Radiological evaluation of anterior lumbar fusion using PEEK cages with adjacent vertebral autograft in spinal deformity long fusion surgeries

详细信息    查看全文

• 作者：Jianqiang Ni ; Yanping Zheng ; Ning Liu ; Xin Wang ; Xiutong Fang…
• 关键词：Adult spine deformity ; PEEK cage ; Local vertebral autograft ; Cage migration
• 刊名：European Spine Journal
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：24
• 期：4
• 页码：791-799
• 全文大小：787 KB
• 参考文献：1. Flynn, JC, Hoque, MA (1979) Anterior fusion of the lumbar spine. End-result study with long-term follow-up. J Bone Joint Surg Am 61: pp. 1143-1150
  2. Burkus, JK (2002) Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages. J Spinal Disord Tech 15: pp. 337-349 CrossRef
  3. Stauffer, RN, Coventry, MB (1972) Anterior interbody lumbar spine fusion. Analysis of Mayo Clinic series. J Bone Joint Surg Am 54: pp. 756-768
  4. Bradford, DS, Tay, BK, Hu, SS (1999) Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976) 24: pp. 2617-2629 CrossRef
  5. Bridwell, KH, Lenke, LG, McEnery, KW (1995) Anterior fresh frozen structural allografts in the thoracic and lumbar spine. Do they work if combined with posterior fusion and instrumentation in adult patients with kyphosis or anterior column defects?. Spine (Phila Pa 1976) 20: pp. 1410-1418
  6. Kleinstueck, FS, Hu, SS, Bradford, DS (2002) Use of allograft femoral rings for spinal deformity in adults. Clin Orthop Relat Res 394: pp. 84-91 CrossRef
  7. Kuzhupilly, RR, Lieberman, IH, McLain, RF (2002) In vitro stability of FRA spacers with integrated crossed screws for anterior lumbar interbody fusion. Spine (Phila Pa 1976) 27: pp. 923-928 CrossRef
  8. Cain, CM, Schleicher, P, Gerlach, R, Pflugmacher, R, Scholz, M, Kandziora, F (2005) A new stand-alone anterior lumbar interbody fusion device: biomechanical comparison with established fixation techniques. Spine 30: pp. 2631-2636 CrossRef
  9. Schimmel, JJ (2012) PEEK cages in lumbar fusion: midterm clinical outcome and radiological fusion. J Spinal Disord Tech.
  10. Galbusera, F, Schmidt, H, Wilke, H-J (2012) Lumbar interbody fusion: a parametric investigation of a novel cage design with and without posterior instrumentation. Eur Spine J 21: pp. 455-462 CrossRef
  11. Blumenthal, SL, Gill, K (1993) Can lumbar spine radiographs accurately determine fusion in postoperative patients? Correlation of routine radiographs with a second surgical look at lumbar fusions. Spine (Phila Pa 1976) 18: pp. 1186-1189 CrossRef
  12. McAfee, PC (2001) Symposium: a critical discrepancy-a criteria of successful arthrodesis following interbody spinal fusions. Spine (Phila Pa 1976) 26: pp. 320-334 CrossRef
  13. McAfee, PC, DeVine, JG, Chaput, CD (2005) The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine (Phila Pa 1976) 30: pp. S60-S65 CrossRef
  14. Cutler, AR, Siddiqui, S, Mohan, AL (2006) Comparison of polyetheretherketone cages with femoral cortical bone allograft as a single-piece interbody spacer in transforaminal lumbar interbody fusion. J Neurosurg Spine 5: pp. 534-539 CrossRef
  15. Crandall, DG, Revella, J (2009) Transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion as an adjunct to posterior instrumented correction of degenerative lumbar scoliosis: three year clinical and radiographic outcomes. Spine (Phila Pa 1976) 34: pp. 2126-2133 CrossRef
  16. Anand, N, Baron, EM, Thaiyananthan, G (2008) Minimally invasive multilevel percutaneous correction and fusion for adult lumbar degenerative scoliosis: a technique and feasibility study. J Spinal Disord Tech 21: pp. 459-467 CrossRef
  17. Strube, P (2012) Stand-alone anterior versus anteroposterior lumbar interbody single-level fusion after a mean follow-up of 41 months. J Spinal Di
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0932

文摘

Purpose The aim of this study was to evaluate the radiographic characteristics of polyetheretherketone (PEEK) cages packed with adjacent vertebral autograft material in lumbar anterior lumbar interbody fusion (ALIF) in spinal deformity long fusion surgeries. Methods This is a retrospective radiographic study. From April 2008 to April 2012, 40 patients (5 males and 35 females, mean age 67?±?9?years) with coronal and/or sagittal spine deformities underwent staged corrective surgery combined with lumbar ALIF using PEEK cages at the L3–L4, L4–L5 or L5–S1 segment with posterior long (? levels) instrumentation. The mean follow-up time was 27.5?months (13-9?months). We examined the interbody fusion rate and cage subsidence at 3?months postoperatively and final follow-up. Additionally, we evaluated the distance of cage migration at final follow-up and the improvement in lumbar lordosis. The rate of “collapse-of the adjacent vertebra where the autograft was harvested was assessed at the final follow-up. Finally, we examined the cage-related postoperative complications in this series. Results Solid interbody fusion was achieved in 96.4?% (81/84) of the levels at the final follow-up. A mild forward cage migration was observed, and the mean migration distance at final follow-up was 0.83?mm in L3/4, 0.36?mm in L4/5 and 0.55?mm in L5/S1. There was cage subsidence observed in 8.3?% (7/84) of the levels. In all patients, the PEEK cage maintained a significant increase in segmental lordosis at all postoperative visits. However, a mild reduction in segmental lordosis still occurred with time. The adjacent lumbar vertebral bodies where the autografts were harvested appeared to be intact in height radiologically at the final follow-up. There were no postoperative complications due to bone harvesting or cage insertion. Proximal junctional kyphosis was found in one patient who underwent a subsequent revision surgery. Conclusions The use of lumbar ALIF with PEEK cages and adjacent vertebral autografts in spinal deformity long fusion surgeries is an effective and safe procedure. The allograft filler is safe and effective in maintaining the shape of harvested vertebrae. Additional long-term follow-up studies are needed to further justify its use.