Magnetic Resonance Imaging Evaluation of Posterior Lumbar Interbody Fusion

Kröner, A.; Eyb, R.; Lange, Andreas; Lomoschitz, K.; Mahdi, Taher; Engel, A.

doi:10.1097/01.brs.0000218583.43398.e3

Cited by 32 publications

(21 citation statements)

References 15 publications

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“…First, it is not straightforward to objectively assess the radiographic fusion status, especially with implants in the grafted sites. Computed tomography and MRI are reportedly more reliable to assess the fusion status [23,37], but we did not use these highcost technologies in this study. Blumenthal and Gill [4] stated the only reliable method to determine fusion rate may be reexploration which is obviously impractical on a routine basis.…”

Section: Discussionmentioning

confidence: 76%

Instrumented Posterior Lumbar Interbody Fusion in Adult Spondylolisthesis

Wang

Chen

2008

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 76%

Instrumented Posterior Lumbar Interbody Fusion in Adult Spondylolisthesis

Wang

Chen

2008

Clinical Orthopaedics &Amp; Related Research

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“…Although b-TCP used for spinal fusion has been found to be satisfactory in animal models [15], lumbar posterior fusion [5] and anterior cervical fusion [16], no reports on b-TCP as the single filling material for PLIF cages have been found. Several studies have shown that there is good evidence to support the use of b-TCP as a bone graft extender for posterolateral fusion [17].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple radiological methods, like dynamic and static radiographs [8-10, 17, 23], magnetic resonance imaging [16] and CT scans [9,26], have been used to assess fusion status. In addition, a wide variety of criteria and classification systems have been published [3,27].…”

Section: Discussionmentioning

confidence: 99%

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

et al. 2012

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Purpose Due to the disadvantages of iliac crest bone and the poor bone quality of autograft gained from decompression surgery, alternative filling materials for posterior lumbar interbody fusion cages have been developed. b-Tricalcium phosphate is widely used in cages. However, data regarding the fusion rate of b-TCP assessed by computer tomography are currently not available. Materials A prospective clinical trial involving 34 patients (56.7 years) was performed: 26 patients were treated with single-level, five patients double-level and three patients triple-level PLIF filled with b-TCP and bone marrow aspirate perfusion, and additional posterior pedicle screw fixation. Fusion was assessed by CT and X-rays 1 year after surgery using a validated fusion scale published previously. Functional status was evaluated with the visual analogue scale and the Oswestry Disability Index before and 1 year after surgery. Results Forty-five levels in 34 patients were evaluated by CT and X-ray with a follow-up period of at least 1 year. Clinically, the average ODI and VAS for leg and back scores improved significantly (P \ 0.001). CT assessment revealed solid fusion in 12 levels (26.67 %) and indeterminate fusion in 15 levels (34.09 %). Inadequate fusion (non-union) was detected in 17 levels (38.63 %). Conclusion The technique of PLIF using b-TCP yielded a good clinical outcome 1 year after surgery, however, a high rate of pseudoarthrosis was found in this series therefore, we do not recommend b-TCP as a bone graft substitute using the PLIF technique.

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“…In order to address this question, we aimed to compare the agreement and confidence between independent assessors in determining fusion using both MRI and CT postoperatively following ALIF. Although the role of MRI in evaluating lumbar fusion has been studied previously, 14 to the authors knowledge this is the first study evaluating MRI for fusion in ALIF and also the first study to compare MRI and CT.…”

Section: Introductionmentioning

confidence: 99%

Fusion Assessment by MRI in Comparison With CT in Anterior Lumbar Interbody Fusion: A Prospective Study

Kitchen

Rao

Zotti

et al. 2018

Global Spine Journal

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Study Design:Prospective cohort study.Objectives:To evaluate the role of magnetic resonance imaging (MRI) in evaluation of fusion status following anterior lumbar interbody fusion (ALIF) and compare agreement and confidence in assessing fusion or its absence on MRI to the current standard computed tomography (CT).Methods:A prospective follow up of patients undergoing surgery by 2 spine surgeons between 2012 and 2015 at a single institution. Fusion was assessed at different time points in these patients by 2 independent musculoskeletal radiologists. Fusion was analyzed in coronal and sagittal planes using both imaging modalities, with confidence being attributed on a scale of 0 to 3. Assessors were blinded to patient data.Results:Fourteen patients (25 levels) with mean follow-up of 10.2 months (range 2.4-20.3 years) and age of 41 years (range 20.7-61.5 years) were assessed. MRI within the interbody cage in coronal (κ = .58) and sagittal (κ = .50) planes had the highest interobserver agreement. CT anterior to the cage in coronal (κ = .48) and sagittal (κ = .44) planes, as well as within the cage in coronal (κ = .50) and sagittal planes (κ = .44) showed moderate agreement. Confidence anterior to the interbody cage using MRI scan was reduced when compared with remaining angles and imaging modalities.Conclusions:The study demonstrates that MRI may be a useful tool in the assessment of fusion following ALIF with results comparable to CT, and that it may have a useful role in select patients especially considering marked radiation exposure reduction.

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Magnetic Resonance Imaging Evaluation of Posterior Lumbar Interbody Fusion

Abstract: The results of our study demonstrate that the most reliable radiographic indicator of fusion is the presence of bone bridging through the cages shown on coronal planes.

Cited by 32 publications

References 15 publications

Instrumented Posterior Lumbar Interbody Fusion in Adult Spondylolisthesis

Instrumented Posterior Lumbar Interbody Fusion in Adult Spondylolisthesis

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

Fusion Assessment by MRI in Comparison With CT in Anterior Lumbar Interbody Fusion: A Prospective Study

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