Circumferential Lumbar Spinal Fusion With Brantigan Cage Versus Posterolateral Fusion With Titanium Cotrel–Dubousset Instrumentation

Abstract

Circumferential lumbar fusion restored lordosis, provided a higher union rate with significantly fewer repeat operations, showed a tendency toward better functional outcome, and resulted in less peak back pain and leg pain than instrumented posterolateral fusion. The clinical perspective of the current study implies a recommendation to favor circumferential fusion as a definitive surgical procedure in complex lumbar pathology involving major instability, flatback, and previous disc surgery in younger patients, as compared with posterolateral fusion with pedicle screws alone.

Transforaminal lumbar interbody fusion (TLIF) versus posterolateral instrumented fusion (PLF) in degenerative lumbar disorders: a randomized clinical trial with 2-year follow-up

“…This could be due to the fact that our study was a singlecentre study, possibly reflecting a more standardized patient selection and surgical technique, as compared to the multi-centre Swedish Spine Study, with 19 different orthopedic departments participating in the study, and with different frequencies of performing the procedure [7]. Neither could we observe any significant difference in re-operation as seen in the ALIF study by Christensen et al [3]. On the contrary, the data from the SPORT study on degenerative spondylolisthesis did not show any difference in complication or repeated surgery rate up to 4 years, between the three fusion groups in that study [1].…”

“…Transforaminal lumbar interbody fusion is today widely used in lumbar spinal fusion because of less violation to the spinal canal, compared to PLIF, and due to less time consumption and morbidity compared to ALIF, to achieve interbody fusion, which by many authors is considered to be the treatment of choice [2,3,15,20,23]. To our knowledge, this study is the first randomized prospective study to analyze a standardized instrumented spinal posterolateral fusion procedure with a TLIF procedure.…”

“…Recently, Neumann et al [17] presented data from an RCT comparing transforaminal lumbar interbody fusion (TLIF) to uninstrumented PLF in degenerative disc disease (DDD), where outcome was significantly in favour of TLIF in visual analogue scale (VAS, pain) and disability Rating Index, but with no significant difference in Oswestry disability Index (ODI). Our group has earlier been able to show benefits of 360°fusion utilizing anterior interbody fusion [3]. Transforaminal lumbar interbody fusion (TLIF) should theoretically offer the same benefits of circumferential fusion, but with less morbidity due to the lesser surgical approach.…”

Artrodesis circunferencial: Plif más tornillos translaminofacetarios

“…A los 24 meses de seguimiento alcanzo 93% fusiones con un 75% de excelentes o buenos resultados, otro artículo interesante es el publicado por Chistensen et al 17 en 2002, es un estudio prospectivo y randomizado, donde compara los resultados obtenidos en 148 pacientes divididos en dos grupos, a los pacientes del primer grupo se le realizo una artrodesis posterolateral instrumentada y a los del segundo una artrodesis de 360 grados con alif e instrumentación posterior con tornillos pediculares o tornillos translaminofacetarios.…”

The in vitro stabilising effect of polyetheretherketone cages versus a titanium cage of similar design for anterior lumbar interbody fusion

“…Shah [33] recently reported on the need for high-quality thin-slice computed tomography to evaluate interbody fusion through titanium cages. Cages made of radiolucent biomaterials [2,3,6] may facilitate fusion assessment in lumbar interbody fusion, although there may be persistent need of computed tomography [32]. The in vitro stabilising effect of polyetheretherketone cages versus a titanium cage of similar design for anterior lumbar interbody fusion Abstract This biomechanical study was performed to test the primary segmental in vitro stabilising effect of a standard and large footprint radiolucent poly-ether-ether-ketone (PEEK) box cage versus a titanium box cage for anterior lumbar interbody fusion.…”