Outcome of the Graf ligamentoplasty procedure compared with anterior lumbar interbody fusion with the Hartshill horseshoe cage

Madan, Sanjeev; Boeree, N. R.

doi:10.1007/s00586-002-0488-5

Cited by 36 publications

(7 citation statements)

References 27 publications

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“…Rigby et al also found discouraging outcomes with Graf ligaments, and concluded that inferior results could be attributed to permanent stretching of Dacron fibers over time that may have inadvertently compromised the stability of instrumented segments . By contrast, a prospective randomized study comparing Graf ligamentoplasty with anterior lumbar interbody fusion (ALIF) found that 93% patients in the Graf group had significant improvement in Oswestry disability index (ODI) scores compared to 77.8% in the ALIF group at a mean FuP of 30 months . Another study comparing Graf procedure, rigid plate fixation and spinal fusion without fixation, found a significant improvement in low back outcome scale (LBOS) scores in the Graf group compared with the other two, even with a high percentage (58% in Graf) of compensable patients .…”

Section: Graf Artificial Ligament Stabilizationmentioning

confidence: 97%

Pedicle screw‐based posterior dynamic stabilizers for degenerative spine: In vitro biomechanical testing and clinical outcomes

Chamoli

Diwan

Tsafnat

2013

J Biomedical Materials Res

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Dynamic stabilization in a degenerate symptomatic spine may be advantageous compared with conventional fusion procedures, as it helps preserve motion and minimizes redistribution of loads at instrumented and adjacent segments. This article presents a systematic review of biomechanical and clinical evidence available on some of the pedicle screw based posterior dynamic stabilization (PDS) devices. Using Medline, Embase, and Scopus online databases, we identified four pedicle-screw-PDS devices for which both, biomechanical testing and clinical follow-up data are available: Graf artificial ligaments, Isobar TTL, Polyetheretherketone rods, and Dynesys. The current state-of-the-art of pedicle-screw-PDS devices is far from achieving its desired biomechanical efficacy, which has resulted in a weak support for the posited clinical benefits. Although pedicle-screw-PDS devices are useful in salvaging a moderately degenerate functionally suboptimal disc, for severe disc degeneration cases fusion is still the preferred choice. We conclude that a pedicle-screw-PDS device should aim at restoring load sharing amongst spinal elements while preserving the qualitative and quantitative nature of spinal motion, especially minimize posterior shift of the helical axis of motion. More precise and objective assessment techniques need to be standardized for in vivo evaluation of intervertebral motion and load sharing amongst spinal elements across different pedicle-screw-PDS devices.

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Section: Graf Artificial Ligament Stabilizationmentioning

confidence: 97%

Pedicle screw‐based posterior dynamic stabilizers for degenerative spine: In vitro biomechanical testing and clinical outcomes

Chamoli

Diwan

Tsafnat

2013

J Biomedical Materials Res

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“…It was designed to limit flexion and less so extension of a specific spinal segment by locking the facet joints. Results from early studies were very promising with one paper showing Graf ligament stabilisation resulting in a higher satisfaction rate (93%) when compared to traditional fusion (78%) [ 22 ]. However, on a longer follow-up, the use of the Graf ligament was found to be associated with high revision rates with up to 41% of patients stating they would not have the operation again [ 23 24 ].…”

Section: Surgical Options For Back Painmentioning

confidence: 99%

Low Back Pain: Current Surgical Approaches

2015

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Low back pain (LBP) is a worldwide phenomenon. The UK studies place LBP as the largest single cause of absence from work; up to 80% of the population will experience LBP at least once in their lifetime. Most individuals do not seek medical care and are not disabled by their pain once it is managed by nonoperative measures. However, around 10% of patients go on to develop chronic pain. This review outlines the basics of the traditional approach to spinal surgery for chronic LBP secondary to osteoarthritis of the lumbar spine as well as explains the novel concepts and terminology of back pain surgery. Traditionally, the stepwise approach to surgery starts with local anaesthetic and steroid injection followed by spinal fusion. Fusion aims to alleviate pain by preventing movement between affected spinal segments; this commonly involves open surgery, which requires large soft tissue dissection and there is a possibility of blood loss and prolonged recovery time. Established minimally invasive spine surgery techniques (MISS) aim to reduce all of these complications and they include laparoscopic anterior lumbar interbody fusion and MISS posterior instrumentation with pedicle screws and rods. Newer MISS techniques include extreme lateral interbody fusion and axial interbody fusion. The main problem of fusion is the disruption of the biomechanics of the rest of the spine; leading to adjacent level disease. Theoretically, this can be prevented by performing motion-preserving surgeries such as total disc replacement, facet arthroplasty, and non fusion stabilisation. We outline the basic concepts of the procedures mentioned above as well as explore some of the novel surgical therapies available for chronic LBP.

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“…Clinical reports of its use have been published with mixed results. 37 – 39 Some of the variation may be from variability of indications. However, device-related complications are not uncommon.…”

Section: Categorizing Current Lumbar Motion-preserving Devicesmentioning

confidence: 99%

Motion-preserving technologies for degenerative lumbar spine: The past, present, and future horizons

Serhan¹,

Mhatre²,

Defossez³

et al. 2011

SAS Journal

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Over the past few decades, remarkable advancements in the understanding of the origin of low-back pain and lumbar spinal disorders have been achieved. Spinal fusion is generally considered the “gold standard” in the treatment of low-back pain; however, fusion is also associated with accelerated degeneration of adjacent levels. Spinal arthroplasty and dynamic stabilization technologies, as well as the continuous improvement in diagnosis and surgical interventions, have opened a new era of treatment options. Recent advancements in nonfusion technologies such as motion-preservation devices and posterior dynamic stabilization may change the gold standard. These devices are designed with the intent to provide stabilization and eliminate pain while preserving motion of the functional spinal unit. The adaption of nonfusion technologies by the surgical community and payers for the treatment of degenerative spinal conditions will depend on the long-term clinical outcome of controlled randomized clinical studies. Although the development of nonfusion technology has just started and the adoption is very slow, it may be considered a viable option for motion preservation in coming years. This review article provides technical and surgical views from the past and from the present, as well as a glance at the future endeavors and challenges in instrumentation development for lumbar spinal disorders.© 2011 SAS - The International Society for the Advancement of Spine Surgery. Published by Elsevier Inc. All rights reserved.

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Outcome of the Graf ligamentoplasty procedure compared with anterior lumbar interbody fusion with the Hartshill horseshoe cage

Cited by 36 publications

References 27 publications

Pedicle screw‐based posterior dynamic stabilizers for degenerative spine: In vitro biomechanical testing and clinical outcomes

Pedicle screw‐based posterior dynamic stabilizers for degenerative spine: In vitro biomechanical testing and clinical outcomes

Low Back Pain: Current Surgical Approaches

Motion-preserving technologies for degenerative lumbar spine: The past, present, and future horizons

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