Comparing expandable and static interbody cages in lumbar interbody fusion

Elgafy, Hossein; Behrens, Kyle M

doi:10.21037/jss-23-5

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Bone fragments can be removed from the canal with direct visualization, potentially providing a better neurological outcome. This technique maintains the integrity of the posterior column and allows for continuous correction of angular deformities [ 11 ]. However, in our study, 14 thoracal and lumbar cases were approached posteriorly, because the anterior approach has many potentially morbid complications like chylothorax, pulmonary problems, and chest pain.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A Retrospective Study of 16 Patients Using Expandable Cages

Demir,

Demirel

2024

Med Sci Monit

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Background Reconstruction surgery using titanium vertebral body replacements aids in spinal stability after damage. Functional evaluation includes Nurick and ASIA grading systems. This study compares outcomes of single and double-level corpectomy in patients treated with thoracolumbar reconstruction. Material/Methods Records of 16 patients who underwent vertebral reconstruction with expandable cages after single (n=9) and double (n=8) corpectomy were analyzed retrospectively. Thoracal and lumbar cases were approached posteriorly (n=14). Clinical evaluation was performed by neurological examination, Nurick Scale, American Spinal Injury Association (ASIA) Neurological Scores, and Visual Analog Scale (VAS). Preoperative and postoperative 3-month scores were recorded. Radiological evaluation was performed by calculation of regional angulation and postoperative recovery of vertebral body height. Results Preoperatively, 2 patients had no motor or functional sensory deficits (ASIA grade E) and 6 patients were ASIA grade D. Immediately after surgery, 4 of the ASIA grade D patients improved to ASIA grade E, while 2 patients remained ASIA grade D during follow-up. Four patients were ASIA grade A; their conditions showed no improvement postoperatively. Preoperative and postoperative 3-month Nurick grade was statistically significant ( P =0.022). Postoperative Cobb angle improved by a mean of 5.4° ( P =0.001). Improvement by at least 1 grade in neurological recovery was observed in 6 (38%) of the cases. Pain scores analyzed using the VAS changed from a mean of 7 to a mean of 2.63 ( P <0.001). Conclusions In our experience, expandable cages are useful in the restoration of different pathologies of the thoracolumbar trunk with low complication and revision rates. With expandable cages it is possible to achieve restoration of the Cobb angle, improvement in Nurick Grade and effective pain palliation.

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Section: Discussionmentioning

confidence: 99%

Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A Retrospective Study of 16 Patients Using Expandable Cages

Demir,

Demirel

2024

Med Sci Monit

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“…While posterior approaches offer the advantage of nerve decompression and instrumentation along with cage insertion, accessing the disc space can be challenging due to neural and bony structures, which limits the use of large cages. Inserting a small cage into the disc space and then expanding it to occupy a larger area within the disc space allows for more stable anterior support and ample bone graft material, which theoretically leads to increased fusion rates and reduced subsidence risk [35,[49][50][51][52].…”

Section: Advantages Of Expandable Cagesmentioning

confidence: 99%

Expandable Cages for Lumbar Interbody Fusion: A Narrative Review

Lee,

Yoon,

Park

et al. 2024

JCM

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Lumbar fusion surgery for treating degenerative spinal diseases has undergone significant advancements in recent years. In addition to posterior instrumentation, anterior interbody fusion techniques have been developed along with various cages for interbody fusion. Recently, expandable cages capable of altering height, lordotic angle, and footprint within the disc space have garnered significant attention. In this manuscript, we review the current status, clinical outcomes, and future prospects of expandable cages for lumbar interbody fusion based on the existing literature. Expandable cages are suitable for minimally invasive spinal surgeries. Small-sized cages can be inserted and subsequently expanded to a larger size within the disc space. While expandable cages generally demonstrate superior clinical outcomes compared to static cages, some studies have suggested comparable or even poorer outcomes with expandable cages than static cages. Careful interpretation through additional long-term follow-ups is required to assess the utility of expandable cages. If these shortcomings are addressed and the advantages are further developed, expandable cages could become suitable surgical instruments for minimally invasive spinal surgeries.

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A review of computational optimization of bone scaffold architecture: methods, challenges, and perspectives

Foroughi,

Valeri,

Razavi

2024

Prog. Biomed. Eng.

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The design and optimization of bone scaffolds are critical for the success of bone tissue engineering (BTE) applications. This review paper provides a comprehensive analysis of computational optimization methods for bone scaffold architecture, focusing on the balance between mechanical stability, biological compatibility, and manufacturability. Finite Element Method (FEM), Computational Fluid Dynamics (CFD), and various optimization algorithms have been discussed for their roles in simulating and refining scaffold designs. The integration of multiobjective optimization and topology optimization has been highlighted for developing scaffolds that meet the multifaceted requirements of BTE. Challenges such as the need for consideration of manufacturing constraints, and the incorporation of degradation and bone regeneration models into the optimization process have been identified. The review underscores the potential of advanced computational tools and additive manufacturing techniques in evolving the field of BTE, aiming to improve patient outcomes in bone tissue regeneration. The reliability of current optimization methods is examined, with suggestions for incorporating non-deterministic approaches and in vivo validations to enhance the practical application of optimized scaffolds. The review concludes with a call for further research into artificial intelligence-based methodologies to drive the next generation of scaffold design and optimization.

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Comparing expandable and static interbody cages in lumbar interbody fusion

Cited by 3 publications

References 19 publications

Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A Retrospective Study of 16 Patients Using Expandable Cages

Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A Retrospective Study of 16 Patients Using Expandable Cages

Expandable Cages for Lumbar Interbody Fusion: A Narrative Review

A review of computational optimization of bone scaffold architecture: methods, challenges, and perspectives

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