Carbon Fiber Implant to Aid Interbody Lumbar Fusion: 1-year Clinical Results in the First 26 Patients

Brantigan, John W.; Steffee, Arthur D.

doi:10.1007/978-4-431-68234-9_41

Cited by 257 publications

(275 citation statements)

References 17 publications

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“…Fusion was evaluated according to modified BrantiganSteffee classification [19]; these criteria include the denser and more mature bone in fusion area than originally achieved during surgery, no interspace between the cage and the vertebral body, and mature bony trabeculae bridging in fusion area. If one of the three criteria was not met, we classified the patient as being in a non-fusion state.…”

Section: Thoracoscopic Corpectomymentioning

confidence: 99%

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

et al. 2013

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Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58°, improved to 9.2°postoperatively and to 13.8°at the final follow-up. No cases of implant failure were reported at the final follow-up.Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities in managing burst thoracic and thoracolumbar fractures.

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Section: Thoracoscopic Corpectomymentioning

confidence: 99%

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

et al. 2013

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“…A pain drawing was used for them to show the site of pain. They were asked to describe the characteristics of the pain, which was scored as: numbness (4), pin prick (3), burning (2), and/or stabbing (1).…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…PLIF offers several advantages [1,10,16,50,52]. It restores disc height, the load bearing ability of anterior ligaments and muscles, root canal dimensions, and spinal balance.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

Madan

Boeree

2003

European Spine Journal

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“…Harvest of bi-cortical or tri-cortical bone graft can moreover cause up to 30% donor site complications [13,41,52], with donor site pain often persisting for more than 1 year [13]. The need for rigid axial mechanical support has led to the development of interbody implants or the so-called 'cages' [2,6,39,48]. The cage is expected to provide mechanical support and improve the three-dimensional initial stability, so cancellous grafting material housed within and around the cage can successfully incorporate to a biologic fusion.…”

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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Carbon Fiber Implant to Aid Interbody Lumbar Fusion: 1-year Clinical Results in the First 26 Patients

Cited by 257 publications

References 17 publications

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

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

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