Clinical Efficacy of a Stand-Alone, Threaded-Titanium Fusion Cage for Single-Level Degenerative Lumbar Spinal Disorders

Kyung-Jin Song; Young-Jin Lim; Byung-Wan Choi; Kyu-Bum Seo

doi:10.4055/jkoa.2008.43.2.152

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

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(2): 152-159.

Published online: 30 April 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.2.152

Clinical Efficacy of a Stand-Alone, Threaded-Titanium Fusion Cage for Single-Level Degenerative Lumbar Spinal Disorders

Kyung-Jin Song, M.D., Young-Jin Lim, M.D., Byung-Wan Choi, M.D.^*, Kyu-Bum Seo, M.D.^†

Department of Orthopedic Surgery, College of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Korea.

^*Department of Orthopedic Surgery, Gwangju Veterans Hospital, Korea.

^†Department of Orthopedic Surgery, Jeju National University Hospital, Korea.

Address reprint requests to Kyung-Jin Song, M.D., Ph.D. Department of Orthopedic Surgery, Chonbuk National University Hospital, 634-18, Geumam-dong, Deokjin-gu, Jeonju 561-712, Korea. Tel: +82.63-250-1760, 1770 Fax: +82.63-271-6538, kysong@chonbuk.ac.kr

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.

Keywords: Degenerative lumbar spinal disorders, Posterior lumbar interbody fusion, Threaded fusion cage (TFC)

Figures and Tables

Fig. 1

Radiologic measurement of disc height (repeated measured ANOVA test. p=0.05).

Fig. 2

Radiologic measurements of segmental lordosis and lumbar lordosis (repeated measured ANOVA test. p=0.68, p=0.53).

Fig. 3

Clinical outcome according to the preoperative diagnosis.

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.

Table 1

Clinical Outcome Measurement (Ragab et al, Spine 2003)

Table 2

Patient Data Profile

DS, degenerative spondylosis; LSS, lumbar spinal stenosis; ASD, adjacent segmental degeneration; AV, average; SD, standard deviation.

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