Lumbar Fusion and Stabilization pp 379-395 | Cite as
Carbon Fiber Implant to Aid Interbody Lumbar Fusion: 1-year Clinical Results in the First 26 Patients
Abstract
Posterior lumbar interbody fusion (PLIF), pioneered by Ralph Cloward in the 1940’s [1,2] is a biomechanically optimum fusion. A successful PLIF maintains the disk height, protects the nerve roots, restores weight bearing to anterior structures, restores the annulus to tension, and immobilizes the unstable de-generated intervertebral disk area. A successful PLIF restores every mechanical function of the functional spinal unit except motion. Problems with PLIF have included excessive bleeding (usually epidural), the need for donor bone (with risk of AIDS and hepatitis), prolonged healing time of donor bone, the difficulty of cutting precise bony channels, the difficulty of providing sterile donor bone of precise dimensions, the potential of instability, the risk of retropulsion of graft and consequent neural damage, and post-operative collapse of the donor bone and pseudarthrosis.
Keywords
Pedicle Screw Interbody Fusion Disk Height Posterior Lumbar Interbody Fusion Donor BonePreview
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References
- 1.Cloward RB (1953) The treatment of ruptured lumbar intervertebral disks by vertebral body fusion. J Neurosurg 10: 154PubMedCrossRefGoogle Scholar
- 2.Cloward RB (1985) Posterior lumbar interbody fusion updated. Clin Orthop 193: 16–19PubMedGoogle Scholar
- 3.Lin PM, Cautilli RA, Joyce MF (1983) Posterior lumbar interbody fusion. Clin Orthop 180: 154–168PubMedGoogle Scholar
- 4.Lin PM (1985) Posterior lumbar interbody fusion technique: Complications and pitfalls. Clin Orthop 183: 90–102Google Scholar
- 5.Ma GW (1985) Posterior lumbar interbody fusion with specialized instruments. Clin Orthop 193: 57–63PubMedGoogle Scholar
- 6.Steffee AD, Sitkowski DJ (1988) Reduction and stabilization of grade IV spondylolisthesis. Clin Orthop 227: 82–89PubMedGoogle Scholar
- 7.Steffee AD, Biscup RS, Sitkowski DJ (1986) Segmental spine plates with pedicle screw fixation. Clin Orthop 203: 45–53PubMedGoogle Scholar
- 8.Steffee AD (1989) The variable screw placement system with posterior lumbar interbody fusion. In: Lin PM, Gill K (eds) Lumbar interbody fusion: Principles and techniques in spine surgery. Aspen, Rockville, MD, pp 81–93Google Scholar
- 9.Brantigan JW, Cunningham BW, Warden K, McAfee PC, Steffee AD (in press) Compression strength of allograft bone for PLIF. SpineGoogle Scholar
- 10.Brantigan JW, Steffee AD, Geiger JM (1991) A carbon fiber implant to aid interbody lumbar fusion: Mechanical testing. Spine 16: S277–282PubMedCrossRefGoogle Scholar
- 11.Henderson ED (1966) Results of the surgical treatment of spondylolisthesis. J Bone Joint Surg [Am] 48: 619–642Google Scholar
- 12.Naylor A (1974) The late results of laminectomy for lumbar disk prolapse: A review after 10–25 years. J Bone Joint Surg [Br] 56: 17–29Google Scholar
- 13.Prolo DJ, Oklund SA, Butcher M (1986) Toward uniformity in evaluating results of lumbar spine operations: A paradigm applied to posterior lumbar interbody fusions. Spine 11: 601–606Google Scholar
- 14.Spengler DM, Ouellette EA, Battie M (1990) Elective diskectomy for herniation of a lumbar disk. J Bone Joint Surg [Am] 72: 230–237Google Scholar
- 15.White AH, Von Rogov P, Zucherman J, Heiden D (1987) Lumbar laminectomy for herniated disk: a prospective controlled comparison with internal fixation fusion. Spine 12: 305–307PubMedCrossRefGoogle Scholar
- 16.Finnegan WJ, Fenlin JM, Marvel JP, Rothman RH (1979) Results of surgical intervention in the symptomatic multiply-operated back patient. J Bone Joint Surg [Am] 61: 1077–1082Google Scholar
- 17.Flynn JC, Hoque MA (1979) Anterior fusion of the lumbar spine. J Bone Joint Surg [Am] 61: 1143–1150Google Scholar
- 18.Hutter CG (1983) Posterior intervertebral body fusion: A 25-year study. Clin Orthop 179: 86–96PubMedGoogle Scholar
- 19.Quimjian JD, Matrka PJ (1988) Decompresion laminectomy and lateral spinal fusion in patients with previously failed lumbar spine surgery. Orthopedics 11: 563–659PubMedGoogle Scholar
- 20.Stauffer RN, Coventry MB (1972) Anterior interbody lumbar spine fusion: Analysis of Mayo Clinic series. J Bone Joint Surg [Am] 54: 756–768Google Scholar
- 21.Waddell G, Kummel EG, Lotto WN, Graham JD (1979) Failed lumbar disk surgery and repeat surgery following industrial injuries. J Bone Joint Surg 61: 201–207PubMedGoogle Scholar
- 22.Chow SP, Leong JCY, Ma A, Yau ACMC (1980) Anterior spinal fusion for deranged lumbar intervertebral disks: A review of 97 cases. Spine 5: 452–458PubMedCrossRefGoogle Scholar
- 23.Goldner JL, Urbaniak JR, McCollum DE (1971) Anterior disk excision and inter-body spinal fusion for chronic low back pain. Orthop Clin North Am 2: 543–568PubMedGoogle Scholar
- 24.Prothero SR, Parkes JC, Stinchfield FE (1966) Complications after low-back fusion in 1,000 patients. J Bone Joint Surg [Am] 48: 57–65Google Scholar
- 25.Cleveland M, Bosworth DM, Thompson FR (1948) Pseudarthrosis in the lumbo-sacral spine. J Bone Joint Surg [Am] 30: 302–312Google Scholar
- 26.Zinreich SJ, Long DM, Davis R, Quinn CB, McAfee PC, Wang H (1990) Three- dimensional CT imaging in postsurgical “failed back” syndrome. J Comput Assist Tomogr 14: 574–580PubMedCrossRefGoogle Scholar
- 27.Hibbs RA, Swift WE (1929) Developmental abnormalities at the lumbosacral juncture causing paint and disability. Surg Gynecol Obstet 48: 604–612Google Scholar
- 28.Thompson WAL, Gristina AG, Healy WA (1974) Lumbosacral spine fusion: A method of bilateral posterolateral fusion combined with a Hibbs fusion. J Bone Joint Surg 56: 1643–1647Google Scholar
- 29.Brodsky AE, Kovalsky ES, Khalil MA (1991) Correlation of radiologic assessment of lumbar spine fusions with surgical exploration. Spine 16: S261–265PubMedCrossRefGoogle Scholar
- 30.Brantigan JW, Cunningham BW, Warden K, McAfee PC, Steffee AD (1992) Interbody lumbar fusion using a carbon fiber cage implant vs. allograft bone: An investigational study in the Spanish goat. Orthopaedic Surgical Research Society Meeting, February 18, Washington D.C.Google Scholar
- 31.Wetzel FT, LaRocca H (1991) The failed posterior lumbar interbody fusion. Spine 16: 839–845PubMedCrossRefGoogle Scholar