Biomechanical Comparison of Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion

2008 ◽  
Vol 21 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Avraam Ploumis ◽  
Chunhui Wu ◽  
Gustav Fischer ◽  
Amir A. Mehbod ◽  
Wentien Wu ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Biomechanical Comparison

Anterior Lumbar Interbody Fusion With Cage Retrieval for the Treatment of Pseudarthrosis After Transforaminal Lumbar Interbody Fusion: A Single-Institution Case Series

2020 ◽  
Author(s):  
Michael M Safaee ◽  
Alexander Tenorio ◽  
Alexander F Haddad ◽  
Bian Wu ◽  
Serena S Hu ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Medical Center ◽  
Perioperative Complications ◽  
Academic Medical Center ◽  
Case Series ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Additional Surgery ◽  
Tract Infections

Abstract BACKGROUND The treatment of pseudarthrosis after transforaminal lumbar interbody fusion (TLIF) can be challenging, particularly when anterior column reconstruction is required. There are limited data on TLIF cage removal through an anterior approach. OBJECTIVE To assess the safety and efficacy of anterior lumbar interbody fusion (ALIF) as a treatment for pseudarthrosis after TLIF. METHODS ALIFs performed at a single academic medical center were reviewed to identify cases performed for the treatment of pseudarthrosis after TLIF. Patient demographics, surgical characteristics, perioperative complications, and 1-yr radiographic data were collected. RESULTS A total of 84 patients were identified with mean age of 59 yr and 37 women (44.0%). A total of 16 patients (19.0%) underwent removal of 2 interbody cages for a total of 99 implants removed with distribution as follows: 1 L2/3 (0.9%), 6 L3/4 (5.7%), 37 L4/5 (41.5%), and 55 L5/S1 (51.9%). There were 2 intraoperative venous injuries (2.4%) and postoperative complications were as follows: 7 ileus (8.3%), 5 wound-related (6.0%), 1 rectus hematoma (1.1%), and 12 medical complications (14.3%), including 6 pulmonary (7.1%), 3 cardiac (3.6%), and 6 urinary tract infections (7.1%). Among 58 patients with at least 1-yr follow-up, 56 (96.6%) had solid fusion. There were 5 cases of subsidence (6.0%), none of which required surgical revision. Two patients (2.4%) required additional surgery at the level of ALIF for pseudarthrosis. CONCLUSION ALIF is a safe and effective technique for the treatment of TLIF cage pseudarthrosis with a favorable risk profile.

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

2010 ◽  
Vol 12 (1) ◽  
pp. 82-87 ◽  
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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