Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

Madan, Sanjeev; Boeree, N. R.

doi:10.1007/s00586-002-0516-5

Cited by 90 publications

(66 citation statements)

References 53 publications

(69 reference statements)

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“…Recently, the improved devices to enhance a stabilization effect for single anterior surgery have been introduced and promoted the fusion rate. Current reports of open ALIF surgery have stated 93-100% of fusion success rate, which would be comparable with other fusion procedures 4,[18][19][20]25) . However, the present study showed about 84-86% of fusion success rate, which was relatively inferior to other results previously reported.…”

supporting

confidence: 51%

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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supporting

confidence: 51%

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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“…Different procedures of lumbar fusion and different types of artificial disc may modify the comparing effect between the interventions, although no artificial disc is shown to be superior or inferior to the others [2]. Fusion method could result in different operative data and radiographic results, even if there is no significant difference in clinical and function results [15,23,33,44]. Due to these limitations, the combined results of this meta-analysis should be cautiously accepted.…”

Section: Discussionmentioning

confidence: 98%

A meta-analysis of artificial total disc replacement versus fusion for lumbar degenerative disc disease

Zhu

Han

et al. 2010

Eur Spine J

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Lumbar fusion has been developed for several decades and became the standard surgical treatment for symptomatic lumbar degenerative disc disease (DDD). Artificial total disc replacement (TDR), as an alternative for spinal arthrodesis, is becoming more commonly employed treating lumbar DDD. It is still uncertain whether TDR is more effective and safer than lumbar fusion. To systematically compare the effectiveness and safety of TDR to that of the fusion for the treatment of lumbar DDD, we performed a meta-analysis. Cochrane review methods were used to analyze all relevant randomized controlled trials published up to July 2009. Five relevant randomized controlled trials involving 837 patients were identified. Patients in TDR group have sightly better functioning and less back or leg pain without clinical significance, and significantly higher satisfaction status in TDR group compared with lumbar fusion group at the 2-year followup. But these outcomes are highly influenced by the study with BAK cage interbody fusion, the function/pain and patient satisfaction status are no longer significantly different between two groups after excluding this study. At 5 years, these outcomes are not significantly different between comparing groups. The complication and reoperation rate of two groups are similar both at 2 and at 5 years. In conclusion, TDR does not show significant superiority for the treatment of lumbar DDD compared with fusion. The benefits of motion preservation and the long-term complications are still unable to be concluded. More highquality RCTs with long-term follow-up are needed.

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“…Reported fusion rates vary between 92% and 100% [25][26][27][28]. There are few reports on circumferential fusion for tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Instrumented circumferential fusion for tuberculosis of the dorso-lumbar spine. A single or double stage procedure?

El-Sharkawi

Said

2011

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to present our experience in treating dorso-lumbar tuberculosis by one-stage posterior circumferential fusion and to compare this group with a historical group treated by anterior debridement followed by postero-lateral fusion and stabilization. Methods Between 2003 and 2008, 32 patients with active spinal tuberculosis were treated by one-stage posterior circumferential fusion and prospectively followed for a minimum of two years. Pain severity was measured using Visual Analogue Scale (VAS). Neurological assessment was done using the Frankel scale. The operative data, clinical, radiological, and functional outcomes were also compared to a similar group of 25 patients treated with anterior debridement and fusion, followed 10-14 days later by posterior stabilization and postero-lateral fusion. Results The mean operative time and duration of hospital stay were significantly longer in the two-stage group. The mean estimated blood loss was also larger, though insignificantly, in the two-stage group. The incidence of complications was significantly lower in the one-stage group. At final follow-up, all 34 patients with pre-operative neurological deficits showed at least one Frankel grade of neurological improvement, all 57 patients showed significant improvement of their VAS back pain score, the mean kyphotic angle has significantly improved, all patients achieved solid fusion and 43 (75.4%) patients returned to their pre-disease activity level or work. Conclusion Instrumented circumferential fusion, whether in one or two stages, is an effective treatment for dorso-lumbar tuberculosis. One-stage surgery, however, is advantageous because it has lower complication rate, shorter hospital stay, less operative time and blood loss.

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Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

Cited by 90 publications

References 53 publications

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

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

A meta-analysis of artificial total disc replacement versus fusion for lumbar degenerative disc disease

Instrumented circumferential fusion for tuberculosis of the dorso-lumbar spine. A single or double stage procedure?

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