The in vitro stabilising effect of polyetheretherketone cages versus a titanium cage of similar design for anterior lumbar interbody fusion

Object The aim of this study was to determine the in vitro biomechanical responses of lumbar spinal segments after implantation of tapered cages. Methods Range of motion (ROM)– and stiffness-related data were determined in 10 human cadaveric T12–S1 columns subjected to flexion, extension, and lateral bending modes before and after anterior lumbar interbody fusion in which stand-alone LT-CAGE devices were used. The overall column showed no significant changes in ROM or stiffness. At the instrumented level, stiffness increased significantly (p < 0.05) in flexion and lateral bending modes. Indications of instability in extension were present, but these values were not statistically significant. There was no evidence of adjacent-level instability at any level in any mode, except for the segment superior to the fixation level in flexion; here there was a significant increase in ROM (p < 0.05) and a decrease in stiffness. Conclusions The anatomical conformity and bilateral placement of cages provide ample stability and rigidity at the treated level, comparable to that of other cage systems. Because hypermobility is traditionally related to early degenerative changes, the present results appear to suggest that cages do not significantly contribute to such alterations.

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In Vitro, Biomechanical Comparison of an Anterior Lumbar Interbody Fusion with an Anteriorly Placed, Low-Profile Lumbar Plate and Posteriorly Placed Pedicle Screws or Translaminar Screws

Spine ◽

10.1097/01.brs.0000174275.95104.12 ◽

2005 ◽

Vol 30 (16) ◽

pp. 1846-1851 ◽

Cited By ~ 58

Author(s):

Brian P. Beaubien ◽

Alihan Derincek ◽

William D. Lew ◽

Kirkham B. Wood

Keyword(s):

Interbody Fusion ◽

Pedicle Screws ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Low Profile ◽

Translaminar Screws ◽

Biomechanical Comparison

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Revision of transforaminal lumbar interbody fusion using anterior lumbar interbody fusion: a biomechanical study in nonosteoporotic bone

Journal of Neurosurgery Spine ◽

10.3171/2009.7.spine0921 ◽

2010 ◽

Vol 12 (1) ◽

pp. 82-87 ◽

Cited By ~ 5

Author(s):

Avraam Ploumis ◽

Chunhui Wu ◽

Amir Mehbod ◽

Gustav Fischer ◽

Antonio Faundez ◽

...

Keyword(s):

Interbody Fusion ◽

Posterior Instrumentation ◽

Transforaminal Lumbar Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Posterior Fixation ◽

Lumbar Interbody Fusion ◽

Mineral Density ◽

Normal Bone Mineral Density ◽

Flexion Extension

Object Transforaminal lumbar interbody fusion (TLIF) is a popular fusion technique for treating chronic low-back pain. In cases of interbody nonfusion, revision techniques for TLIF include anterior lumbar interbody fusion (ALIF) approaches. Biomechanical data of the revision techniques are not available. The purpose of this study was to compare the immediate construct stability, in terms of range of motion (ROM) and neutral zone (NZ), of a revision ALIF procedure for an unsuccessful TLIF. An in vitro biomechanical comparison of TLIF and its ALIF revision procedure was conducted on cadaveric nonosteoporotic human spine segments. Methods Twelve cadaveric lumbar motion segments with normal bone mineral density were loaded in unconstrained axial torsion, lateral bending, and flexion-extension under 0.05 Hz and ± 6-nm sinusoidal waveform. The specimens underwent TLIF (with posterior pedicle fixation) and anterior ALIF (with intact posterior fixation). Multidirectional flexibility testing was conducted following each step. The ROM and NZ data were measured and calculated for each test. Results Globally, the TLIF and revision ALIF procedures significantly reduced ROM and NZ compared with that of the intact condition. The revision ALIF procedures achieved similar ROM as the TLIF procedure. Conclusions Revision ALIF maintained biomechanical stability of TLIF in nonosteoporotic spines. Revision ALIF can be performed without sacrificing spinal stability in cases of intact posterior instrumentation.

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In Vitro Stability of FRA Spacers With Integrated Crossed Screws for Anterior Lumbar Interbody Fusion

Spine ◽

10.1097/00007632-200205010-00007 ◽

2002 ◽

Vol 27 (9) ◽

pp. 923-928 ◽

Cited By ~ 21

Author(s):

Ranjith R. Kuzhupilly ◽

Isador H. Lieberman ◽

Robert F. McLain ◽

Antonio Valdevit ◽

Helen Kambic ◽

...

Keyword(s):

Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

In Vitro Stability

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In vitro fixator rod loading after transforaminal compared to anterior lumbar interbody fusion

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2005.12.005 ◽

2006 ◽

Vol 21 (5) ◽

pp. 435-442 ◽

Cited By ~ 12

Author(s):

A. Kettler ◽

T. Niemeyer ◽

L. Issler ◽

U. Merk ◽

M. Mahalingam ◽

...

Keyword(s):

Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion

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Kinematic efficacy of supplemental anterior lumbar interbody fusion at lumbosacral levels in thoracolumbosacral deformity correction with and without pedicle subtraction osteotomy at L3: an in vitro cadaveric study

European Spine Journal ◽

10.1007/s00586-017-5222-4 ◽

2017 ◽

Vol 26 (11) ◽

pp. 2773-2781 ◽

Cited By ~ 11

Author(s):

Benny T. Dahl ◽

Jonathan A. Harris ◽

Manasa Gudipally ◽

Mark Moldavsky ◽

Saif Khalil ◽

...

Keyword(s):

Interbody Fusion ◽

Deformity Correction ◽

Pedicle Subtraction Osteotomy ◽

Anterior Lumbar Interbody Fusion ◽

Cadaveric Study ◽

Lumbar Interbody Fusion

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In vitro biomechanical comparison of an anterior and anterolateral lumbar plate with posterior fixation following single-level anterior lumbar interbody fusion

Journal of Neurosurgery Spine ◽

10.3171/spi-07/09/332 ◽

2007 ◽

Vol 7 (3) ◽

pp. 332-335 ◽

Cited By ~ 11

Author(s):

Wesley M. Johnson ◽

Tann A. Nichols ◽

Deepika Jethwani ◽

Bernard H. Guiot

Keyword(s):

Interbody Fusion ◽

Plate Fixation ◽

Anterior Lumbar Interbody Fusion ◽

Posterior Fixation ◽

Lumbar Interbody Fusion ◽

Lateral Bending ◽

Anterior Plate ◽

Axial Torsion ◽

Flexion Extension

Object Anterior lumbar interbody fusion (ALIF) is often supplemented with instrumentation to increase stability in the spine. If anterior plate fixation provided the same stability as posterior pedicle screw fixation (PSF), then a second approach and its associated morbidity could be avoided. Methods Seven human cadaveric L4–5 spinal segments were tested under three conditions: ALIF with an anterior plate, ALIF with an anterolateral plate, and ALIF supplemented by PSF. Range of motion (ROM) was calculated for flexion/extension, lateral bending, and axial torsion and compared among the three configurations. Results There were no significant differences in ROM during flexion/extension, lateral bending, or axial torsion among any of the three instrumentation configurations. Conclusions The addition of an anterior plate or posterior PS/rod instrumentation following ALIF provides substantially equivalent biomechanical stability. Additionally, the position of the plate system, either anterior or anterolateral, does not significantly affect the stability gained.

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