Transforaminal Lumbar Interbody Fusion With rhBMP-2 in Spinal Deformity, Spondylolisthesis, and Degenerative Disease—Part 2

Crandall, Dennis G.; Revella, Jan; Patterson, Jason; Huish, Eric G.; Chang, Michael S.; McLemore, Ryan

doi:10.1097/brs.0b013e3182880298

Cited by 51 publications

(42 citation statements)

References 40 publications

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“…There were many complications associated with its use, which include seroma formation, osteolysis and cage subsidence, heterotopic bone formation and radiculitis. [29][30][31] Although further refinement of the dosage used in MIS-TLIF procedures has reduced the incidence of such complications, these associated problems still remain a concern for many surgeons embarking on this procedure.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical comparison between cortical screw–rod construct versus pedicle screw–rod construct in transforaminal lumbar interbody fusion

Wei

Haw

Bashir

et al. 2017

J Orthop Surg (Hong Kong)

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Objective: To compare construct stiffness of cortical screw (CS)-rod transforaminal lumbar interbody fusion (TLIF) construct (G2) versus pedicle screw (PS)-rod TLIF construct (G1) in the standardized porcine lumbar spine. Methods: Six porcine lumbar spines (L2-L5) were separated into 12 functional spine units. Bilateral total facetectomies and interlaminar decompression were performed for all specimens. Non-destructive loading to assess stiffness in lateral bending, flexion and extension as well as axial rotation was performed using a universal material testing machine. Results: PS and CS constructs were significantly stiffer than the intact spine except in axial rotation. Using the normalized ratio to the intact spine, there is no significant difference between the stiffness of PS and CS: flexion (1.41 + 0.27, 1.55 + 0. Conclusion:The CS-rod TLIF construct provided comparable construct stiffness to a traditional PS-rod TLIF construct in a 'standardized' porcine lumbar spine model.

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Section: Discussionmentioning

confidence: 99%

Biomechanical comparison between cortical screw–rod construct versus pedicle screw–rod construct in transforaminal lumbar interbody fusion

Wei

Haw

Bashir

et al. 2017

J Orthop Surg (Hong Kong)

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“…At an average of 5 years of follow-up, fusion was achieved in 864 (99.1%) of 872 levels and seroma formation occurred in 0.4% of patients, ectopic bone growth in 0.6%, radiculitis in 1%, and symptomatic osteolysis or cage subsidence in none. 7,8 With such low rates, the study was inadequately powered to detect significant differences between dose groups. 5 Overall, although small risks exist, the current widespread use of BMP for TLIF procedures seems safe when appropriate surgical techniques are used.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis

Gologorsky¹,

Skovrlj²,

Steinberger³

et al. 2014

SPI

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Object Transforaminal lumbar interbody fusion (TLIF) with segmental pedicular instrumentation is a wellestablished procedure used to treat lumbar spondylosis with or without spondylolisthesis. Available biomechanical and clinical studies that compared unilateral and bilateral constructs have produced conflicting data regarding patient outcomes and hardware complications. Methods A prospective cohort study was undertaken by a group of neurosurgeons. They prospectively enrolled 80 patients into either bilateral or unilateral pedicle screw instrumentation groups (40 patients/group). Demographic data collected for each group included sex, age, body mass index, tobacco use, and Workers' Compensation/litigation status. Operative data included segments operated on, number of levels involved, estimated blood loss, length of hospital stay, and perioperative complications. Long-term outcomes (hardware malfunction, wound dehiscence, and pseudarthrosis) were recorded. For all patients, preoperative baseline and 6-month postoperative scores for Medical Outcomes 36-Item Short Form Health Survey (SF-36) outcomes were recorded. Results Patient follow-up times ranged from 37 to 63 months (mean 52 months). No patients were lost to follow-up. The patients who underwent unilateral pedicle screw instrumentation (unilateral cohort) were slightly younger than those who underwent bilateral pedicle screw instrumentation (bilateral cohort) (mean age 42 vs 47 years, respectively; p = 0.02). No other significant differences were detected between cohorts with regard to demographic data, mean number of lumbar levels operated on, or distribution of the levels operated on. Estimated blood loss was higher for patients in the bilateral cohort, but length of stay was similar for patients in both cohorts. The incidence of pseudarthrosis was significantly higher among patients in the unilateral cohort (7 patients [17.5%]) than among those in the bilateral cohort (1 patient [2.5%]) (p = 0.02). Wound dehiscence occurred for 1 patient in the unilateral cohort. Reoperation was offered to 8 patients in the unilateral cohort and 1 patient in the bilateral cohort (p = 0.03). The physical component scores of the Medical Outcomes SF-36 outcomes improved significantly for all patients (p < 0.001). Conclusions Transforaminal lumbar interbody fusion with either unilateral or bilateral segmental pedicular instrumentation is an effective treatment for lumbar spondylosis. Because patients with unilateral constructs were 7 times more likely to experience pseudarthrosis and require reoperation, TLIF with bilateral constructs might be the biomechanically superior technique.

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“…A rthrodesis and neural decompression via transforaminal lumbar interbody fusion (TLIF) is an effective treatment modality for degenerative spinal disorders including spondylolisthesis (2,3,9,10,16,50). Through a unilateral approach and a single posterior incision this technique allows for simultaneous spinal canal decompression and anterior interbody arthrodesis (15,25).…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) for Spondylolisthesis in 282 Patients: In Situ Arthrodesis versus Reduction

et al. 2015

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Transforaminal Lumbar Interbody Fusion With rhBMP-2 in Spinal Deformity, Spondylolisthesis, and Degenerative Disease—Part 2

Abstract: 3.

Cited by 51 publications

References 40 publications

Biomechanical comparison between cortical screw–rod construct versus pedicle screw–rod construct in transforaminal lumbar interbody fusion

Biomechanical comparison between cortical screw–rod construct versus pedicle screw–rod construct in transforaminal lumbar interbody fusion

Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis

Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) for Spondylolisthesis in 282 Patients: In Situ Arthrodesis versus Reduction

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