A Comparative Study of anterior Interbody Fusion with and without Anterior Instrumentation in Multi-level Tuberculosis of Thoraco-Lumbar Spine

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.

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Anterior Interbody Fusion using a Horizontal Cylinder Cage in a Degenerative Lumbar Spine

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2001.36.3.265 ◽

2001 ◽

Vol 36 (3) ◽

pp. 265

Author(s):

Seok Woo Kim ◽

Young Seok Chung ◽

Yung Khee Chung ◽

Jun Dong Chang ◽

Chang Ju Lee

Keyword(s):

Lumbar Spine ◽

Interbody Fusion ◽

Horizontal Cylinder ◽

Degenerative Lumbar Spine ◽

Anterior Interbody Fusion

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The Changes of Sagittal Alignment after Anterior Interbody Fusion with Posterior Fixation in Spondylolisthesis of the Lumbar Spine

Journal of Korean Society of Spine Surgery ◽

10.4184/jkss.2004.11.3.131 ◽

2004 ◽

Vol 11 (3) ◽

pp. 131 ◽

Cited By ~ 2

Author(s):

Chang-Hoon Jeon ◽

Yong-Chan Kim ◽

Nam-Su Chung ◽

Nam-Hyun Kim ◽

Jin-Yeol Yi

Keyword(s):

Lumbar Spine ◽

Interbody Fusion ◽

Sagittal Alignment ◽

Posterior Fixation ◽

Anterior Interbody Fusion

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Anterior interbody fusion of the lumbar spine

Der Orthopäde ◽

10.1007/pl00003412 ◽

1997 ◽

Vol 26 (6) ◽

pp. 563-567

Author(s):

C. Wimmer ◽

M. Krismer ◽

H. Gluch ◽

W. Sterzinger ◽

M. Ogon

Keyword(s):

Lumbar Spine ◽

Interbody Fusion ◽

Anterior Interbody Fusion

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Effects of autogenous bone graft impaction and tricalcium phosphate on anterior interbody fusion in the porcine lumbar spine

Acta Orthopaedica ◽

10.1080/759369191 ◽

2004 ◽

Vol 75 (4) ◽

pp. 1-1

Author(s):

Haisheng Li ◽

Xuenong Zou ◽

Qingyun Xue ◽

Niels Egund ◽

Martin Lind ◽

...

Keyword(s):

Lumbar Spine ◽

Bone Graft ◽

Tricalcium Phosphate ◽

Interbody Fusion ◽

Autogenous Bone Graft ◽

Autogenous Bone ◽

Anterior Interbody Fusion

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Single stage posterior instrumentation and anterior interbody fusion for tuberculosis of dorsal and lumbar spines

Nepal Orthopaedic Association Journal ◽

10.3126/noaj.v2i1.8136 ◽

2013 ◽

Vol 2 (1) ◽

pp. 21-26

Author(s):

BK Pandey ◽

GM Sangondimath ◽

HS Chhabra

Keyword(s):

Lumbar Spine ◽

Interbody Fusion ◽

Posterior Instrumentation ◽

Surgical Techniques ◽

Operation Time ◽

Single Stage ◽

Anterior Fusion ◽

Related Complication ◽

Anterior Interbody Fusion

Background: Spine is the most common site for osseous involvement of tuberculosis, accounting around 50% cases of musculoskeletal tuberculosis. The most frequent sites of the involvement are the thoracic and lumbar spine. The anterior column is primarily affected resulting in progressive or residual kyphotic deformity even after the eradication of the disease by chemotherapy. Various surgical techniques like anterior fusion, posterior or combined fusion have been described. In this study we evaluated the clinical outcome and radiological results of single stage posterior instrumentation and anterior interbody fusion for tuberculosis of dorsal and lumbar spine. Methods: Details of the patients of tuberculosis of dorsal and lumbar spine operated with single stage posterior instrumentation and anterior interbody fusion from December 2004 to June 2008 were retrieved from the hospital database. There were 55 cases operated with this technique. Thirty patients, whose final details were available, were involved in this study. Pre-operative, post-operative and final follow up clinical and radiological assessments were performed. The follow up ranged from 18 to 60 months. Results: Average operation time was 5 hours 45 minutes and blood loss was 1100 ml. Anterior body fusion was achieved in all the patients. 93.3% of the patients had neurological improvement. Satisfactory post-operative kyphotic angle correction was achieved. There was minimal final loss of kyphotic correction. One patient had post-operative wound infection. Post operative paralytic ileus, chest infection, urinary tract infection, jaundice were the complications found in the patients. No graft related complication was seen. There was no recurrence of the disease in any of the cases. Conclusion: Single stage anterior debridement and interbody fusion with posterior instrumentation can be performed safely to achieve satisfactory clinical and radiographic outcomes in patients of thoracic and lumbar tuberculosis. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8136 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 21-26

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Microsurgical Anterior Approaches to the Lumbar Spine for Interbody Fusion and Total Disc Replacement

Neurosurgery ◽

10.1097/00006123-200211002-00022 ◽

2002 ◽

Vol 51 (suppl_2) ◽

pp. S2-159-S2-165 ◽

Cited By ~ 35

Author(s):

H. Michael Mayer ◽

Karsten Wiechert

Keyword(s):

Lumbar Spine ◽

Anterior Approach ◽

Interbody Fusion ◽

Postoperative Morbidity ◽

Total Disc Replacement ◽

Anterior Lumbar Interbody Fusion ◽

Disc Replacement ◽

Lumbar Interbody Fusion ◽

Anterior Interbody Fusion

Abstract OBJECTIVE Anterior approaches to the lumbar spine for the treatment of various degenerative or postoperative abnormalities associated with low back pain have always been a matter of debate. They are known to be associated with considerable surgical trauma, high postoperative morbidity, and, occasionally, unacceptably high complication rates. In 1997, we inaugurated two new microsurgical modifications of conventional anterior approach techniques, which have been applied in anterior lumbar interbody fusion and more recently in total disc replacement. This article describes the results of microsurgical anterior interbody fusion in a consecutive series of 171 patients as well as preliminary results of these techniques for total disc replacement in 26 patients. METHODS The approaches are performed with the use of a surgical microscope. Lumbar segments L2–L5 are exposed through a lateral retroperitoneal approach. L5–S1 can be reached through a midline retroperitoneal or transperitoneal approach. Both approaches can be performed through a limited skin incision of 4 cm. RESULTS An independent observer evaluated results of anterior lumbar interbody fusion in 171 patients during a 2-year follow-up period. The clinical follow-up demonstrated low perioperative and postoperative morbidity with an average blood loss of less than 100 ml at the fusion site. Pseudoarthrosis rates were less than 5%, and clinical results, as evaluated in accordance with the scoring system developed by Prolo et al., did not differ significantly from conventional open techniques. Total disc replacement through a microsurgical anterior approach seems to be a promising alternative to fusion procedures with even less intraoperative and perioperative morbidity. CONCLUSION Microsurgical anterior approaches to the lumbar spine provide a reasonable surgical alternative to conventional approaches for anterior interbody fusion and total disc replacement.

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