Lumbar Interbody Cages

Abstract

Interbody cage devices, used to assist interbody fusion, are rapidly gaining popularity in the surgical management of chronic low back pain. This update provides a structural classification of commonly used devices and assesses them against a set of clearly defined surgical goals, including ability to correct the existing mechanical deformation, ability to provide mechanical stability, ability to provide a suitable environment for arthrodesis, and ability to limit "built-in" morbidity. In addition, the materials used in the devices are examined regarding their biomechanical, biologic, and radiographic characteristics.

The interobserver-validated relevance of intervertebral spacer materials in MRI artifacting

“…Of all intervertebral spacers we examined, the UCC scored the highest in comparison to the human bone control. This is in line with recent publications [1,20] that showed that carbon produced a very low rate of artifact reactions. In this connection, the limited distinguishability of the implant-bone contact area was negligible.…”

Bioresorbable polymers: heading for a new generation of spinal cages

“…Since Bagby's [7] initial experiences with a stainless steel basket in cervical spinal fusions, there has been a rapid evolution in the technology of interbody fusion cages, using various designs and materials [73,111]. Metal and titanium cages devices provide adequate mechanical stability and withstand loading with ease; however, a major disadvantage of these cages is that their modulus of elasticity is much higher as compared to vertebral bone tissue, leading to stress shielding within the cage [53,105].…”

Surgical Interbody Research Group–radiographic assessment of interbody fusion devices: fusion criteria for anterior lumbar interbody surgery

“…No uniform methods or criteria for determining fusion after lumbar interbody fusion have been established. 7,24 Interbody fusion is assessed by various imaging modalities; however, no single study or technique has been identified as being definitive in establishing the presence of fusion or pseudarthrosis after surgery. 23 The most commonly used methods of assessing fusion are the interpretation of plain radiographs, dynamic radiographs, Tc bone scans, biplanar tomographs, axial CT scans, and MR images.…”