Intraoperative Decrease in Amplitude of Somatosensory-Evoked Potentials of the Lower Extremities With Interbody Fusion Cage Placement During Lumbar Fusion Surgery

Spine ◽  
2012 ◽  
Vol 37 (20) ◽  
pp. E1290-E1295 ◽  
Author(s):  
Jan William Duncan ◽  
Richard Anthony Bailey ◽  
Rocio Baena
Keyword(s):  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Lower Extremities ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Design and Research of Interspinous Lumbar Non-Fusion Device

2010 ◽  
Author(s):  
Lei Li ◽  
Zhaohua Chang ◽  
Xuelian Gu ◽  
Chengli Song
Keyword(s):  
Stress Concentration ◽  
Vertebral Body ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Pedicle Screws ◽  
Adjacent Level ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Adjacent Level Degeneration ◽  
Interbody Fusion Cage

Objective: Long term clinical data showed that lumbar fusion for Lumbar spinal stenosis (LSS) and lumbar disc degeneration (LDD) therapy could change the loads of disc and articular facet and increase the motion of adjacent segments which lead to facet arthropathy and adjacent level degeneration. This study is to design and analyze an interspinous process device (IPD) that could prevent adjacent level degeneration in the LSS and LDD therapy. Method: The IPD was designed based on anatomical parameters measured from 3D CT images directly. The IPD was inserted at the validated finite element model of the mono-segmental L3/L4. The biomechanical performance of a pair of interbody fusion cages and a paired pedicel screws were studied to compare with the IPD. The model was loaded with the upper body weight and muscle forces to simulate five loading cases including standing, compression, flexion, extension, lateral bending and axial rotation. Results: The interbody fusion cage induced serious stress concentration on the surface of vertebral body, has the worst biomechanical performance among the three systems. Pedicle screws and interbody fusion cage could induce stress concentration within vertebral body which leads to vertebral compression fracture or screw loosening. Regarding to disc protection, the IPD had higher percentage to share the load of posterior lumbar structure than the pedicel screws and interbody fusion cage. Conclusion: IPD has the same loads as pedicle screw-rod which suggests it has a good function in the posterior stability. While the IPD had much less influence on vertebral body. Furthermore, IPD could share the load of intervertebral discs and facet joints to maintain the stability of lumbar spine.

Evaluation of Lumbar Spine Stabilization Using Anterior Interbody Fusion Cage

2002 ◽  
Author(s):  
Robert X. Gao ◽  
Mathew E. Mitchell ◽  
R. Scott Cowan
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Healing Process ◽  
Spine Stabilization ◽  
Anterior Interbody Fusion ◽  
Wide Range ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Spinal surgery uses a wide range of instrumentation devices to provide comfort to the patient, stabilize the spine, and enhance the bony healing process after surgery. In order to improve upon the effectiveness of these devices, the interaction between the spine and the implant devices needs to be studied from both medical and engineering perspectives. This paper investigates the effect of an anterior interbody fusion cage on lumbar spine stabilization, by means of numerical analysis using the finite element technique and experimental testing. Specifically, the relative displacement within an intact L4-L5 motion segment has been simulated and measured, under a range of compression, flexion, extension, torsion, and lateral bending loads. Subsequently, the effect of a single anterior lumbar fusion cage implanted into the segment was simulated and experimentally validated, under similar loading conditions. Comparison between the intact and cage-implanted segments indicated varying stabilizing ability of the fusion cage, which is highly dependent upon the cage position and the type of loading.

scholarly journals Minimally Invasive Transforaminal Lumbar Interbody Fusion Ameliorates Persistent Pain After Lumbar Fusion Surgery

2020 ◽  
Author(s):  
Jun Li ◽  
Kai Liu ◽  
Li Yang ◽  
DEGUO WANG
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Persistent Pain ◽  
Lumbar Interbody Fusion ◽  
Fusion Surgery ◽  
Drainage Fluid ◽  
Lumbar Fusion Surgery ◽  
Degenerative Lumbar Diseases

Abstract Background: Approximately 4-20% patients with degenerative lumbar diseases showed persistent pain after lumbar fusion surgery that may develop into failed back surgery syndrome (FBSS), and this persistent pain may be related to the postoperative increased release of inflammatory mediators. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) can obviously reduce the intraoperative soft tissue trauma. The aim of this study is to investigate the persistent pain in the patients with degenerative lumbar diseases undergoing MIS-TLIF compared with conventional‑invasive TLIF. Material and methods: This study retrospectively included 146 patients (MIS-TLIF vs. conventional‑invasive TLIF: 56 vs. 90), and the incidence of persistent pain were evaluated. Furthermore, inflammation related markers in both blood and drainage fluid samples, including white blood cell (WBC) count, C-reactive protein (CRP), creatine kinase (CK), interleukin-6 (IL-6) and IL-1β, were tested before and after operation. Results: Significantly larger number of patients undergoing conventional‑invasive TLIF showed postoperative persistent pain compared to those undergoing MIS-TLIF (4/56, 7.1% vs. 20/90, 22.2%; P < 0.05). In both treatment groups, the patients with postoperative persistent pain showed increased IL-6 and IL-1β in drainage fluid, as well as increased IL-6 in blood samples (P < 0.05), and there is significant correlation between the inflammation markers in drainage fluid and the extent of postoperative persistent pain in patients with postoperative persistent pain (P < 0.05). Conclusions: Local inflammatory substance accumulation may be potential cause for postoperative persistent pain, and MIS-TLIF may reduce this inflammatory accumulation at the surgical site and subsequently reduce the risk of persistent pain.

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