Biomechanical Assessment of Anterior Lumbar Interbody Fusion With an Anterior Lumbosacral Fixation Screw-Plate: Comparison to Stand-Alone Anterior Lumbar Interbody Fusion and Anterior Lumbar Interbody Fusion With Pedicle Screws in an Unstable Human Cadaver Model

Gerber, Mark; Crawford, Neil R.; Chamberlain, Robert H.; Fifield, Mary S.; LeHuec, Jean Charles; Dickman, Curtis A.

doi:10.1097/01.brs.0000206360.83728.d2

Cited by 86 publications

(45 citation statements)

References 24 publications

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“…The instability during the bone healing process is hypothesized to be one of the main reasons for pseudarthrosis [8][9][10] and subsidence [3]. Compared with standalone cage, supplementary fixation increases the stiffness and stability [3] and significantly improves the fusion rate [11]. The addition of rod-pedicle screw fixation increases the risk of compromising neurological and muscular elements and produces worse clinical outcomes when compared to stand-alone procedure [12] while also increasing the occurrence of adjacent disc degeneration [13].…”

Section: Introductionmentioning

confidence: 99%

Stand-alone ALIF with integrated intracorporeal anchoring plates in the treatment of degenerative lumbar disc disease: a prospective study on 65 cases

Allain

Delécrin²,

Beaurain³

et al. 2014

Eur Spine J

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Purpose ALIF with cages is expected to restore disc height and stabilize the spine promoting fusion, while avoiding damage attributed to rod-pedicle screw fixation. However, it may be related to an increased risk of fusion failure and subsidence. A prospective study was conducted by five investigators across three centers to confirm performance of a PEEK cage for stand-alone ALIF in the treatment of lumbar degenerative disc disease (DDD). Methods Sixty-five patients, with back ± leg pain, requiring surgery for DDD, were included. Efficacy and safety were evaluated at 6 weeks, 3, 6, and 12 months postoperatively. Fusion and subsidence were assessed through CT-images at 12-month follow-up. Disc height was measured. Clinical outcomes included back and leg pain (VAS), disability (Oswestry Disability Index), Quality of Life (Short-Form 36), and adverse events. Results The fusion and the subsidence rates were 96.3 and 2.0 %, respectively. ALIF surgery restored anterior and posterior disc height compared to baseline. There were no device-related serious adverse events, and no revision surgeries. Clinical outcomes improved significantly through 12-month follow-up. Conclusion Safety and efficacy of this stand-alone cage with integrated intracorporeal plates was confirmed through 12 months for treatment of degenerative conditions. The design of the cage and plates may contribute to the decreased subsidence rate observed.

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Section: Introductionmentioning

confidence: 99%

Stand-alone ALIF with integrated intracorporeal anchoring plates in the treatment of degenerative lumbar disc disease: a prospective study on 65 cases

Allain

Delécrin²,

Beaurain³

et al. 2014

Eur Spine J

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show abstract

“…Postoperative pain would be minimal and short hospitalization and early return to social activity is possible. For these reasons, ALIF using stand-alone cage has been introduced and clinically attempted 2,3,9,15,26,28) . In the present study, ALIF using two different kinds of stand-alone cage reduced pain and improved function in the patients of symptomatic lumbar IFS in mid-term follow up, regardless of device type.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, ALIF using stand-alone interbody cage has been introduced and clinically used, which it can make the surgery to be performed only anterior access 2,3,9,15,26,28) . However, though there have been several biomechanical studies to assess stabilization property of stand-alone device, clinical studies to evaluate clinical and radiological results of standalone ALIF surgeries have been rarely reported.…”

Section: Introductionmentioning

confidence: 99%

Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage in Treatment of Lumbar Intervertebral Foraminal Stenosis : Comparative Study of Two Different Types of Cages

Cho

Ryu

Park

2010

J Korean Neurosurg Soc

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Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis ® (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR ® (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ± 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ± 2.3 � 2.3 ± 2.2, 6.3 ± 3.2 �1.6 ± 1.6, and 53.7 ± 18.6 � 28.3 ± 13.1, respectively), which were not different between the two devices groups. In Stabilis ® group, postoperative immediately increased disc and IVF heights (10.09 ± 4.15 mm � 14.99 ± 1.73 mm, 13.00 ± 2.44 mm � 16.28 ± 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ± 1.67 mm, 13.59 ± 2.01 mm, respectively). In SynFix-LR ® group, immediately increased disc and IVF heights (9.60 ± 2.82 mm � 15.61 ± 0.62 mm, 14.01 ± 2.53 mm � 21.27 ± 1.93 mm, respectively) were maintained until the last follow up (13.72 ± 1.21 mm, 17.87 ± 2.02 mm, respectively). The changes of IVF width of each group was minimal pre-and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR ® group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis ® group.

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“…Oxland et al (14) in their literature review showed that supplemental pedicle screw fixation to ALIF cage substantially improved stabilization in all directions (flexion, extension, lateral bending and rotation). Similarly, Gerber et al (15) showed that although range of motion was decreased with an ALIF cage alone, supplemental fixation either from anterior plate/screws or pedicle screws was required for superior biomechanical stability. More recently, the new stand-alone cages (with screws) have been shown to have improved stability in all planes comparable to © OSS Press Ltd. All rights reserved.…”

Section: Approach Indications and Relative Contraindicationsmentioning

confidence: 99%

Comparison of ALIF vs. XLIF for L4/5 interbody fusion: pros, cons, and literature review

Winder¹,

Gambhir²

2016

J. Spine Surg.

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The incidence of lumbar fusion for the treatment of various degenerative lumbar spine diseases has increased dramatically over the last twenty years. Many lumbar fusion techniques have been developed and popularized, each with its own advantages and disadvantages. Anterior lumbar interbody fusion (ALIF) initially introduced in the 1930's, has become a common and widely accepted technique for lumbar fusions over the last decade offering several advantages over standard posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). More recently, the lateral trans-psoas approach termed extreme, direct or lateral lumbar interbody fusion (XLIF, DLIF, LLIF) is gaining widespread popularity.The aim of this paper is to compare the approaches, advantages and disadvantages of ALIF and XLIF for L4/5 interbody fusion based on relevant literature.

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Biomechanical Assessment of Anterior Lumbar Interbody Fusion With an Anterior Lumbosacral Fixation Screw-Plate: Comparison to Stand-Alone Anterior Lumbar Interbody Fusion and Anterior Lumbar Interbody Fusion With Pedicle Screws in an Unstable Human Cadaver Model

Cited by 86 publications

References 24 publications

Stand-alone ALIF with integrated intracorporeal anchoring plates in the treatment of degenerative lumbar disc disease: a prospective study on 65 cases

Stand-alone ALIF with integrated intracorporeal anchoring plates in the treatment of degenerative lumbar disc disease: a prospective study on 65 cases

Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage in Treatment of Lumbar Intervertebral Foraminal Stenosis : Comparative Study of Two Different Types of Cages

Comparison of ALIF vs. XLIF for L4/5 interbody fusion: pros, cons, and literature review

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