Interbody options in lumbar fusion

Patel, Dil V.; Yoo, Joon S; Karmarkar, Sailee S; Lamoutte, Eric H; Singh, Kern

doi:10.21037/jss.2019.04.04

Cited by 44 publications

(37 citation statements)

References 52 publications

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“…Moreover, metallic artifacts due to the titanium render the evaluation of bone fusion status after surgery difficult. 6 A previous study reported that the autologous local bone graft in titanium cage for posterior lumbar spinal fusion showed a poor ratio of the fused area of local bone inside the cages (<50%), which indicated the insufficiency for load transmission. 7 …”

mentioning

confidence: 96%

A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic, and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior Lumbar Interbody Fusion

Lee

Kim

Kang

et al. 2020

Clinical Spine Surgery: A Spine Publication

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mentioning

confidence: 96%

A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic, and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior Lumbar Interbody Fusion

Lee

Kim

Kang

et al. 2020

Clinical Spine Surgery: A Spine Publication

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“…Lumbar interbody fusion has been used for over a century to treat a variety of neurosurgical conditions, including disc herniation, spinal instability, spondylolisthesis, spinal stenosis, deformity, trauma, malignancy, and infection [ 1 ]. First described by Albee and Hibbs in 1911, the fusion of the lumbar spine has been improved by advances in fusion instrumentation, innovative biologics, and new bone-grafting capabilities [ 1 , 2 ]. These advances have expanded the clinical utility of this procedure and greatly improved postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcomes After Single-Level Endoscopic Transforaminal Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis

Stone

Myers

Gupta

et al. 2020

Cureus

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Background and objective Novel surgical advancements have introduced endoscopic operative techniques for low back surgery, including transforaminal lumbar interbody fusion (TLIF), which theoretically allows for improved decompression with minimal invasiveness. In addition, endoscopically performed TLIF has allowed for the use of local anesthesia as an alternative method to general anesthesia for patients. We aimed to evaluate the clinical outcomes in patients undergoing endoscopic TLIF and also compare the outcomes in patients undergoing general versus local anesthesia. Methods The databases of PubMed, Medline, Embase, and the Cochrane Library were queried for all studies involving patients undergoing endoscopic TLIF. After the extraction of the data and assessment of study quality via the Newcastle-Ottawa Scale, statistical analysis was performed with the R software (The R Foundation, Vienna, Austria) metafor package. The random-effects model was used as the data was largely heterogeneous (I 2 >50%). Results In total, 15 studies involving a total of 441 patients were selected for the final quantitative meta-analysis. The overall mean difference between the postoperative visual analog scale (VAS) leg scores and preoperative VAS scores was 3.45 (95% CI: 4.93-1.97, p: <0.01). Postoperative VAS low back scores revealed a mean difference of 3.36 (95% CI: 5.09-1.63, p: <0.01). The overall mean difference of ODI scores was 4.58 (95% CI: 6.76-2.40, p: <0.01). Mean blood loss was 136.32 mL and the mean operative time was 149.15 minutes. The mean length of stay postoperatively was lower in the local anesthesia group compared to the general anesthesia group (1.40 vs 5.99 days respectively). There were no outcome variables of patients undergoing general anesthesia versus local anesthesia that showed statistically significant differences in this analysis due to the small amount of data published on patients undergoing endoscopic TLIF with local anesthesia. In addition, the failure of studies in reporting standard deviations as data parameters further limited the quantitative analysis. Conclusion Endoscopic TLIF appears to be a viable option for patients undergoing lumbar interbody fusion. Initial data reveal that endoscopic TLIF with local anesthesia may offer patients outcomes similar to those in patients undergoing endoscopic TLIF with general anesthesia, with lower operative times and length of stay.

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“…Degenerative disease of lumbar intervertebral disc is a common disease in adults [1] , and often leads to symptoms such as low back, lower extremity pain or sensory disorders. Some patients with severe symptoms often need surgical treatment [2] .…”

Section: Introductionmentioning

confidence: 99%

A comparative study between local bone graft with or without cages in unilateral posterior lumbar interbody fusion (PLIF): a retrospective study

He¹,

Feng²,

Chen³

et al. 2020

Preprint

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Objective A retrospective study of the clinical and radiological results between local bone graft with a cage and without cage in patients treated with unilateral fixation and posterior lumbar interbody fusion surgery. Methods A total of 52 patients who underwent PLIF in our institution were evaluated from January 2015 to January 2018. 30 of these patients received PLIF with local bone graft combined with using one cage, and 22 patients received PLIF with local bone graft without using cage. The clinical data and perioperative complications of the two groups were recorded. X-ray were taken before, after operation and at the end of follow-up to calculate the height of intervertebral disc and the fusion rate. SUK's criteria were used to evaluate the quality of spinal fusion at the follow-up time. The results between the cage and non- cage group were compared. Results There was no statistical difference in baseline data between the two groups, and The mean follow-up time was 18.43 months in cage group and 17.50 months in non- cage group (P = 0.553). In additions, the significant difference was not found in the comparison of perioperative evaluation data between the two groups, such as operation time (P = 0.299), blood loss (P = 0.342) and incidence of complications (P = 1.000). Furthermore, the significant difference of VAS score cannot be found in preoperation (Pleg=0.731, Plowback=0.786), postoperation (Pleg=0.534, Plowback=0.725) and the final follow-up (Pleg=0.654, Plowback=0.362) between the two groups. The same results were also obtained in the comparison of ODI index (Ppre=0.682, Pfinal=0.712) and intervertebral height (Ppost=0.363, Pfinal=0.094). The final fusion rates were 96.7% (cage group) and 86.4% (non- cage group) respectively, and there was no statistical difference (P = 0.553). Conclusion Local bone graft has the same advantages as a cage in unilateral PLIF. Comparing with local bone graft using cage, we believe that the local bone graft is a more ideal way in unilateral PLIF, and decrease operation cost.

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Interbody options in lumbar fusion

Cited by 44 publications

References 52 publications

A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic, and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior Lumbar Interbody Fusion

A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic, and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior Lumbar Interbody Fusion

Surgical Outcomes After Single-Level Endoscopic Transforaminal Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis

A comparative study between local bone graft with or without cages in unilateral posterior lumbar interbody fusion (PLIF): a retrospective study

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