Clinical effectiveness of posterior-only approach using polyetheretherketone cage combined with single-segment instrumentation for lumbar tuberculosis in children

We sought to investigate the outcomes of posterior-only approach using polyetheretherketone (PEEK) cage combined with single-segment instrumentation (modified-approach) for mono-segment lumbar tuberculosis in children. Between February 2008 and August 2017 in our hospital, 18 children with single-segment lumbar tuberculosis enrolled in this study were treated by modified-approach. Medical records and radiographs were retrospectively analyzed. Mean follow-up time was 54.6 ± 12.1 months. No severe complications were noted to have occurred. Measures indicated there was satisfactory bone fusion for all patients. Mean Cobb angles were significantly decreased from preoperative angle (19.8° ± 13.1°) to those both postoperatively (− 4.9° ± 7.6°) and at final follow-up (− 3.5° ± 7.3°) (both P < 0.05), with a mean angle loss of 1.7° ± 0.9°. The erythrocyte sedimentation rate (ESR) returned to normal levels for all patients within 3 months postoperatively. All patients had significant postoperative improvement in neurological performance. The modified-approach was an effective and feasible treatment option for mono-segment children with lumbar tuberculosis. Such procedures can likely help patients by increasing retainment of lumbar mobility and reducing invasiveness.

Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

Poly-ether-ether-ketone (PEEK) cages have lower modulus of elasticity when compared with Titanium (TTN) cages. This suggests that PEEK-cages could show a lower rate of subsidence after anterior cervical discectomy-fusion (ACDF) and might lead to a lower loss of correction. We investigated the one to five year-results of standalone PEEK-TTN-porous coated cages in a patient cohort from 2014 to 2017. The patients underwent single-level ACDF for disc herniation and degenerative discopathy. Clinical and radiological outcome were assessed in 50 eligible patients after a mean of 27 months. Results: Solid arthrodesis was found in 84%. Neck disability index (NDI), and visual analogue scale (VAS) of neck and arm show comparable results to the literature. Conclusions: Clinical and radiological outcomes of ACDF with PEEK-body-cages with a porous coated surface show good bony integration. The modulus of elasticity, design, shape, size, cage surface architecture, as well as bone density, endplate preparation, radical microdiscectomy and distraction during surgery should be considered as important factors influencing the clinical results. One main advantage, over titanium cages, is the absence of MRI artifacts, allowing an excellent postoperative follow-up.

Malposition of Cage in Minimally Invasive Oblique Lumbar Interbody Fusion

Introduction. Minimally invasive oblique lumbar interbody fusion is one of the novel lateral lumbar interbody fusion techniques for which the successful early results have been reported. However, new complications were increasingly reported from ongoing studies. Case Presentation. We report a case of an unusual complication of minimally invasive oblique lumbar interbody fusion associated with contralateral nerve root compression due to deep and posterior position of polyetheretherketone cage and discussion of the operating technique for repositioning polyetheretherketone cage. Conclusion. Malposition of polyetheretherketone cage can cause contralateral nerve root compression and neurological complication. The surgical technique to proper pull the polyetheretherketone cage back into the acceptable position should be considered and well prepared.