Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage in Treatment of Lumbar Intervertebral Foraminal Stenosis : Comparative Study of Two Different Types of Cages |
| |
Authors: | Chul-Bum Cho Kyeong-Sik Ryu and Chun-Kun Park |
| |
Institution: | 1Department of Neurosurgery, St. Mary''s Hospital, The Catholic University of Korea, Seoul, Korea.;2Department of Neurosurgery, Seoul St. Mary''s Hospital, The Catholic University of Korea, Seoul, Korea. |
| |
Abstract: | ObjectiveThis retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS).MethodsA total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied Stabilis® (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR® (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ± 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined.ResultsFinal mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ± 2.3 → 2.3 ± 2.2, 6.3 ± 3.2 → 1.6 ± 1.6, and 53.7 ± 18.6 → 28.3 ± 13.1, respectively), which were not different between the two devices groups. In Stabilis® group, postoperative immediately increased disc and IVF heights (10.09 ± 4.15 mm → 14.99 ± 1.73 mm, 13.00 ± 2.44 mm → 16.28 ± 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ± 1.67 mm, 13.59 ± 2.01 mm, respectively). In SynFix-LR® group, immediately increased disc and IVF heights (9.60 ± 2.82 mm → 15.61 ± 0.62 mm, 14.01 ± 2.53 mm → 21.27 ± 1.93 mm, respectively) were maintained until the last follow up (13.72 ± 1.21 mm, 17.87 ± 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR® group (13/15, 86.7%).ConclusionALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis® group. |
| |
Keywords: | Anterior approach Lumbar interbody fusion Lumbar foraminal stenosis Stand-alone cage |
|
|