The Indications for Interbody Fusion Cages in the Treatment of Spondylolisthesis

McAfee, Paul C.; DeVine, John G.; Chaput, Christopher D.; Prybis, Brad G.; Fedder, Ira L.; Cunningham, Bryan W.; Farrell, Dennis J.; Hess, Samuel J.; Vigna, Franco

doi:10.1097/01.brs.0000155578.62680.dd

Cited by 156 publications

(80 citation statements)

References 13 publications

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“…There are a number of publications about surgical treatment of signs related to DS [14,21,30,37,39,47,61] including the recent comprehensive review of Sengupta and Herkowitz [51]. In the present review we concentrated on conservative treatment options and would encourage those who are interested in surgery to read these other articles.…”

Section: Treatment Optionsmentioning

confidence: 99%

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

2007

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Degenerative spondylolisthesis (DS) is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine. Lumbar DS is a major cause of spinal canal stenosis and is often related to low back and leg pain. We reviewed the symptoms, prognosis and conservative treatments for symptoms associated with DS. PubMed and MEDLINE databases (1950-2007) were searched for

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Section: Treatment Optionsmentioning

confidence: 99%

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

2007

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“…1,19,22,30 Interbody cages likewise increase neuroforaminal height to facilitate reduction of degenerative spondylolisthesis and improve chances of successful fusion in this setting. 17 Nonetheless, a number of biomechanical analyses have questioned the adequacy of ALIF cages in terms of stability. 11,21,23 Next-generation designs have thus integrated a fixation plate to secure the distraction cage anteriorly.…”

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confidence: 99%

Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3–4 fixation

Y¹,

Jang

Lee³

et al. 2014

SPI

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Many studies attest to the excellent results achieved using anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. The purpose of this report is to document a rare instance of L-4 vertebral body fracture following use of a stand-alone interbody fusion device for L3–4 ALIF. The patient, a 55-year-old man, had suffered intractable pain of the back, right buttock, and left leg for several weeks. Initial radiographs showed Grade I degenerative spondylolisthesis, with instability in the sagittal plane (upon 15° rotation) and stenosis of central and both lateral recesses at the L3–4 level. Anterior lumbar interbody fusion of the affected vertebrae was subsequently conducted using a stand-alone cage/plate system. Postoperatively, the severity of spondylolisthesis diminished, with resolution of symptoms. However, the patient returned 2 months later with both leg weakness and back pain. Plain radiographs and CT indicated device failure due to anterior fracture of the L-4 vertebral body, and the spondylolisthesis had recurred. At this point, bilateral facetectomies were performed, with reduction/fixation of L3–4 by pedicle screws. Again, degenerative spondylolisthesis improved postsurgically and symptoms eased, with eventual healing of the vertebral body fracture. This report documents a rare instance of L-4 vertebral body fracture following use of a stand-alone device for ALIF at L3–4, likely as a consequence of angular instability in degenerative spondylolisthesis. Under such conditions, additional pedicle screw fixation is advised.

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“…Furthermore, in patients with low BMD, the use of carbon fiber cages, which have a similar modulus of elasticity to that of the adjacent bone, may serve to lessen the incidence of cage subsidence. 5,6,10,14,15 By placing a single cage on the concave side of the deformed segment and by applying asymmetrical dorsal compressive forces to the stabilizing construct, we have been able to achieve excellent coronal curve correction. The selective application of relatively increased compressive forces on the convex side of the curve allows for an additional coronal plane curve correction and applies a compressive force on the interbody graft material in the disc space proper.…”

Section: Discussionmentioning

confidence: 94%

Correction of lumbar coronal plane deformity using unilateral cage placement

Heary¹,

Karimi²

2010

FOC

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The authors describe a surgical technique for the correction of symptomatic degenerative lumbar scoliosis. Using a single, unilateral, interbody cage placed on the concave side of the coronal deformity, combined with a dorsal decompression and instrumented posterolateral fusion, this technique has resulted in excellent curve correction, fusion results, and clinical outcomes in a series of 4 patients. Each of these patients presented with intractable, axial low-back pain and symptomatic unilateral nerve root compression on the concave side of a lumbar scoliotic deformity. The management is described in detail.

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The Indications for Interbody Fusion Cages in the Treatment of Spondylolisthesis

Abstract: Interbody cages in spondylolisthesis are useful to increase neuroforaminal height, to facilitate reduction, and to improve the chances of achieving a successful 360 degrees fusion.

Cited by 156 publications

References 13 publications

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3–4 fixation

Correction of lumbar coronal plane deformity using unilateral cage placement

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