Application of New Allogeneic Lumbar Fusion Cage (Biocage) in Single-Segment Lumbar Degenerative Disease: A Prospective Controlled Study with Follow-Up for ≥2 Years

2019 ◽  
Vol 126 ◽  
pp. e1309-e1314
Author(s):  
Wen-jie Wu ◽  
Yang Li ◽  
Tian-yong Hou ◽  
Peng Cheng ◽  
Ze-hua Zhang ◽  
...  
Keyword(s):  
Lumbar Fusion ◽  
Degenerative Disease ◽  
Controlled Study ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Fusion Cage ◽  
Prospective Controlled Study

scholarly journals Efficacy of Biocage in treating single-segment lumbar degenerative disease in patients with high risk of non-fusion: a prospective controlled study with at least 2 years’ follow-up

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052094550
Author(s):  
Yang Li ◽  
Yang Yu ◽  
Tian-yong Hou ◽  
Ze-hua Zhang ◽  
Jun-chao Xing ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Efficacy ◽  
Fusion Rate ◽  
Degenerative Disease ◽  
Controlled Study ◽  
Allogeneic Bone ◽  
Intervertebral Foramen ◽  
Lumbar Degenerative Disease ◽  
Single Segment

Objective To evaluate the clinical efficacy of an allogeneic bone cage (Biocage; Beijing Datsing Bio-Tech Co., Ltd., Beijing, China) for treatment of single-segment lumbar degenerative disease in patients with a high risk of non-fusion. Methods From January 2013 to December 2016, 67 patients who underwent lumbar fusion were divided into the Biocage group (n = 33) and polyether ether ketone (PEEK) group (n = 34). The patients were followed up for 24 to 48 months. The mean intervertebral height of the fusion level, fusion rate, height of the intervertebral foramen, visual analog scale score, and Oswestry disability index were compared. Results The PEEK group had a lower fusion rate than the Biocage group (88.24% vs. 90.91%), although the difference was not statistically significant. During follow-up, the height of the intervertebral space was similar between the Biocage and PEEK groups (12.88 ± 0.45 and 12.84 ± 1.01 mm, respectively). The height of the intervertebral foramen was larger in the Biocage than PEEK group (20.67 ± 1.34 vs. 20.00 ± 2.05 mm). Good clinical efficacy was achieved in both groups. Conclusion The Biocage is efficient and safe for treatment of single-segment lumbar degenerative disease in patients with a high risk of non-fusion.

Two-year follow-up results of the Isobar TTL Semi-Rigid Rod System for the treatment of lumbar degenerative disease

2013 ◽  
Vol 20 (3) ◽  
pp. 394-399 ◽  
Author(s):  
Zhonghai Li ◽  
Fengning Li ◽  
Shunzhi Yu ◽  
Hui Ma ◽  
Zhaohui Chen ◽  
...  
Keyword(s):  
Degenerative Disease ◽  
Lumbar Degenerative Disease ◽  
Rod System ◽  
Rigid Rod

Distraction of facets with intraarticular spacers as treatment for lumbar canal stenosis: report on a preliminary experience with 21 cases

2013 ◽  
Vol 19 (6) ◽  
pp. 672-677 ◽  
Author(s):  
Atul Goel ◽  
Abhidha Shah ◽  
Madan Jadhav ◽  
Santhosh Nama
Keyword(s):  
Root Canal ◽  
Spinal Canal ◽  
Joint Space ◽  
Degenerative Disease ◽  
Spinal Segment ◽  
Lumbar Degenerative Disease ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Before And After

Object The authors report their experience in treating 21 patients by using a novel form of treatment of lumbar degenerative disease that leads to canal stenosis. The surgery involved distraction of the facets using specially designed Goel intraarticular spacers and was aimed at arthrodesis of the spinal segment in a distracted position. The operation is based on the premise that subtle and longstanding facet instability, joint space reduction, and subsequent facet override had a profound and primary influence in the pathogenesis of degenerative lumbar canal stenosis. The surgical technique and the rationale for treatment are discussed. Methods Between April 2006 and January 2011, 21 cases of lumbar degenerative disease resulting in characteristic lumbar canal stenosis were treated in the authors' department with the proposed technique. The patients were prospectively analyzed. There were 15 men and 6 women who ranged in age from 48 to 71 years (mean 58 years). Nine patients underwent 1-level and 12 patients underwent 2-level treatment. Surgery involved wide opening of the articular joint, denuding of the articular capsule/endplate cartilage, distraction of the facets, and forced impaction of Goel intraarticular spacers. Bone graft pieces obtained by sectioning the spinous processes were placed within and over the joint and in the midline over the adequately prepared host area of laminae. The Oswestry Disability Index and visual analog scale were used to clinically assess the patients before and after surgery and at follow-up. The alterations in the physical architecture of spinal canal and intervertebral foramen dimensions were evaluated before and after placement of the intrafacet implant and after at least 6 months of follow-up. Results All patients had varying degrees of relief from symptoms of local back pain and radiculopathy. Impaction of spacers within the facet joints resulted in an increase in the spinal canal and intervertebral root canal dimensions (mean 2.33 mm), reduction of buckling of the ligamentum flavum, and reduction of the extent of bulge of the disc into the spinal canal. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. No patient worsened neurologically after treatment. During the follow-up period, all patients had evidence of segmental bone fusion. No patient underwent reexploration or further surgery of the lumbar spine. Conclusions Impaction of the spacers within the articular cavity after facet distraction resulted in reversal of several effects of spine degeneration that had caused spinal and root canal stenosis. The safe, firm, and secure stabilization at the fulcrum of lumbar spinal movements provided a ground for segmental spinal arthrodesis. The immediate postoperative and lasting recovery from symptoms suggests the validity of the procedure.

Preliminary Experience with a Novel System of Facet Fixation to Treat Patients with Lumbar Degenerative Disease. A New Perspective in Minimally Invasive Spine Surgery?

2017 ◽  
Vol 79 (04) ◽  
pp. 296-301 ◽  
Author(s):  
Natale Francaviglia ◽  
Gabriele Costantino ◽  
Alessandro Villa ◽  
Domenico Iacopino ◽  
Maria Pappalardo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Degenerative Spondylolisthesis ◽  
Degenerative Disease ◽  
Posterior Fixation ◽  
Adjacent Segment ◽  
Foraminal Stenosis ◽  
Lumbar Degenerative Disease ◽  
Black Disk ◽  
Clinical Series

Purpose We report our experience with a novel surgical device for the treatment of lumbar degenerative microinstability. Facet Wedge (DePuy Synthes, Raynham, Massachusetts, United States) is a novel technique of intra-articular lumbar facet fixation that provides a minimally invasive alternative to standard posterior fixation. Materials and Methods From November 2014 to July 2015, 38 patients underwent single-level Facet Wedge implantation. The main surgical indications included herniated disk (18 patients), spinal canal and foraminal stenosis (14 patients), and Meyerding grade I degenerative spondylolisthesis (6 patients). All the patients showed radiologic signs of microinstability: hyperintensity in both facet joints (facet fluid signal) in T2-weighted magnetic resonance imaging and a black disk as a sign of degenerative disease. No slippage was evident at dynamic radiograph. After a period of conservative treatment (minimum of 6 months), surgery was performed. All patients' follow-up lasted over at least 12 months. Results The low back visual analog scale score decreased significantly after surgery (from an average of 8.2 to 3.1 at final follow-up). Postoperatively, the Oswestry Disability Index showed a significant reduction (14.7 on average). No slippage or signs of adjacent segment degeneration was detected in neuroimaging follow-up. Conclusion Facet Wedge allows facet fixation in lumbar degenerative microinstability. To the best of our knowledge, this is the first clinical series reported in the literature on this novel device.

scholarly journals Clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease: a retrospective study

2019 ◽  
Author(s):  
zhisheng ji ◽  
Zhi-Sheng Ji ◽  
Hua Yang ◽  
Yu-Hao Yang ◽  
Shao-Jin Li ◽  
...  
Keyword(s):  
Clinical Effect ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Intervertebral Space ◽  
Lumbar Degenerative Disease ◽  
Effect Analysis ◽  
Radiographic Outcomes ◽  
Adjacent Segments ◽  
Rigid Group

Abstract Background: Non-fusion fixation is an effective way to treat lumbar degeneration. The present study evaluated the clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease. Method: Forty-one patients with two-segmental lumbar degenerative disease who underwent surgical treatment by Isobar TTL dynamic stabilization system (n=20) and rigid system (n=21) from January 2013 to June 2017. The mean follow-up period was 23.6 (range 15–37) months. Clinical outcomes were evaluated by oswestry dysfunction index (ODI), visual analogue score (VAS) and modified Macnab. Radiographic evaluations included the height of intervertebral space and range of motion (ROM) of the operative segments and proximal adjacent segment. The intervertebral disc signal change was classified by the modified Pfirrmann grade and University of California at Los Angeles (UCLA) system. Results: The clinical outcomes including the ODI and VAS were significantly improved in two groups after operation, but the difference between two groups was not significant. In addition, the clinical efficacy of modified Macnab in two groups was similar too. Radiologic outcomes include height of intervertebral space, lumbar mobility and intervertebral disc signal. The height of intervertebral space of upper adjacent segments of L2/3 in the rigid group were significantly lower than those in the Isobar TTL group at the last follow-up. Furthermore, the number of fixed segment ROM of L3/4 in Isobar TTL group was significantly lower than pre-operation, suggesting that fixed segment ROMs in Isobar TTL group were limited. And, the ROM of upper adjacent segments of L2/3 in the last follow-up of rigid group increased significantly, while the ROM of L2/3 in Isobar TTL group haven’t changed after operation. At last, the incidence of adjacent segment degeneration was significantly greater in the rigid group than the Isobar TTL group according to modified Pfirrmann grading system and the UCLA system. Conclusion: Isobar TTL system could get a good clinical effect for treatment of two-segmental lumbar degenerative disease. Compared with rigid fixation, Isobar TTL system can get better radiographic outcomes and maintain the mobility of the stabilized segments with less influence on the proximal adjacent segment.

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