Repair of a Pseudarthrosis of the Lumbar Spine. A Functional Outcome Study*†

Carpenter, Clyde T.; Dietz, John; Leung, KM; Hanscom, David; Wagner, Theodore A.

doi:10.2106/00004623-199605000-00011

Cited by 94 publications

(42 citation statements)

References 22 publications

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“…Previous studies have shown that, in general, the technical success rate (indicated by obtaining fusion) is greater than the clinical success rate (indicated by decrease in pain) [7,11,28]. Although the radiographic fusion rates in the current study were higher than 90%, the clinical results were variable and often influenced by such factors as litigation, co-morbidities, disability, and secondary gain issues.…”

Section: Discussioncontrasting

confidence: 54%

Outcomes of allogenic cages in anterior and posterior lumbar interbody fusion

Janssen

Lam

Beckham

2001

European Spine Journal

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Interbody lumbar fusions provide a proven logical solution to diseases of the intervertebral discs by eliminating motion of the segment. Historically, there are many techniques to achieve spinal fusion in the lumbar spine. These include anterior, posterior, and foramenal approaches, often in combination with various internal fixation devices. The surgeon's choice of the approach and mechanical or biological implant is dependent on the patient's specific pathology and anatomy, in addition to the experience and training of the surgeon in similar conditions. In the past decade, new mechanical spine implants/spacers have been designed to provide restoration of disc height and improve stabilization of the spine. The ability to radiographically assess the "biology" of bone incorporation in these mechanical (metal) spacers has become a significant limitation.The femoral ring allograft (FRA) and the posterior lumbar interbody fusion (PLIF) spacers have been developed as "biological cages" that permit restoration of the anterior column with machined allograft bone biological cages. Test results demonstrate that the FRA and PLIF spacers have a compressive strength of over 25,000 N. The pyramid-shaped teeth on the surfaces and the geometry of the implant increase the resistance to expulsion at clinically relevant loads (1053 and 1236 N). The technique of anterior column reconstruction with both the FRA and the PLIF biological cages have been previously reported.Clinical outcomes and experience with the FRA spacer (137 patients) and the PLIF spacer (13 patients) were reported on and did not reveal any evidence of bone cage resorption or infectious inflammatory process. There was clinical migration with one PLIF spacer, which was later revised with an anterior approach and a FRA spacer. The radiographic outcomes demonstrated that 94% arthrodesis was achieved with the biological spacer and additional posterior instrumentation. The clinical success of every spine fusion procedure is dependent on many factors such as the extent of the instability, the pathology, type of graft used, the patient's pathology/anatomy and lifestyle.Keywords Biological cages · Femoral ring allograft spacer · Posterior lumbar interbody fusion spacer · Interbody lumbar fusion · Arthrodesis ORIGINAL ARTICLE Eur Spine J (2001) 10 : S158-S168

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Section: Discussioncontrasting

confidence: 54%

Outcomes of allogenic cages in anterior and posterior lumbar interbody fusion

Janssen

Lam

Beckham

2001

European Spine Journal

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“…In the symptomatic patient who shows evidence of pseudoarthrosis later on, revision surgery is warranted. It has been shown that pseudoarthrosis repair can lead to improved clinical results [39,44] , although this revision surgery carries a significant risk of recurrent non-union and a persistently poor outcome [39,40,51] . When surgically treat- ing pseudarthrosis, it is important to remember that better graft material than that used in the index procedure should be used in an optimized environment.…”

Section: Pseudarthrosis (Non-union)mentioning

confidence: 99%

Common surgical complications in degenerative spinal surgery

Papadakis¹

2013

WJO

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The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive surgery to the reduction of complication rate. In this paper the most common surgical complications in degenerative spinal surgery are outlined and discussed.

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“…Several investigations have shown that the results of lumbar spine surgery are also adversely affected by cigarette-smoking, with lower rates of fusion, poorer clinical outcomes, and higher rates of postoperative infection in smokers [4][5][6][7][8][9][10][11] . Initially, it was postulated that the lower rate of consolidation of posterolateral lumbar spinal grafts among smokers was due to a lower oxygen-carrying capacity of the bloodstream 4 .…”

mentioning

confidence: 99%