Anterior Lumbar Fusion Options Technique and Graft Materials

Kozák, J; Heilman, A E; O’Brien, John P.

doi:10.1097/00003086-199403000-00006

Cited by 138 publications

(69 citation statements)

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“…Monosegmental anterior lumbar interbody fusion (ALIF) using autologous bone grafts has a reported failure rate of 3-25% [5,7,19,20]. Monosegmental posterior interbody fusion (PLIF) using autologous grafts will fuse in 88-98% of cases [18].…”

Section: Introductionmentioning

confidence: 99%

Anterior lumbar interbody fusion with threaded fusion cages and autologous bone grafts

Pavlov¹,

Spruit²,

Havinga

et al. 2000

European Spine Journal

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Section: Introductionmentioning

confidence: 99%

Anterior lumbar interbody fusion with threaded fusion cages and autologous bone grafts

Pavlov¹,

Spruit²,

Havinga

et al. 2000

European Spine Journal

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“…dure easily permits direct and complete removal of disc tissue [14,18], while avoiding a trauma to the posterior para-spinal muscles. Operative time, blood loss and hospital stay can be reduced [14,18] compared to PLIF procedures.…”

mentioning

confidence: 99%

“…Operative time, blood loss and hospital stay can be reduced [14,18] compared to PLIF procedures. Moreover, an ALIF can be performed using minimally open [22,44] or laparoscopic surgical techniques [4,21,53], thus further reducing the operative trauma.…”

mentioning

confidence: 99%

Biomechanical stability of five stand-alone anterior lumbar interbody fusion constructs

Tsantrizos¹,

Andreou²,

Aebi³

et al. 2000

European Spine Journal

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IntroductionInterbody fusion is preferred over postero-lateral fusion because it warrants a stronger biomechanical construct [12] and higher fusion rate [11]. It favors load transmission via the anterior column, full restoration of disc height and lordosis, annular fiber tensioning and least demands of bone graft volume [12]. A successful interbody construct provides adequate axial support to resist graft subsidence or collapse and reduces the post-operative segmental mobility to permit graft incorporation [30]. As such, the axial compressive strength and relative three-dimensional stability of an interbody construct are biomechanical measures describing the likelihood of a successful bone fusion [5].Anterior lumbar interbody fusion (ALIF) and posterior lumbar interbody fusion (PLIF) are two accepted approaches of grafted interbody fusion, the latter often combined with pedicle instrumentation [11]. The ALIF proceAbstract Anterior lumbar interbody fusion (ALIF) cages are expected to reduce segmental mobility. Current ALIF cages have different designs, suggesting differences in initial stability. The objective of this study was to compare the effect of different stand-alone ALIF cage constructs and cage-related features on initial segmental stability. Human multisegmental specimens were tested intact and with an instrumented L3/4 disc level. Five different ALIF cages (I/F, BAK, TIS, SynCage, and ScrewCage) were tested non-destructively in axial rotation, flexion/extension and lateral bending. A cage 'pull-out' concluded testing. Changes in neutral zone (NZ) and range of motion (ROM) were analyzed. Cage-related measurements normalized to vertebral dimensions were used to predict NZ and ROM. No cage construct managed to reduce NZ. The BAK and TIS cages had the largest NZ increase in flexion/extension and lateral bending, respectively. Cages did reduce ROM in all loading directions. The TIS cage was the least effective in reducing the ROM in lateral bending. Cages with sharp teeth had higher 'pull-out' forces. Antero-posterior and mediolateral cage dimensions, cage height and wedge angle were found to influence initial stability. The performance of stand-alone ALIF cage constructs generally increased the NZ in any loading direction, suggesting potential directions of initial segmental instability that may lead to permanent deformity. Differences between cages in flexion/extension and lateral bending NZ are attributed to the severity of geometrical cage-endplate surface mismatch. Stand-alone cage constructs reduced ROM effectively, but the residual ROM present indicates the presence of micromotion at the cage-endplate interface.

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“…In the 1960s, common practice was to remove the endplates completely which led to inadequate stability and the shifting of the implants [29]. Later, the endplates were fully preserved and only the cartilaginous surface removed, however, bony fusion was not always achieved [29].…”

mentioning

confidence: 99%

“…Later, the endplates were fully preserved and only the cartilaginous surface removed, however, bony fusion was not always achieved [29]. Comparable biomechanical studies regarding the preservation or conversely the complete removal of the upper lower endplates in ALIF have not been published to date.…”

mentioning

confidence: 99%

Primary stability of anterior lumbar stabilization: interdependence of implant type and endplate retention or removal

et al. 2005

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Anterior Lumbar Fusion Options Technique and Graft Materials

Cited by 138 publications

References 0 publications

Anterior lumbar interbody fusion with threaded fusion cages and autologous bone grafts

Anterior lumbar interbody fusion with threaded fusion cages and autologous bone grafts

Biomechanical stability of five stand-alone anterior lumbar interbody fusion constructs

Primary stability of anterior lumbar stabilization: interdependence of implant type and endplate retention or removal

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