Can the use of a novel bone graft delivery system significantly increase the volume of bone graft material in a lumbar in situ cage, beyond volumes normally achieved via standard cage filling methodology? Results from a cadaveric pilot study.

Ozgur, Burak M.; Gillard, Douglas M.; Truong, Felisha; Wendel, Trevor G.

doi:10.1016/j.inat.2018.04.015

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…As the concept was demonstrated relatively recent, only a few studies have explored the possibility of transplanting greater bone graft volume using novel devices in LIF surgeries. An in-situ cage filling system was investigated using an in vitro lateral lumbar interbody fusion (LLIF) model, in which additional bone graft could be delivered after the pre-packed cage was inserted [ 28 ]. The delivery system significantly increased the cage volume with graft compared with the traditional cage filling methodology, however, it was difficult to predict the functionality of the novel system in a living human spine.…”

Section: Discussionmentioning

confidence: 99%

A novel surgical technique in transforaminal lumbar interbody fusion by the bone graft delivery device: evaluation of therapeutic effect in patients with minimally invasive spine surgery

et al. 2022

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Background Transforaminal Lumbar Interbody Fusion (TLIF) is commonly associated with higher complications and longer operative time. This study aims to evaluate the effectiveness, safety, and usability of a novel minimally invasive surgery (MIS) bone graft delivery device. Methods 73 consecutive patients with lumbar spondylosis, degenerative disc disease, spondylolisthesis, scoliosis or trauma were enrolled in this randomized controlled trial. Group 1 comprised 39 patients treated with the novel MIS bone graft delivery device. Group 2 consisted of 34 patients treated with the conventional system. The primary objective of the study was the assessment of the amount of bone graft delivery using the device. The secondary objectives were the effect of the device on operative time, pain relief, disability improvement, and bone fusion grade. Results Bone delivery amount was significantly higher in the MIS device group (6.7 ± 2.9 mL) compared to the conventional group (2.3 ± 0.5 mL), p < 0.001. Regarding the operation time, the MIS device group was associated significantly lower duration than the conventional group (p < 0.001). After a 3-month follow-up, 39.5% of the patients in the MIS device group and 3.5% of the patients in the conventional group were observed to achieve grade I fusion (complete fusion). There was a significant difference in fusion success rates (p < 0.01). Conclusion The novel MIS bone graft delivery device was associated with successful bone delivery. Our MIS device provides promising modality with less operative time and higher bone fusion rates than conventional modalities. Trial Registration This trial was retrospectively registered on ClinicalTrials.gov (Registration date: 11/19/2021; Registration number: NCT05190055).

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Section: Discussionmentioning

confidence: 99%

A novel surgical technique in transforaminal lumbar interbody fusion by the bone graft delivery device: evaluation of therapeutic effect in patients with minimally invasive spine surgery

et al. 2022

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“…For instance, when using bone graft or a substitute to fill the cage during the implantation process, the graft may scatter in the retroperitoneal space due to the impact of implantation. Additionally, when using demineralized bone matrix (DBM) to fill the cage, a significant amount of DBM may be scraped off due to insufficient entry height, leading to a decrease in the actual amount of bone graft that is successfully implanted into the intervertebral space and potentially reducing the chances of successful fusion [7]. The main contributing factor to these limitations arises from the current methodology employed in OLIF cage placement, which involves filling the cage with bone graft prior to implantation.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Spinal Fusion Cage Design to Improve Bone Substitute Filling on Varying Disc Heights: A 3D Printing Study

Shih,

Lee,

Chen

et al. 2023

Bioengineering

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The success of spinal fusion surgery relies on the precise placement of bone grafts and minimizing scatter. This study aims to optimize cage design and bone substitute filling methods to enhance surgical outcomes. A 3D printed lumbar spine model was utilized to implant 3D printed cages of different heights (8 mm, 10 mm, 12 mm, and 14 mm) filled with BICERA® Bone Graft Substitute mixed with saline. Two filling methods, SG cage (side hole for grafting group, a specially designed innovative cage with side hole, post-implantation filling) and FP cage (finger-packing group, pre-implantation finger packing, traditional cage), were compared based on the weight of the implanted bone substitute. The results showed a significantly higher amount of bone substitute implanted in the SG cage group compared to the FP cage group. The quantity of bone substitute filled in the SG cage group increased with the height of the cage. However, in the FP cage group, no significant difference was observed between the 12 mm and 14 mm subgroups. Utilizing oblique lumbar interbody fusion cages with side holes for bone substitute filling after implantation offers several advantages. It reduces scatter and increases the amount of implanted bone substitute. Additionally, it effectively addresses the challenge of insufficient fusion surface area caused by gaps between the cage and endplates. The use of cages with side holes facilitates greater bone substitute implantation, ultimately enhancing the success of fusion. This study provides valuable insights for future advancements in oblique lumbar interbody fusion cage design, highlighting the effectiveness of using cages with side holes for bone substitute filling after implantation.

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Can the use of a novel bone graft delivery system significantly increase the volume of bone graft material in a lumbar in situ cage, beyond volumes normally achieved via standard cage filling methodology? Results from a cadaveric pilot study.

Cited by 2 publications

References 21 publications

A novel surgical technique in transforaminal lumbar interbody fusion by the bone graft delivery device: evaluation of therapeutic effect in patients with minimally invasive spine surgery

A novel surgical technique in transforaminal lumbar interbody fusion by the bone graft delivery device: evaluation of therapeutic effect in patients with minimally invasive spine surgery

Optimizing Spinal Fusion Cage Design to Improve Bone Substitute Filling on Varying Disc Heights: A 3D Printing Study

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