Journal List > J Korean Orthop Assoc > v.43(2) > 1012758

Song, Lim, Choi, and Seo: Clinical Efficacy of a Stand-Alone, Threaded-Titanium Fusion Cage for Single-Level Degenerative Lumbar Spinal Disorders

Abstract

Purpose

To evaluate the clinical and radiologic efficacy of posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC) alone with autogenous iliac corticocancellous bone graft for single-level degenerative lumbar spinal disorders.

Materials and Methods

Thirty-eight consecutive patients receiving PLIF with TFC alone were evaluated with at least three years of follow-up. Clinical outcome and satisfaction were assessed using Ragab's measurements. Radiological outcomes were analyzed in terms of lumbar lordosis, segmental lordosis, disc height, and fusion rates.

Results

Disc height was 6.18±2.54 mm, 11.71±1.60 mm and 9.94±1.94 mm on average for preoperative, postoperative, and final follow-up, respectively. Lumbar lordosis was 27.46±11.47°, 31.41±8.89° on average for preoperative and at final follow-up, respectively. Segmental lordosis was 11.51±9.35° preoperatively, and 10.86±7.49° at final follow-up. Satisfactory clinical outcome were obtained in 89.2% of patients with successful bone fusion in 73.0% of patients.

Conclusion

Stand alone TFC is an effective treatment modality in maintenance of disc height and lumbar lordosis, with satisfactory long term clinical outcomes in the treatment of single-level degenerative lumbar spinal disorders.

Figures and Tables

Fig. 1
Radiologic measurement of disc height (repeated measured ANOVA test. p=0.05).
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Fig. 2
Radiologic measurements of segmental lordosis and lumbar lordosis (repeated measured ANOVA test. p=0.68, p=0.53).
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Fig. 3
Clinical outcome according to the preoperative diagnosis.
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Fig. 4
A fifty seven year-old male was admitted with back pain and left sciatica. (A) Plain lateral radiograph showing a degenerative change in the L5-S1 lumbar disc space. (B) Postoperative lateral radiographs shows PLIF on L5-S1 with TFC only. (C) Lateral radiographs after 6 months shows absence of halo formation and sclerosis of adjacent bone. (D) Lateral radiographs after 4 years shows ligamentous ossification, and cages have become fully imbedded inside the two united vertebrae.
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Table 1
Clinical Outcome Measurement (Ragab et al, Spine 2003)
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Table 2
Patient Data Profile
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DS, degenerative spondylosis; LSS, lumbar spinal stenosis; ASD, adjacent segmental degeneration; AV, average; SD, standard deviation.

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