scholarly journals The Results of Using a Transforaminal Lumbar Interbody Fusion Cage at the Upper Lumbar Level

Cureus ◽  
2021 ◽  
Author(s):  
Uzay Erdoğan
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lumbar Level ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Biomechanical comparison of transdiscal fixation and posterior fixation with and without transforaminal lumbar interbody fusion in the treatment of L5–S1 lumbosacral joint

2018 ◽  
Vol 232 (4) ◽  
pp. 371-377 ◽  
Author(s):  
Hakan Özalp ◽  
Mustafa Özkaya ◽  
Onur Yaman ◽  
Teyfik Demir
Keyword(s):  
Pedicle Screw ◽  
Axial Compression ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Transdiscal screw fixation is generally performed in the treatment of high-grade L5–S1 spondylolisthesis. The main thought of the study is that the biomechanical performances of the transdiscal pedicle screw fixation can be identical to standard posterior pedicle screw fixations with or without transforaminal lumbar interbody fusion cage insertion. Lumbosacral portions and pelvises of 45 healthy lambs’ vertebrae were dissected. Animal cadavers were randomly and equally divided into three groups for instrumentation. Three fixation systems, L5–S1 posterior pedicle screw fixation, L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion, and L5–S1 transdiscal pedicle screw fixation, were generated. Axial compression, flexion, and torsion tests were conducted on test samples of each system. In axial compression, L5–S1 transdiscal fixation was less stiff than L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion. There were no significant differences between groups in flexion. Furthermore, L5–S1 posterior fixation was stiffest under torsional loads. When axial compression and flexion loads are taken into consideration, transdiscal fixation can be alternatively used instead of posterior pedicle screw fixation in the treatment of L5–S1 spondylolisthesis because it satisfies enough stability. However, in torsion, posterior fixation is shown as a better option due to its higher stiffness.

Do we need a transforaminal lumbar interbody fusion cage to increase the stability of functional spinal unit when comparing unilateral and bilateral fixation?

2018 ◽  
Vol 232 (7) ◽  
pp. 655-664
Author(s):  
Murat Ulutaş ◽  
Mustafa Özkaya ◽  
Onur Yaman ◽  
Teyfik Demir
Keyword(s):  
Pedicle Screw ◽  
Axial Compression ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Control Group ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Transforaminal lumbar interbody fusion was an alternative to posterior lumbar interbody fusion for decompression surgeries. This study investigates the biomechanical responses of the unilateral and bilateral pedicle screw fixations with/without transforaminal lumbar interbody fusion cages under axial compression, flexion, and torsional loads. Ovine vertebrae were used in this study. Cadavers, randomly divided into five, were intact control group, bilateral pedicle screw fixation group, bilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage, unilateral pedicle screw fixation group, and unilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage. Axial compression, flexion, and torsion tests were performed on specimens. All study groups provided higher stiffness and yield load values than control group under axial compression. Addition of transforaminal lumbar interbody fusion cage to bilateral fixation increased the stiffness under axial compression. Moreover, additional use of transforaminal lumbar interbody fusion in unilateral fixation increased the yield load values under axial compression. Control group was the stiffest in flexion test. Placing a transforaminal lumbar interbody fusion cage to both unilateral and bilateral fixations did not significantly change the stiffness values. Additional transforaminal lumbar interbody fusion cage increased the yield moment of the bilateral fixation. In torsion test, control group had the highest stiffness and yield torque. The facet joints are the most important parts of the vertebrae on the stability. When comparing the bilateral and unilateral fixations with transforaminal lumbar interbody fusion addition, the more facet preserving approach has significantly higher stability under axial compression, flexion, and torsion. Unilateral fixation with transforaminal lumbar interbody fusion cage can be said biomechanically stable and advantageous fixation system because of the advantage on the less facet and soft tissue resection compared to bilateral fixation with transforaminal lumbar interbody fusion.

Primary Stiffness of a Modified Transforaminal Lumbar Interbody Fusion Cage With Integrated Screw Fixation

Spine ◽  
2014 ◽  
Vol 39 (17) ◽  
pp. E994-E1000 ◽  
Author(s):  
Alexander Keiler ◽  
Werner Schmoelz ◽  
Stefanie Erhart ◽  
Kanna Gnanalingham
Keyword(s):  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

scholarly journals Mimickers in Spine: Migrated Cages Causing Radiculopathy

2019 ◽  
Vol 2 (1-3) ◽  
pp. 21-27
Author(s):  
Saurav Narayan Nanda ◽  
Mantu Jain ◽  
Sudarsan Behera ◽  
Manisha Gaikwad
Keyword(s):  
Bone Grafting ◽  
Interbody Fusion ◽  
Promising Result ◽  
Posterior Lumbar Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Neurological Complications ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Cage Migration ◽  
Spine Disorders

The procedure of interbody fusion has become an established treatment for many spine disorders. This arthrodesis can be achieved by hardware (fusion cage) through many approaches. Initially, posterior lumbar interbody fusion was popularized but had some serious neurological complications related to insertion as well as the migration of the cage. Gradually, transforaminal lumbar interbody fusion (TLIF) was introduced, which proved safer as it involves minimal cord handling, and also migration, if any, remains asymptomatic. We had two patients who were operated for interbody fusion using TLIF technique with subsequent posterior migration of the banana-shaped fusion cage 4–6 month after the index surgery. Both patients presented with radiculopathy mimicking a prolapsed intervertebral disc. These were evaluated and operated with the removal of the migrated cages and revision with bigger-size cages with adequate bone grafting. At the 1-year follow-up, both had remission of symptoms, and radiographs showed no subsequent migration. TLIF procedure is an established procedure to achieve arthrodesis in varying spine disorders with promising result. However, there are only a few reports describing cage migration after the procedure and these have been asymptomatic. Revision surgery is contemplated in the setting of neurological compression or instability. A bigger fusion cage in a compressive mode with adequate bone grafting is used to achieve arthrodesis. The principles of interbody fusion must be followed, and utmost precautions must be taken to prevent this unfortunate complication.

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