Evaluation of Lumbar Spine Fusion

Kant, Andrew; Daum, Wayne J.; Dean, Susan; Uchida, Tatsuo

doi:10.1097/00007632-199511000-00009

Cited by 165 publications

(14 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, due to the harmful effects of radiation exposure, CT is not currently used as a routine method for fusion-status evaluation in our hospital. Although plain radiography is not the best method for assessing the fusion status [11], plain radiographs, accompanied by those in the flexion and extension bending views, are commonly used for this purpose because they are relatively inexpensive and easy to Patients who underwent revision surgery were excluded. Open boxes, union group (n = 30); filled boxes, nonunion group (n = 10).…”

Section: Discussionmentioning

confidence: 99%

Union versus nonunion after posterolateral lumbar fusion: a comparison of long-term surgical outcomes in patients with degenerative lumbar spondylolisthesis

et al. 2008

View full text Add to dashboard Cite

It has been reported that in patients undergoing posterolateral lumbar fusion (PLF), the fusion status is not related to the short-term operative results. To determine whether the fusion status influences the long-term operative results of PLF, we retrospectively examined the surgical outcomes of uninstrumented PLF for a minimum of 8 years (average, 9.5 years), by comparing cases exhibiting union with those exhibiting nonunion. Uninstrumented PLF was performed for the treatment of lumbar canal stenosis (LCS) with degenerative spondylolisthesis. Since nine patients were lost to final follow-up, the study included 42 patients, and the follow-up rate was 82.4%. The mean age of the patients was 64.1 years (range 46-77 years). Eight patients exhibited fusion at the L3-4 level and 34 patients, at the L4-5 level. The fusion status was assessed using plain radiographs. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scores. Nonunion was noted in 26% (11/42) of the patients. There were no statistically significant differences between the groups exhibiting union and nonunion with respect to age, sex, preoperative JOA score, or preoperative lumbar instability. The union group achieved better operative results than the nonunion group at the 5-year and final follow-up (P = 0.006 and 0.008, respectively) although there was no significant difference in the percent recovery at 1 and 3-year follow-up (P = 0.515 and 0.506, respectively). A stepwise regression analysis revealed that the best combination of predictors for percent recovery at the time of final follow-up included the fusion status and the presence of comorbid disease. The results indicate that the fusion status following PLF is a critical factor influencing the long-term but not short-term operative results in the treatment of LCS with degenerative spondylolisthesis.

show abstract

Section: Discussionmentioning

confidence: 99%

Union versus nonunion after posterolateral lumbar fusion: a comparison of long-term surgical outcomes in patients with degenerative lumbar spondylolisthesis

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Pseudarthrosis can be further graded by the Lenke classification, in the case of posterolateral fusions [42] , or by the Brantigan, Steffee, Fraser classification, in cases where PLIF cages are used [43] . Radiography however is dreadfully unreliable in detecting non-union (its accuracy ranges from 82%-68% [44,45] ) when compared to surgical exploration. Flexion-extension views may be helpful in detecting instability in the fused segments, although their value in the lumbar spine has been questioned [46,47] .…”

Section: Pseudarthrosis (Non-union)mentioning

confidence: 99%

“…In the symptomatic patient who shows evidence of pseudoarthrosis later on, revision surgery is warranted. It has been shown that pseudoarthrosis repair can lead to improved clinical results [39,44] , although this revision surgery carries a significant risk of recurrent non-union and a persistently poor outcome [39,40,51] . When surgically treat- ing pseudarthrosis, it is important to remember that better graft material than that used in the index procedure should be used in an optimized environment.…”

Section: Pseudarthrosis (Non-union)mentioning

confidence: 99%

Common surgical complications in degenerative spinal surgery

Papadakis¹

2013

WJO

View full text Add to dashboard Cite

The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive surgery to the reduction of complication rate. In this paper the most common surgical complications in degenerative spinal surgery are outlined and discussed.

show abstract

“…Furthermore, metallic spinal implants are strongly radiopaque on roentgenograms, which is the most widely used follow-up imaging after spinal surgery [112] (see Figure 3). This results in an obscured view and therefore hampered assessment of fusion, since the presence of a bony bridge throughout the spinal implant can not be seen [112,113,114,115]. Not only do metals/alloys interfere with simple x-ray films, they will therefore also interfere with computer axial tomography scanning (CAT) and cause artefacts (scattering) with magnetic resonance imaging (MRI) [100] In contrast, the presence of a bony bridge on a plain roentgenogram in radiolucent spinal implants can be visualized and does correlate with surgical exploration, considered the gold standard [116].…”

Section: Biofunctionalitymentioning

confidence: 99%

Biodegradable Polymers in Bone Tissue Engineering

et al. 2009

View full text Add to dashboard Cite

The use of degradable polymers in medicine largely started around the mid 20th century with their initial use as in vivo resorbing sutures. Thorough knowledge on this topic as been gained since then and the potential applications for these polymers were, and still are, rapidly expanding. After improving the properties of lactic acid-based polymers, these were no longer studied only from a scientific point of view, but also for their use in bone surgery in the 1990s. Unfortunately, after implanting these polymers, different foreign body reactions ranging from the presence of white blood cells to sterile sinuses with resorption of the original tissue were observed. This led to the misconception that degradable polymers would, in all cases, lead to inflammation and/or osteolysis at the implantation site. Nowadays, we have accumulated substantial knowledge on the issue of biocompatibility of biodegradable polymers and are able to tailor these polymers for specific applications and thereby strongly reduce the occurrence of adverse tissue reactions. However, the major issue of biofunctionality, when mechanical adaptation is taken into account, has hitherto been largely unrecognized. A thorough understanding of how to improve the biofunctionality, comprising biomechanical stability, but also visualization and sterilization of the material, together with the avoidance of fibrotic tissue formation and foreign body reactions, may greatly enhance the applicability and safety of degradable polymers in a wide area of tissue engineering applications. This review will address our current understanding of these biofunctionality factors, and will subsequently discuss the pitfalls remaining and potential solutions to solve these problems.

show abstract

Evaluation of Lumbar Spine Fusion

Cited by 165 publications

References 0 publications

Union versus nonunion after posterolateral lumbar fusion: a comparison of long-term surgical outcomes in patients with degenerative lumbar spondylolisthesis

Union versus nonunion after posterolateral lumbar fusion: a comparison of long-term surgical outcomes in patients with degenerative lumbar spondylolisthesis

Common surgical complications in degenerative spinal surgery

Biodegradable Polymers in Bone Tissue Engineering

Contact Info

Product

Resources

About