J Korean Orthop Assoc.  2008 Apr;43(2):152-159. 10.4055/jkoa.2008.43.2.152.

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

• Song KJ
• Lim YJ
• Choi BW
• Seo KB

• KMID: 2106433
• DOI: http://doi.org/10.4055/jkoa.2008.43.2.152

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+/-11.47degrees, 31.41+/-8.89degrees on average for preoperative and at final follow-up, respectively. Segmental lordosis was 11.51+/-9.35degrees preoperatively, and 10.86+/-7.49degrees 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.

Keyword

Degenerative lumbar spinal disorders; Posterior lumbar interbody fusion; Threaded fusion cage (TFC)

MeSH Terms

Animals
Follow-Up Studies
Humans
Lordosis
Transplants

Figure

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  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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