Long-Term Outcomes of Posterior Lumbar Interbody Fusion Using Stand-Alone Ray Threaded Cage for Degenerative Disk Disease: A 20-Year Follow-Up

Baeesa, Saleh; Medrano, Belén García; Noriega, David C.

doi:10.4184/asj.2016.10.6.1100

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…Our results of FJR compare favorably with monosegmental lumbar fusion concerning leg and back pain, 15 as well as improvement of ODI score. 21 The revision rate in our small series of FJR was 15.4%, and compares to large series of rigid lumbar fusions with 19.3% after 4 years, mostly due to adjacent level disease. 22 A large retro-spective cohort study of 912 cases revealed a 31% prevalence for adjacent level surgery after 10 years.…”

Section: Fjr Versus Rigid Fusionsupporting

confidence: 45%

Facet Joint Replacement: Intermediate- and Long-Term Outcome in a Large Case Series

Knappe

Reinecke

Flörke

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background The long-term outcome of facet joint replacement (FJR) still is to be proven. Methods We present a prospective case series of 26 (male-to-female ratio of 1:1; mean age: 61 years) patients undergoing FJR with a follow-up of at least 1 year (range: 12–112; mean: 67 months). Visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and the 12-Item Short Form Health Survey (SF-12) were applied pre- and postoperatively (after 3, 6, and 12 months) as well as at the last follow-up (N = 24). Using X-rays of the lumbar spine (N = 20), the range of motion (ROM) and disk height in the indicator and adjacent levels were assessed. Results FJR was performed at L3/L4 (N = 7), L4/L5 (N = 17), and L5/S1 (N = 2). Mean VAS (mm) for back pain decreased from 71 to 18, mean VAS for right leg pain from 61 to 7, and from 51 to 3 for the left leg. Mean ODI dropped from 51 to 22% (for all p < 0.01). Eighty seven percent of patients were satisfied and pretreatment activities were completely regained in 78.3% of patients. Disk height at the indicator and adjacent levels and ROM at the indicator segment and the entire lumbar spine were preserved. No loosening of implants was observed. Explantation of FJR and subsequent fusion had to be performed in four cases (15.4%). Conclusions In selected cases, long-term results of FJR show good outcome concerning pain, quality of life, preservation of lumbar spine motion, and protection of adjacent level.

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Section: Fjr Versus Rigid Fusionsupporting

confidence: 45%

Facet Joint Replacement: Intermediate- and Long-Term Outcome in a Large Case Series

Knappe

Reinecke

Flörke

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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“…Moreover, Costa et al [1] argue that when placing stand-alone cage, the facet joints are preserved and the destruction of the posterior and facet joint ligaments and of the endplates is minimal, conditions that are crucial to successful bone fusion. On the other hand, long-term follow-ups [79] have obtained that PLIF stand-alone cages were associated with good clinical outcomes but although the fusion rate was excellent, maintenance of disc heights and lordotic alignment were not achieved in the long term. Therefore, there are still pending questions.…”

Section: Discussionmentioning

confidence: 99%

Is there any advantage of using stand-alone cages? A numerical approach

2019

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Background Segment fusion using interbody cages supplemented with pedicle screw fixation is the most common surgery for the treatment of low back pain. However, there is still much controversy regarding the use of cages in a stand-alone fashion. The goal of this work is to numerically compare the influence that each surgery has on lumbar biomechanics. Methods A non-linear FE model of the whole lumbar spine was developed to compare between two types of cages (OLYS and NEOLIF) with and without supplementary fixation. The motion of the whole spine was analysed and the biomechanical environment of the adjacent segments to the operated one was studied. Moreover, the risk of subsidence of the cages was qualitatively evaluated. Results A great ROM reduction occurred when supplementary fixation was used. This stiffening increased the stresses at the adjacent levels. It might be hypothesised that the overloading of these segments could be related with the clinically observed adjacent disc degeneration. Meanwhile, the stand-alone cages allowed for a wider movement, and therefore, the influence of the surgery on adjacent discs was much lower. Regarding the risk of subsidence, the contact pressure magnitude was similar for both intervertebral cage designs and near the value of the maximum tolerable pressure of the endplates. Conclusions A minimally invasive posterior insertion of an intervertebral cage (OLYS or NEOLIF) was compared using a stand-alone design or adding supplementary fixation. The outcomes of these two techniques were compared, and although stand-alone cage may diminish the risk of disease progression to the adjacent discs, the spinal movement in this case could compromise the vertebral fusion and might present a higher risk of cage subsidence. Electronic supplementary material The online version of this article (10.1186/s12938-019-0684-8) contains supplementary material, which is available to authorized users.

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“…(2) The CBT approach may reduce injury or trauma to the neurovascular structures in close proximity to the pedicle; (3) The CBT may also avoid injury to the medial branch nerves, which arise from the dorsal rami of each lumbar spinal nerve 24) . It has been reported that MIDLF results in less damage to the multifidus muscle compared to PLIF 15) .…”

Section: Discussionmentioning

confidence: 99%

“…Lateral flexion-extension radiography and computed tomography (CT) scans were obtained at the 12-month postoperative follow up to evaluate bone fusion status. There are many analyses for spinal instability 3,12,16,30) . A stable spine was defined as no or less than 2 mm translation and no angulation in the flexion-extension radiographs of patients.…”

Section: Radiographic Evaluations and Clinical Outcomesmentioning

confidence: 99%

Midline Lumbar Fusion for Patients with Adjacent Segmental Disease after Posterior Lumbar Interbody Fusion: A Comparative Study between Midline Lumbar Fusion and Posterior Lumbar Interbody Fusion

Kim

2017

Nerve

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This study is a comparative analysis for the radiologic and clinical outcomes of midline lumbar fusion (MIDLF) and posterior lumbar interbody fusion (PLIF) in patients with adjacent segmental disease (ASD) after PLIF. Methods: Thirty patients who met the inclusion criteria were targeted. Of those 30 patients, 10 underwent MIDLF and 20 underwent PLIF. Preoperative and postoperative radiologic outcomes for bone fusion and clinical outcomes for blood loss, operation time and visual analog scale for pain relief were evaluated between the two groups. Postoperative bone fusion status was measured using a 6-point scoring system. Results: Bone fusion was successfully achieved in both groups. The MIDLF group had significantly less blood loss during the operation and shorter operation times than those in the PLIF group (p<0.05). There was a statistically significant interaction between group and time in the mean level of axial pain (p<0.05). Compared to before surgery, axial pain improved in both groups at each postoperative follow up. MIDLF was significantly more effective in the relief of axial pain than PLIF at every postoperative follow up (p<0.05). Conclusion: MIDLF was as effective as PLIF in bone fusion and relief of postoperative axial pain. MIDLF may be a good alternative in patients with ASD after PLIF.

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Long-Term Outcomes of Posterior Lumbar Interbody Fusion Using Stand-Alone Ray Threaded Cage for Degenerative Disk Disease: A 20-Year Follow-Up

Cited by 9 publications

References 27 publications

Facet Joint Replacement: Intermediate- and Long-Term Outcome in a Large Case Series

Facet Joint Replacement: Intermediate- and Long-Term Outcome in a Large Case Series

Is there any advantage of using stand-alone cages? A numerical approach

Midline Lumbar Fusion for Patients with Adjacent Segmental Disease after Posterior Lumbar Interbody Fusion: A Comparative Study between Midline Lumbar Fusion and Posterior Lumbar Interbody Fusion

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