life. Treatment for ASD is challenging due to complex nature of deformity and high prevalence of comorbidities. Spino-pelvic harmony that is evaluated by pelvic incidence (PI) minus lumbar lordosis (LL) is the most important concept, which allows us to understand pathology of ASD more deeply. Proposed optimum "PI minus LL" is within ±10°...
March 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Abhijit Pawar, Alexander Hughes, Federico Girardi, Andrew Sama, Darren Lebl, Frank Cammisa
The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular...
December 2015: Asian Spine Journal
Naiguo Wang, Dachuan Wang, Feng Wang, Bingyi Tan, Zenong Yuan
The objective of this study was to investigate short segment decompression of degenerative lumbar scoliosis (DLS) and the efficiency of fusion treatment.After DLS surgery, the patients were retrospectively reviewed using the VAS (visual analog scale) and ODI (Oswestry Disability Index) to assess clinical outcomes. All patients underwent posterior lumbar decompressive laminectomy, pedicle screw internal fixation, and posterolateral bone graft fusion surgery. Radiographic measurements included the scoliotic Cobb angle, the fused Cobb angle, the anterior intervertebral angle (AIA), the sagittal intervertebral angle (SIA), and lumbar lordosis angle...
November 2015: Medicine (Baltimore)
Mustafa Alkadhim, Carmine Zoccali, Salman Abbasifard, Mauricio J Avila, Apar S Patel, Kamran Sattarov, Christina M Walter, Ali A Baaj
PURPOSE: The minimally invasive (MI) lateral lumbar interbody fusion (LLIF) approach has become increasingly popular for the treatment of degenerative lumbar spine disease. The neural anatomy of the lumbar plexus has been studied; however, the pertinent surgical vascular anatomy has not been examined in detail. The goal of this study is to examine the vascular structures that are relevant in relation to the MI-LLIF approach. METHODS: Anatomic dissection of the lumbar spines and associated vasculature was performed in three embalmed, adult cadavers...
November 2015: European Spine Journal
O Linhardt, J Grifka, A Benditz
BACKGROUND: The aim of this study was to report surgical results with open TLIF (transforaminal lumbar intervertebral fusion) of segment L V/S I, in comparison with TLIF of segment L IV/V. PATIENTS AND METHODS: 60 patients with degenerative spine disease were operated with TLIF spondylodesis and followed up in a clinical and radiological study. 30 patients were operated in segment L IV/V (group 1) and another 30 in segment L V/S I (group 2). These patients were followed up 2 weeks and 12 months after surgery, by means of a clinical examination and questionnaires on pain (visual analogue scale) and quality of life (Oswestry score)...
October 2015: Zeitschrift Für Orthopädie und Unfallchirurgie
Dimitri Verbruggen, Thomas Tampere, Dirk Uyttendaele, Gwen Sys, Bart Poffyn
PURPOSE: To evaluate the long-term clinical results and the effectiveness of the anterior lumbar interbody fusion procedure. METHODS: Between 1999 and 2005, 60 ALIFs were performed in 59 patients. Mean age was 41.1 years. Clinically, patients were evaluated at a mean follow-up of 9.5 years using the Visual Analogue Scale grading scale, the Oswestry Disability score and the SF-36 questionnaire. RESULTS: Preoperative and postoperative clinical evaluation scores of 38 patients were available...
September 2015: Acta Orthopaedica Belgica
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