Fusion rate and influence of surgery-related factors in lumbar interbody arthrodesis for degenerative spine diseases: a meta-analysis and systematic review

Formica, Matteo; Vallerga, Davide; Zanirato, Andrea; Cavagnaro, Luca; Basso, Marco; Divano, Stefano; Mosconi, Lorenzo; Quarto, Emanuele; Siri, Giacomo; Felli, Lamberto

doi:10.1007/s12306-019-00634-x

Cited by 46 publications

(40 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With the aging population, degenerative spinal disease (DSD) has become an important pathological cause of immobility and incapacitation in elder adults. Globally, the incidence of DSD exceeds 43.1%, of which 35.3% have severe dysfunction [1][2][3][4]. The incidence of DSD in low-and middle-income classes is 4 times higher than that of the high-income class.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the clinical efficacy of two fixation methods combined with OLIF in the treatment of lumbar spondylolisthesis

Zhang¹,

Guo²,

Li³

2021

Preprint

View full text Add to dashboard Cite

Background To observe the clinical efficacy of an anterior single rob-screw fixation (ASRSF) combined with the oblique lumbar intervertebral fusion (OLIF) approach compared with a posterior percutaneous screw fixation(PPSF) combined with OLIF in the treatment of lumbar spondylolisthesis. Methods This is a retrospective case-control study. Patients with lumbar spondylolisthesis treated with either ASRSF combined with OLIF or PPSF combined with OLIF from January 2016 to January 2018 were enrolled in this study. None of the patients had posterior decompression. The visual analog scale (VAS) and Oswestry dysfunction index (ODI) were used for clinical efficacy assessment. The pre- and post-operational disc height, height of foramen, subsidence and migration of cages, fusion rate, and surgery-related complications were compared between the two groups. Results Fifty-three patients were included in this single-center study. According to the fixation methods, patients were divided into the ASRSF group (group A, 25 cases) and the PPSF group (group B, 28 cases). There was no statistical difference in surgery-related complications between groups. There was a significant difference in the VAS score at 1 week post-surgery(2.3 ± 0.5Vs3.5 ± 0.4, P = 0.01), and 3 months post-operation (2.2 ± 0.3VS 3.0 ± 0.3, P = 0.01). Comparison of post-operative imaging data showed that there was a significant difference in the height of the foramen between groups at 3 months post-surgery(18.1 ± 2.3 mm Vs 16.9 ± 1.9 mm, P = 0.04). At 24 months post-surgery, the ODI was 12.65 ± 3.6 in group A and 19.1 ± 3.4 in group B (P = 0.01). Twelve months after surgery, the fusion rate in group A was 72.0% and78.6% in group B (not statistically significant, P = 0.75). Fusions were identified in all patients at 24 months post-surgery. Conclusion Compared to PPSF, ASRSF combined with OLIF for lumbar spondylolisthesis can reduce post-operative low back pain in the early stages, maintain the height of the foramen superiorly, and improve the performance of lumbar function.

show abstract

Section: Introductionmentioning

confidence: 99%

“…The incidence of DSD in low-and middle-income classes is 4 times higher than that of the high-income class. DSD has increasingly become a social issue that seriously affects the quality of life of many people [2,3,5]. Among DSD patients, the incidence of lumbar spondylolisthesis is more than 12.5% [2,3].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical efficacy of two fixation methods combined with OLIF in the treatment of lumbar spondylolisthesis

Zhang¹,

Guo²,

Li³

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…However, spinal fusion alone cannot provide su cient strength and stability for the surgical segment, which may lead to spinal instability or even surgical failure [6,10]. Therefore, a supplemental posterior pedicle screw xation system was introduced to improve the biomechanical stability of the spine and surgical success rates [11,12]. Currently, titanium alloy (Ti) is the preferred material for pedicle-based screw xation systems because of its excellent strength, fatigue resistance, and biocompatibility [13,14].…”

Section: Introductionmentioning

confidence: 99%

“…Currently, titanium alloy (Ti) is the preferred material for pedicle-based screw xation systems because of its excellent strength, fatigue resistance, and biocompatibility [13,14]. The superior construct stiffness of the Ti xation system ensures spine stability and promotes solid fusion [11,15,16]. However, as a stress shielding effect and abnormal motion are caused by excessive rigidity of the xation system, it is di cult to avoid adjacent segment disease (ASD) and instrumentation failure [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Effects of Polyetheretherketone and Titanium Rods in Transforaminal Lumbar Interbody Fusion: A Finite Element Analysis

Li¹,

Cao²,

Wang³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Currently, the comprehensive biomechanical evaluation of polyetheretherketone (PEEK) rods in transforaminal lumbar interbody fusion (TLIF) is limited. The purpose of this study was to compare the biomechanical differences between titanium alloy (Ti) rods and PEEK rods in TLIF. Methods: L3-5 lumbar models were developed using the finite element method. Four surgical models of TLIF were constructed by simulating different fusion methods and rods: cage fusion with Ti rods, cage fusion with PEEK rods, bone graft alone with Ti rods, and bone graft alone with PEEK rods. The range of motion (ROM) and stress distribution of the surgical and adjacent segments were then compared. Results: Compared to the Ti rods, the PEEK rods increased the ROM by 0.7–20% at the L4/5 segment and decreased the ROM by 0.8–15.1% at the L3/4 segment. The disc stresses at the L3/4 level were similar among the surgical models (0.79–1.80 MPa). The peak stresses of the screws, rods, and bone-screw interfaces in the PEEK rod models were 0–1.2 times, 1.6–4.4 times, and 0–1.4 times lower than those of the Ti rod models, respectively. PEEK rods increased the average strain of the bone graft by 0.5–61.6% and the stresses of the cage by 0.9–44.1% and endplates by 2.1–52.9%. Conclusion: In TLIF, PEEK rods played a positive role in restoring the ROM. They also increased the strain of the bone graft, stresses of the endplates and cages, and the risk of rod fracture and reduced the stress of the screw-rod system. Bone grafts alone combined with PEEK rods had acceptable biomechanical behavior in TLIF.

show abstract

“…Due to the high primary stability and fusion rates of over 90%, the use of interbody implants (cages) is a standard procedure in addition to posterior stabilization [4]. The additive stabilization offers high primary stability in the segment.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Model for Testing Cage Subsidence in the Osteoporotic Spine Under Permanent Maximum Load

Schleifenbaum¹,

Heilmann²,

Riemer³

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundFusions in cases of reduced bone density are a tough challenge. As not only does bone quality have an influence on force transmission, these forces must be bridged for much longer time, as a fusion takes longer than in bone-healthy patients. However, cage subsidence or displacement results to loss of reposition and pain. From a biomechanical point of view, the majority of current studies have focussed on the range of motion or have shown test setups for single component tests. Definite setups for biomechanical testing of the primary stability of a 360° fusion using a screw rod system and cage on the osteoporotic spine are missing. The aim of this study is to develop a test stand to provide information about the bone-implant interface under reproducible conditions.MethodsAfter pre-testing with artificial bone, human functional spine units were tested with 360° fusion in TLIF technique. The movement sequences was conducted in flexion, extension, right-left lateral bending and right-left axial rotation on an osteoporotic human model.ResultsDuring the testings of human cadavers, 4 vertebrae were fully tested and were inconspicuous even after radiological and macroscopic examination. 1 vertebra showed a subsidence of 2mm and 1 vertebra had a cage collapsed into the vertebra.ConclusionsThis setup is suitable for biomechanical testing of cyclical continuous loads on the osteoporotic spine. The embedding method is stable and ensures a purely monosegmental setup. The optical monitoring provides a very accurate indication of cage movement, which correlates with the macroscopic and radiological results.

show abstract

Fusion rate and influence of surgery-related factors in lumbar interbody arthrodesis for degenerative spine diseases: a meta-analysis and systematic review

Cited by 46 publications

References 85 publications

Comparison of the clinical efficacy of two fixation methods combined with OLIF in the treatment of lumbar spondylolisthesis

Comparison of the clinical efficacy of two fixation methods combined with OLIF in the treatment of lumbar spondylolisthesis

Biomechanical Effects of Polyetheretherketone and Titanium Rods in Transforaminal Lumbar Interbody Fusion: A Finite Element Analysis

Biomechanical Model for Testing Cage Subsidence in the Osteoporotic Spine Under Permanent Maximum Load

Contact Info

Product

Resources

About