Containment and Stabilization of Bone Graft in Anterior Lumbar Interbody Fusion: The Role of the Hartshill Horseshoe Cage

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

“…The fusion rate in the ALIF group cannot be conclusively proven. Anterior interbody fusion rates vary between 19% and 96%, depending on the method of evaluation, fixation technique, and graft material [4,13,15,18,20,22,26,28,30,33,38,42,47,51]. However, radiological trabecular continuity is difficult to see with the titanium implant, making it difficult to assess how many patients with a satisfactory clinical outcome do not have a bony fusion.…”

“…Corticocancellous bonegrafts were used in many of these reported techniques, to achieve anterior fusion [25,30,39]. Postoperative problems like height loss, graft collapse and pseudarthrosis led to the development of carbon-fibre cages [1,52], and titanium rings [26,33] filled with cancellous grafts. The Hartshill horseshoe cage in this study achieves immediate stabilisation, and the screws in the superior and inferior vertebral bodies provide rigid fixation.…”

“…Flynn and Hoque [13], Stauffer and Coventry [47], and Newman and Grinstead [38] have reported complications of graft extrusion, compression and instability contributing to pseudarthrosis associated with ALIF without instrumentation. The Hartshill horseshoe cage was designed to overcome these problems [33]. It is a horseshoe-shape cage made of titanium that is inserted after removal of the disc in ALIF.…”

Anterior lumbar interbody fusion: Does stable anterior fixation matter?

“…Fusion rates in the literature on anterior interbody fusion vary between 19 and 96%, depending on the fixation technique, the bone graft used, and the method of fusion evaluation [2,7,9,12,13,15,18,19,21,22,24,27,29,32]. Corticocancellous bone grafts were used in many of these reported techniques to achieve anterior fusion [17,21,25].…”

“…Flynn and Hoque [7], Stauffer and Coventry [29], and Newman and Grinstead [24] have reported complications of graft extrusion, compression and instability contributing to pseudarthrosis associated with interbody graft without rigid fixation. The Hartshill Horseshoe cage was designed to overcome these problems [22].It is a horseshoeshape cage made of titanium that is inserted after removal of the disc in anterior lumbar interbody fusion. Tricortical iliac crest graft is inserted within the confines of the implant.…”