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Anterior Lumbar Intervertebral Fusion

Weerasak Singhatanadgige, Daniel G Kang, Dol Wiranuwat, Chotetawan Tanavalee, Wicharn Yingsakmongkol, Worawat Limthongkul
PURPOSE: To assess the anatomic path of the middle sacral artery (MSA) at the presacral area and its relationship to the spinal midline during an axial lumbar interbody fusion (AxiaLif) approach. METHODS: Fifty human cadavers (25 males, 25 females) were used in this study. A transabdominal approach was used to expose the anterior aspect of the L5/S1 intervertebral disc and the presacral space. We measured the size and distance from the spinal midline at the following positions: (a) middle of the L5/S1 disc level, (b) 1 cm below the sacral promontory (SP), and (c) 2 cm below the SP...
January 2018: Journal of Orthopaedic Surgery
Kevin Phan, Alan Lackey, Nicholas Chang, Yam-Ting Ho, David Abi-Hanna, Jack Kerferd, Monish M Maharaj, Rhiannon M Parker, Gregory M Malham, Ralph J Mobbs
Background: Recurrent intervertebral disc herniation is a relatively common occurrence after primary discectomy for lumbar intervertebral disc herniation. For recurrent herniations after repeat discectomies, a growing body of evidence suggests that fusion is effective in appropriately selected cases. Theoretically, anterior lumbar interbody fusion (ALIF) allows for comprehensive discectomy, less trauma to spinal nerves and paraspinal muscles and avoidance of the disadvantages of repeat posterior approaches...
December 2017: Journal of Spine Surgery (Hong Kong)
Neel Anand, Ryan B Cohen, Jason Cohen, Babak Kahndehroo, Sheila Kahwaty, Eli Baron
BACKGROUND: CMIS techniques are heavily dependent on placement of lateral interbody cages. Cages with an increased lordotic angle are being advocated to improve segmental lordosis and SVA. We assessed the segmental lordosis achieved with the individual cages. We further studied three variables and the effect each had on segmental lordosis: the lordosis angle of the cage, the position of the cage in the intervertebral space, and the level that it has been placed. METHODS: This is a retrospective study of 66 consecutive patients who underwent lateral interbody fusion using lordotic cages as part of CMIS correction of scoliosis from June 2012 to January 2016...
2017: International Journal of Spine Surgery
Shuhei Murase, Yasushi Oshima, Yujiro Takeshita, Kota Miyoshi, Kazuhito Soma, Naohiro Kawamura, Junichi Kunogi, Takashi Yamazaki, Dai Ariyoshi, Shigeo Sano, Hirohiko Inanami, Katsushi Takeshita, Sakae Tanaka
OBJECTIVE Interbody fusion cages are widely used to achieve initial fixation and secure spinal fusion; however, there are certain technique-related complications. Although anterior cage dislodgement can cause major vascular injury, the incidence is extremely rare. Here, the authors performed a review of anterior cage dislodgement following posterior lumbar interbody fusion (PLIF) surgery. METHODS The authors retrospectively reviewed the cases of 4625 patients who had undergone PLIF at 6 institutions between December 2007 and March 2015...
July 2017: Journal of Neurosurgery. Spine
Harry Pinson, Giorgio Hallaert, Patrick Herregodts, Karel Everaert, Tim Couvreur, Jacques Caemaert, Jean-Pierre Kalala, Dirk Van Roost
OBJECTIVE: This study critically evaluates the long-term results of standalone anterior lumbar interbody fusion (ALIF), without use of rhBMP-2, as a therapeutic option for symptomatic patients with degenerative disc disease (DDD). Furthermore, this study intends to identify predictive parameters for anterior lumbar interbody fusion outcome. METHODS: A retrospective cohort study with additional telephone interview to obtain missing data was performed. All patients who underwent an L4-L5 or L5-S1 ALIF-procedure, or both, in the period between 2006 and 2011 were identified...
July 2017: World Neurosurgery
Kengo Fujii, Tetsuya Abe, Toru Funayama, Hiroshi Noguchi, Keita Nakayama, Kousei Miura, Katsuya Nagashima, Hiroshi Kumagai, Masashi Yamazaki
When ossification of the yellow ligament (OYL) occurs in the lumbar spine and extends to the lateral wall of the spinal canal, facetectomy is required to remove all of the ossified lesion and achieve decompression. Subsequent posterior fixation with interbody fusion will then be necessary to prevent postoperative progression of the ossification and intervertebral instability. The technique of lateral lumbar interbody fusion (LLIF) has recently been introduced. Using this procedure, surgeons can avoid excess blood loss from the extradural venous plexus and detachment of the ossified lesion and the ventral dura mater is avoidable...
2017: Case Reports in Orthopedics
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...
April 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
Bunyamin Calisir, Murat Ulutas, Suat Boyaci, Kaya Aksoy
AIM: Fusion development is the primary goal in spinal surgeries that are conducted for the treatment of vertebral body pathologies such as trauma, tumor and infection. Stabilization using metal plate screws together either with an autograft, allograft or xenograft is used. We evaluated fusion development in stabilizations that were carried out with xenograft (XG) with XG plate-screw (XPS) and XG with metal plate-screw (MPS) systems in dogs" lumbar vertebrae (L5-7 segment) in terms of radiological, biomechanical and histopathological aspects...
2017: 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
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