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Radiological comparison of instrumented posterior lumbar interbody fusion with one or two closed-box plasmapore coated titanium cages: follow-up study over more than seven years.

AbstractSTUDY DESIGN:
A retrospective clinical study with a follow-up of more than 7 years was conducted.
OBJECTIVE:
To compare interbody fusion, segmental lordosis and changes in disc and foramen height in patients who had received instrumented posterior lumbar interbody fusion (PLIF) with 1 or 2 closed-box titanium cages.
SUMMARY OF BACKGROUND DATA:
PLIF using 2 cages is a popular surgical method for treating degenerative lumbar spinal diseases. Implantation of a single cage in instrumented PLIF is still controversial.
METHODS:
From 1994 to 1997, 46 patients with degenerative lumbar spinal disease underwent single-level instrumented PLIF surgery using 1 (n = 22) or 2 (n = 24) interbody rectangular-shaped titanium blocks coated with Plasmapore (Prospace, B. Braun Aesculap AG, Tuttlingen). Mean follow-up was 8 years, ranging from 7 to 10 years. Anteroposterior and lateral radiographs of the patients were taken immediately after surgery and at the last follow-up examination. Segmental stability, change in segmental height, foramen height, and segmental lordosis were evaluated in both groups.
RESULTS:
Eight years after surgery, segmental stability (1-cage: 95.5%; 2 cages: 95.8%; P > 0.05), change in segmental height (1-cage: -1.9% +/- 3.7%; 2-cage: -2.4% +/- 3.6%; P > 0.05), foramen height (1-cage: -3.7% +/- 9.9%; 2-cage: -6.6% +/- 6.5%; P > 0.05) and segmental lordosis (1-cage: -2.4 degrees +/- 4.8; 2-cage -1.0 degrees +/- 4.0; P > 0.05) did not differ significantly between the 2 groups. Due to adjacent segment syndrome, 3 patients with a previous 2-cage PLIF received additional fusion surgery.
CONCLUSION:
In the long-term, instrumented PLIF with a single closed-box titanium cage shows similar radiologic results compared to fusion with 2 titanium cages. Implantation of a single titanium closed-box cage in an instrumented PLIF seems to be adequate in case of degenerative lumbar spinal disease.
AuthorsStefan Kroppenstedt, Martin Gulde, Robert Schönmayr
JournalSpine (Spine (Phila Pa 1976)) Vol. 33 Issue 19 Pg. 2083-8 (Sep 01 2008) ISSN: 1528-1159 [Electronic] United States
PMID18758364 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Coated Materials, Biocompatible
  • Titanium
Topics
  • Adult
  • Aged
  • Coated Materials, Biocompatible
  • Equipment Design
  • Female
  • Humans
  • Internal Fixators
  • Lordosis (diagnosis, physiopathology)
  • Lumbar Vertebrae (diagnostic imaging, physiopathology, surgery)
  • Male
  • Middle Aged
  • Radiography
  • Range of Motion, Articular
  • Retrospective Studies
  • Spinal Fusion (instrumentation)
  • Titanium

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