History of Spinal Fusion: Where we Came from and Where we are Going

Virk, Sohrab; Qureshi, Sheeraz A.; Sandhu, Harvinder S.

doi:10.1007/s11420-020-09747-7

Cited by 29 publications

(24 citation statements)

References 96 publications

(107 reference statements)

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“…Spinal instrumentation continues to evolve to achieve better surgical outcomes. Spinal fusion procedures are commonly used to treat various spinal pathologies, including degenerative conditions, deformity, trauma, infection, and tumors [1,4]. The existing pedicle screw-rod systems have increased the success rate and practicality of the fusion procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Instrumented spinal fusion is a procedure that uses metal implants to minimize or eliminate the movement of the spinal column to promote bony fusion at the implanted levels [1]. The inception of the Harrington rod instrumentation and its successful use to treat scoliosis was a major advancement in spinal surgery [2].…”

Section: Introductionmentioning

confidence: 99%

“…Pedicle screw stabilization with plates was introduced in 1970 by Roy Camille and provided excellent rigidity but was practical for only one level fusion because of the difficulty in adapting the plates to multiple levels [3]. Monoaxial pedicle screw systems with bendable rods provided a major advancement by allowing the interconnection of screws at multiple levels thus enabling the treatment of a multitude of spinal conditions [1,4]. The addition of the polyaxial screw head added further practicality to the construct and allowed adaptation to minimally invasive techniques [1,4].…”

Section: Introductionmentioning

confidence: 99%

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A Novel Plate-Based System (UNIMAX) for Posterior Instrumented Spinal Fusion

Pisharodi

Aljuboori

Goel

et al. 2020

Cureus

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The polyaxial head pedicle screw-rod system is a commonly used spinal instrumentation technique to achieve stabilization, deformity correction, and bony fusion. We present a novel plate-based pedicle screw system (UNIMAX TM) that can be used for multi-level instrumentation with potential advantages for selected applications. Methods Bilateral titanium monoaxial pedicle screws are linked at each level by robust transversely oriented cross plates forming ring constructs capable of rigid triangulation at each level. The cross plates are then interconnected by sagittally oriented rigid plates situated medial to the screw heads. Biomechanically, the construct was tested for quasi-static torsion and fatigue in axial compression. The system is approved by the Food and Drug Administration (FDA). The system and case examples are presented showing its potential advantages. Results The quasi-static torsion, the mean for the angular displacement, torsional stiffness, and torsional ultimate strength was 2.5 degrees (SD ± 0.8), 5.3 N-m/mm (SD ± 0.7), and 21.6 N-m (SD ± 4.4). For the fatigue in axial compression, the closed ring construct failed when the applied load and bending moment were ≥ 1500 N and ≥ 60 N.m. This system maximizes the construct rigidity, allows easy extension to adjacent levels, and can be incorporated intuitively into practice. The ring construct with triangulation at each level, together with its biomechanical robustness, predicts a high pullout resistance. It requires an open posterior approach incompatible with minimally invasive techniques. Conclusion This system may have advantages over the screw-rod systems in carefully selected situations requiring extra rigidity and high pull-out strength for complex reconstructions, sagittal and/or coronal correction, patients with poor bone quality, revisions, and/or extension to adjacent levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Novel Plate-Based System (UNIMAX) for Posterior Instrumented Spinal Fusion

Pisharodi

Aljuboori

Goel

et al. 2020

Cureus

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“…[1][2][3] Despite the increasing utilization of instrumented fusion for the treatment of lum-bar pathology, there is still a lack of medical literature detailing concrete fusion indications and studies validating guidelines as predictors of outcomes. [4][5][6] This is largely secondary to heterogeneity in clinical decision-making amongst spine surgeons and surgical indications in lumbar spine pathology management.…”

Section: Introductionmentioning

confidence: 99%

Are Lumbar Fusion Guidelines Followed? A Survey of North American Spine Surgeons

et al. 2021

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Objective: To evaluate the use of guidelines for lumbar spine fusions among spine surgeons in North America. Methods: An anonymous survey was electronically sent to all AO Spine North America members. Survey respondents were asked to indicate their opinion surrounding the suitability of instrumented fusion in a variety of clinical scenarios. Fusion indications in accordance with North America Spine Society (NASS) guidelines for lumbar fusion were considered NASS-concordant answers. Respondents were considered to have a NASS-concordant approach if ≥ 70% (13 of 18) of their answers were NASS-concordant answers. Comparisons were performed using bivariable statistics. Results: A total of 105 responses were entered with complete data available on 70. Sixty percent of the respondents (n = 42) were considered compliant with NASS guidelines. NASS-discordant responses did not differ between surgeons who stated that they include the NASS guidelines in their decision-making algorithm (5.10 ± 1.96) and those that did not (4.68 ± 2.09) (p = 0.395). The greatest number of NASS-discordant answers in the United States. was in the South (5.75 ± 2.09), with the lowest number in the Northeast (3.84 ± 1.70) (p < 0.01). For 5 survey items, rates of NASS-discordant answers were ≥ 40%, with the greatest number of NASS-discordant responses observed in relation to indications for fusion in spinal deformity (80%). Spine surgeons utilizing a NASS-concordant approach had a significant lower number of NASS-discordant answers for synovial cysts (p = 0.03), axial low back pain (p < 0.01), adjacent level disease (p < 0.01), recurrent stenosis (p < 0.01), recurrent disc herniation (p = 0.01), and foraminal stenosis (p < 0.01). Conclusion:This study serves an important role in clarifying the rates of uptake of clinical practice guidelines in spine surgery as well as to identify barriers to their implementation.

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“…Modern technologies of minimally invasive and endoscopic techniques, navigation system, BoneScalpel, robotic surgeries, and motion-preserving technologies have increased the utility as well as safety during spine surgeries in various setups. This is one of the possible factors behind the increasing popularity of this subspecialty [2,3]. The comfortable feeling, with which the spine surgeons are working, is reflected in their generally good health and fitness status; their demeanor is not haunted and worried.…”

mentioning

confidence: 99%

Dedicating “BackBone- The Spine Journal” to the Spine Research

2020

BBJ

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History of Spinal Fusion: Where we Came from and Where we are Going

Cited by 29 publications

References 96 publications

A Novel Plate-Based System (UNIMAX) for Posterior Instrumented Spinal Fusion

A Novel Plate-Based System (UNIMAX) for Posterior Instrumented Spinal Fusion

Are Lumbar Fusion Guidelines Followed? A Survey of North American Spine Surgeons

Dedicating “BackBone- The Spine Journal” to the Spine Research

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