scholarly journals Functional and radiological comparison of transforaminal lumbar interbody fusion method with interbody fusion device versus stand-alone bone graft in lumbar canal stenosis or degenerative lumbar instability

2021 ◽  
Vol 7 (2) ◽  
pp. 291
Author(s):  
Ashish Kumar Gupta ◽  
Jitendra Singh Rathore ◽  
Lokpal Singh Bhati ◽  
Devendra Singh Rathore ◽  
R. C. Meena
Keyword(s):  
Bone Graft ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Group Comparison ◽  
Vas Score ◽  
Current Series ◽  
Local Bone ◽  
Rate Score ◽  
Group A

<p><strong>Background: </strong>Spinal stability is the vertebral ability to maintain their relationship and limit their relative displacements during physiologic postures and loads.</p><p><strong>Methods:</strong> Hospital based prospective randomized comparative study design between 2 groups included patients of both sex attending SMS hospital Jaipur, from April 2018 to June 2019 or till sample size was achieved, with due permission from institutional ethical committee and review board and after taking written informed consent from patients.</p><p><strong>Results: </strong>Inter group comparison of VAS score showed same results in both groups which showed statistically non-significant results. VAS score showed significantly reduction in both group A and B till the study period. Inter group comparison of ODI score showed same results in both groups which showed statistically non-significant results. ODI score showed significantly reduction in both group A and B till the study period. Inter group comparison of fusion rate score showed same results in both groups which showed statistically non-significant results. Fusion rate score showed significantly increased in both group A and B till the study period and at the 12 month it was 100% fusion rate.</p><p><strong>Conclusions: </strong>In the current series, the TLIF procedure with local bone graft alone improved anterior vertebral translation, disc height, and lumbar lordosis. A proper surgical technique with adequate discectomy and facetectomy would contribute greatly to the improvement of the radiological parameters; however, this improvement was not maintained at the latest follow up.</p><p><strong> </strong></p>

Reduction and transforaminal lumbar interbody fusion with posterior fixation versus transsacral cage fusion in situ with posterior fixation in the treatment of Grade 2 adult isthmic spondylolisthesis in the lumbosacral spine

2010 ◽  
Vol 13 (3) ◽  
pp. 394-400 ◽  
Author(s):  
Kai Gong ◽  
Zhe Wang ◽  
Zhuojing Luo
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Leg Pain ◽  
Posterior Fixation ◽  
Isthmic Spondylolisthesis ◽  
Disc Space ◽  
Group A ◽  
Group B

Object In situ transsacral fusion in the treatment of low-grade isthmic spondylolisthesis has rarely been reported. The authors treated 13 cases of L-5 Grade 2 isthmic spondylolisthesis associated with collapsed disc space and osteoporosis by using transsacral fusion and fixation, and compared its clinical and radiological outcomes with the results of transforaminal lumbar interbody fusion (TLIF) and instrumental reduction in 21 patients. Methods The authors retrospectively analyzed 21 patients in Group A who were treated with reduction and TLIF, and 13 patients in Group B who were treated with transsacral cage fusion. Oswestry Disability Index and visual analog scale scores of back and leg pain were used to evaluate clinical outcomes. Radiological parameters for assessment included the percentage of slippage, whole lumbar lordosis, and lumbosacral angle. Operative data, fusion rate, and perioperative complications were recorded as well. Results The mean operation time and blood loss in Group B was less than that in Group A. Both groups realized good recovery from previous symptoms. The decrease in back and leg pain after surgery was significant within each group, without much difference between the 2 groups. No significant differences were found in lumbosacral angle, whole lumbar lordosis, visual analog scale score, and Oswestry Disability Index score between the 2 groups after surgery. The solid fusion rate was 95.2% in Group A and 92.3% in Group B. In Group A, 2 patients suffered from graft site pain, 1 had a superficial infection, and 1 had screw loosening; in Group B, dural tears were found in 2 patients, transient S-1 paresthesia in 2, and extensor hallucis longus muscle weakness in 1. Conclusions For patients with a collapsed disc space and poor bone quality, posterior in situ transsacral cage fusion may be used as an alternative to the TLIF procedure. The short-term clinical and radiological outcomes in the transsacral cage group were comparable with those in the TLIF group, although with a relatively higher neurological complication rate.

scholarly journals Efficacy of Platelet-Rich Plasma for Bone Fusion in Transforaminal Lumbar Interbody Fusion

2018 ◽  
Vol 12 (1) ◽  
pp. 112-118 ◽  
Author(s):  
Go Kubota ◽  
Hiroto Kamoda ◽  
Sumihisa Orita ◽  
Kazuhidee Inage ◽  
Michihiro Ito ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Platelet Rich Plasma ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Bone Union ◽  
Leg Pain ◽  
Control Group ◽  
Bone Fusion ◽  
Local Bone ◽  
Fusion Cage

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To examine the efficacy of platelet-rich plasma (PRP) for bone fusion in transforaminal lumbar interbody fusion (TLIF) using local bone grafting.</p></sec><sec><title>Overview of Literature</title><p>Several authors have reported the efficacy of PRP for bone union in animal models. However, the use of PRP for bone fusion in TLIF surgery has not been fully explored.</p></sec><sec><title>Methods</title><p>Twenty patients underwent single-level TLIF surgery because of L4 spondylolisthesis. An interbody fusion cage and local bone were used in nine patients (control group) and an interbody fusion cage, local bone, and PRP were used in 11 patients (PRP group). PRP was prepared from the patients' blood samples (400 mL) immediately before surgery. The duration of bone union and postoperative bone fusion rate were assessed using plain radiography at every 3 months postoperatively and computed tomography at 12 or 24 months postoperatively, respectively. Lower back pain, leg pain, and leg numbness were evaluated using the visual analog scale preoperatively and at 3, 6, 12, and 24 months postoperatively.</p></sec><sec><title>Results</title><p>The platelet count was 8.7 times higher in PRP than in blood. The bone union rate was significantly superior in the PRP group than in the control group (91% and 77%, respectively; <italic>p</italic>=0.035), whereas the average duration of bone union was not significantly different between the groups (7.7±0.74 and 10.0±2.00 months, respectively; <italic>p</italic>=0.131). There was no significant difference in lower back pain, leg pain, and leg numbness in both groups during follow-up (<italic>p</italic>&gt;0.05).</p></sec><sec><title>Conclusions</title><p>Our study suggests that the use of PRP in TLIF surgery increases bone fusion rate.</p></sec>

scholarly journals Using a mixture of local bone dust and morselized bone as graft materials in single- and double-level ACDF

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fei Ma ◽  
Shicai Xu ◽  
Yehui Liao ◽  
Qiang Tang ◽  
Chao Tang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Neck Disability Index ◽  
Fusion Rate ◽  
Single Level ◽  
Vas Score ◽  
Local Bone ◽  
Significant Difference ◽  
Cage Subsidence ◽  
Group A ◽  
Group B

Abstract Background Using a cage filled with local bone in anterior cervical discectomy and fusion (ACDF) can eliminate morbidities associated with autograft harvest from the iliac crest while achieving high fusion rates. However, there is still no consensus regarding the methods for using local bone grafts. This retrospective study was performed to compare the clinical and radiological outcomes of using a mixture of bone dust and morselized bone versus morselized bone alone in ACDF. Methods A retrospective study of 228 patients affected by cervical degenerative disease who had undergone single- or double-level ACDF between January 2014 and June 2018 was performed. Nanohydroxyapatite/polyamide-66 (n-HA/PA66) combined with morselized bone was used in 111 patients (group A: single-level ACDF in 51 patients and double-level ACDF in 60 patients), whereas the n-HA/PA66 cage combined with a mixture of bone dust and morselized bone was used in 117 patients (group B: single-level ACDF in 58 patients and double-level ACDF in 59 patients). The fusion rate, extent of cage subsidence, fusion segmental height (FSH), C2-7 lordosis, segmental sagittal alignment (SSA), 10-point visual analog scale (VAS) score, and Neck Disability Index (NDI) were compared between the two groups. Results The VAS score and NDI were significantly reduced after the operation in group A and group B. At the final follow-up, the fusion rate was 90.2 % (46/51) and 94.8 % (55/58) in patients treated with single-level ACDF in group A and group B, respectively (p > 0.05). In patients treated with double-level ACDF, bone fusion was achieved in 52 patients (86.7 %) in group A and 55 patients (93.2 %) in group B (p > 0.05). The fusion rate of single- and double-level ACDF was higher in patients in group B than those in group A at the 3-month, 6-month and 12-month follow-ups (p < 0.05). The extent of cage subsidence after single- and double-level ACDF was lower in patients in group B (1.5 ± 0.5 mm and 2.3 ± 0.8 mm, respectively) than in those in group A (1.8 ± 0.7 mm and 2.9 ± 1.4 mm, respectively) (p < 0.05). There was no significant difference between the two groups in the C2-7 lordosis, FSH, SSA, VAS score, or NDI before or after the operation (p > 0.05). Conclusions Using a mixture of local bone dust and morselized bone as cage-filling materials yielded comparably good clinical outcomes as using morselized bone alone in single- and double-level ACDF. However, the mixture graft of bone dust and morselized bone was more beneficial in promoting early fusion and reducing cage subsidence.

scholarly journals Augmenting posterolateral fusion with transforaminal lumbar interbody fusion cage improves clinical outcome, but not fusion rate, of posterior decompression

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091002
Author(s):  
Teoman Atici ◽  
Selcan Yerebakan ◽  
Cenk Ermutlu ◽  
Ali Özyalçın
Keyword(s):  
Clinical Outcome ◽  
Spinal Stenosis ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Posterior Decompression ◽  
Group A ◽  
Group B ◽  
Lumbar Spinal

Objective This study was performed to compare fusion rates and clinical outcomes of posterior decompression by posterolateral fusion (PLF) versus transforaminal lumbar interbody fusion (TLIF) for treatment of lumbar spinal stenosis. Methods This retrospective cohort study involved 157 patients with lumbar spinal stenosis treated with instrumented PLF alone or instrumented PLF combined with TLIF from 2010 to 2018. The patients were divided into two groups: the PLF group (Group A), in which posterior decompression with instrumented PLF was performed, and the cage-augmented group (Group B), in which TLIF was added to the procedures described for the PLF group. Patient outcomes (Oswestry Disability Index, visual analog scale score, and 36-Item Short-Form Health Survey scores) and fusion rates were compared. Results The fusion rate was similar between the two groups. Among patients with two- and three-level fusion, improvements in the clinical outcome scores were significantly greater in Group B than Group A. Conclusion Combining TLIF with PLF provides better clinical outcomes than PLF alone when multilevel fusion is indicated. TLIF augmentation does not improve the fusion rates in either single- or multi-level surgery.

Use of a nano-hydroxyapatite/polyamide composite in anterior cervical subtotal corpectomy and fusion

2021 ◽  
Vol 11 (9) ◽  
pp. 1491-1496
Author(s):  
Xiaojiang Li ◽  
Xudong Zhang ◽  
Shanshan Dong ◽  
Haijun Li ◽  
Chunlan Wang ◽  
...  
Keyword(s):  
Bone Graft ◽  
Vertebral Body ◽  
Cervical Spondylotic Myelopathy ◽  
Interbody Fusion ◽  
Japanese Orthopaedic Association ◽  
Fusion Rate ◽  
Graft Material ◽  
Improvement Rate ◽  
Fusion Surgery ◽  
Cervical Vertebral Body

This study aimed to explore the safety and efficacy of using nano-hydroxyapatite/polyamide (N-HA/PA) composite in anterior cervical vertebral body subtotal corpectomy and interbody fusion. Total 50 patients with cervical spondylotic myelopathy were enrolled to undergo anterior cervical spondylectomy. Bone graft pedicles were compounded with N-HA/PA and intervertebral body fusion was performed. Study outcomes included surgical efficacy and the degree of fusion. Patients in whom vertebral body fusion was performed with N-HA/PA composite pedicles had significantly improved symptoms. The postoperative Japanese Orthopaedic Association scores increased to 18.56±4.37 from 11.37±3.52, reflecting an improvement rate of 87.3%. The composite pedicle fusion rate was 96.4%. Therefore, N-HA/PA composite pedicle as a bone graft material in fusion surgery provides significant therapeutic efficacy. Moreover, the composite pedicle fusion rate is high, making it ideal for anterior cervical vertebral body subtotal corpectomy and fusion.

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