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Morphological analysis of interbody fusion following posterior lumbar interbody fusion with cages using computed tomography.

Abstract Posterior lumbar interbody fusion (PLIF) using cages in conjunction with pedicle screw fixation is considered the gold standard for surgical treatment of degenerative lumbar spine disorders due to its biomechanical stability and high fusion rate. However, research regarding patterns of fusion in the interbody space during the early postoperative period is lacking.Sixty consecutive patients were recruited from May 2013 to June 2015. All patients underwent PLIF using 2 titanium cages filled with local bone chips from decompressed lamina and facet bone in conjunction with pedicle screw fixation. Computed tomography scans were obtained 3 to 6 months following surgery in order to evaluate the partial fusion state. Computed tomography (CT) classification of fusion morphology was divided into 8 groups and then into compartments according to fusion space, and the rate of fusion for each was calculated. Further follow-up was conducted to confirm fusion state and assess outcomes.The most frequent pattern of interbody fusion was bilateral intra-cage fusion with unilateral lateral bridging of extra-cage areas (N = 36, 43.4%); the least frequent was interspace bridging of the 2 cages alone (N = 0, 0%). The fusion rate for the intra-cage area (Compartment 1) reached 100%. However, the fusion in the lateral space outside of cages (Compartment 2) was not satisfactory, though reasonable (72.3%). All patients were confirmed as achieving adequate fusion at the final follow-up, with improved clinical outcomes.Widening of the contact area between the vertebral body and cages is recommended to promote increased interbody fusion during the early postoperative period.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834885
OWN - NLM
STAT- In-Process
DA  - 20170823
LR  - 20170823
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Morphological analysis of interbody fusion following posterior lumbar interbody
      fusion with cages using computed tomography.
PG  - e7816
LID - 10.1097/MD.0000000000007816 [doi]
AB  - Posterior lumbar interbody fusion (PLIF) using cages in conjunction with pedicle 
      screw fixation is considered the gold standard for surgical treatment of
      degenerative lumbar spine disorders due to its biomechanical stability and high
      fusion rate. However, research regarding patterns of fusion in the interbody
      space during the early postoperative period is lacking.Sixty consecutive patients
      were recruited from May 2013 to June 2015. All patients underwent PLIF using 2
      titanium cages filled with local bone chips from decompressed lamina and facet
      bone in conjunction with pedicle screw fixation. Computed tomography scans were
      obtained 3 to 6 months following surgery in order to evaluate the partial fusion 
      state. Computed tomography (CT) classification of fusion morphology was divided
      into 8 groups and then into compartments according to fusion space, and the rate 
      of fusion for each was calculated. Further follow-up was conducted to confirm
      fusion state and assess outcomes.The most frequent pattern of interbody fusion
      was bilateral intra-cage fusion with unilateral lateral bridging of extra-cage
      areas (N = 36, 43.4%); the least frequent was interspace bridging of the 2 cages 
      alone (N = 0, 0%). The fusion rate for the intra-cage area (Compartment 1)
      reached 100%. However, the fusion in the lateral space outside of cages
      (Compartment 2) was not satisfactory, though reasonable (72.3%). All patients
      were confirmed as achieving adequate fusion at the final follow-up, with improved
      clinical outcomes.Widening of the contact area between the vertebral body and
      cages is recommended to promote increased interbody fusion during the early
      postoperative period.
FAU - Seo, Dong Kwang
AU  - Seo DK
AD  - Department of Neurological Surgery, Asan Medical Center, University of Ulsan
      College of Medicine, Seoul, Republic of Korea.
FAU - Kim, Myeong Jong
AU  - Kim MJ
FAU - Roh, Sung Woo
AU  - Roh SW
FAU - Jeon, Sang Ryong
AU  - Jeon SR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/08/24 06:00
MHDA- 2017/08/24 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007816 [doi]
AID - 00005792-201708250-00022 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7816. doi: 10.1097/MD.0000000000007816.