Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months
Context: Anterior lumbar interbody fusion (ALIF) is a common procedure for patients suffering degenerative, deformity, or posttraumatic pathologies of the lumbar spine. Aims: The aim of this study is to evaluate the clinical and radiological outcomes of a combination Titanium/Polyetheretherketone (T...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=42;epage=47;aulast=Mobbs |
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| author | Ralph J Mobbs Tajrian Amin Kevin Phan Darweesh Al Khawaja Wen Jie Choy William C. H. Parr Vedran Lovric William R Walsh |
| author_facet | Ralph J Mobbs Tajrian Amin Kevin Phan Darweesh Al Khawaja Wen Jie Choy William C. H. Parr Vedran Lovric William R Walsh |
| author_sort | Ralph J Mobbs |
| collection | DOAJ |
| description | Context: Anterior lumbar interbody fusion (ALIF) is a common procedure for patients suffering degenerative, deformity, or posttraumatic pathologies of the lumbar spine.
Aims: The aim of this study is to evaluate the clinical and radiological outcomes of a combination Titanium/Polyetheretherketone (Ti/PEEK) 3-screw fixation ALIF cage.
Settings and Design: This was a prospective multisurgeon series of 87 patients (105 implants), with a minimum 24-month follow-up. Twelve patients (12/87) were supplemented with posterior percutaneous pedicle screw fixation for additional stability for pars defect spondylolisthesis correction. Radiological follow-up with fine-cut computed tomography (CT) scan occurred at 4–6 months, and again at 18–24 months if no fusion observed on initial CT, was performed to evaluate early and final fusion rates, and integration of the Ti/PEEK cage at the end-plate junction. Clinical follow-up included the subjective measures of pain and functional status and objective wearable device monitoring.
Results: The fusion rate was 85% (97/105 implants) 6 months postoperatively, with no implant-related complications, and 95% at 24 months, based on independent radiological assessment. Patients experienced statistically significant improvement in subjective pain and functional outcomes compared to preoperative status. The objective measures revealed a daily step count with a 27% improvement, and gait velocity with a mean increase from 0.97 m/s to 1.18 m/s, at 3 months postoperatively.
Conclusions: A Ti/PEEK cage, with allograft and bone morphogenetic protein-2 (BMP-2), achieved rapid interbody progression to fusion and is an effective implant for use in anterior lumbar surgery with high early fusion rates and no peri-endplate lucency. Supercritical CO2 allograft provided an osteoconductive scaffold and combined well with BMP-2 to facilitate fusion. |
| first_indexed | 2024-04-13T19:11:14Z |
| format | Article |
| id | doaj.art-88587d096fed4c16b0ba2a4cd7799e44 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-04-13T19:11:14Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-88587d096fed4c16b0ba2a4cd7799e442022-12-22T02:33:50ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372022-01-01131424710.4103/jcvjs.jcvjs_133_21Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 monthsRalph J MobbsTajrian AminKevin PhanDarweesh Al KhawajaWen Jie ChoyWilliam C. H. ParrVedran LovricWilliam R WalshContext: Anterior lumbar interbody fusion (ALIF) is a common procedure for patients suffering degenerative, deformity, or posttraumatic pathologies of the lumbar spine. Aims: The aim of this study is to evaluate the clinical and radiological outcomes of a combination Titanium/Polyetheretherketone (Ti/PEEK) 3-screw fixation ALIF cage. Settings and Design: This was a prospective multisurgeon series of 87 patients (105 implants), with a minimum 24-month follow-up. Twelve patients (12/87) were supplemented with posterior percutaneous pedicle screw fixation for additional stability for pars defect spondylolisthesis correction. Radiological follow-up with fine-cut computed tomography (CT) scan occurred at 4–6 months, and again at 18–24 months if no fusion observed on initial CT, was performed to evaluate early and final fusion rates, and integration of the Ti/PEEK cage at the end-plate junction. Clinical follow-up included the subjective measures of pain and functional status and objective wearable device monitoring. Results: The fusion rate was 85% (97/105 implants) 6 months postoperatively, with no implant-related complications, and 95% at 24 months, based on independent radiological assessment. Patients experienced statistically significant improvement in subjective pain and functional outcomes compared to preoperative status. The objective measures revealed a daily step count with a 27% improvement, and gait velocity with a mean increase from 0.97 m/s to 1.18 m/s, at 3 months postoperatively. Conclusions: A Ti/PEEK cage, with allograft and bone morphogenetic protein-2 (BMP-2), achieved rapid interbody progression to fusion and is an effective implant for use in anterior lumbar surgery with high early fusion rates and no peri-endplate lucency. Supercritical CO2 allograft provided an osteoconductive scaffold and combined well with BMP-2 to facilitate fusion.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=42;epage=47;aulast=Mobbsanterior lumbar interbody fusionbone morphogenetic protein-2integral fixationpolyetheretherketonesupercritical co2 allografttitanium |
| spellingShingle | Ralph J Mobbs Tajrian Amin Kevin Phan Darweesh Al Khawaja Wen Jie Choy William C. H. Parr Vedran Lovric William R Walsh Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months Journal of Craniovertebral Junction and Spine anterior lumbar interbody fusion bone morphogenetic protein-2 integral fixation polyetheretherketone supercritical co2 allograft titanium |
| title | Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months |
| title_full | Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months |
| title_fullStr | Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months |
| title_full_unstemmed | Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months |
| title_short | Standalone titanium/polyetheretherketone interbody cage for anterior lumbar interbody fusion: Clinical and radiological results at 24 months |
| title_sort | standalone titanium polyetheretherketone interbody cage for anterior lumbar interbody fusion clinical and radiological results at 24 months |
| topic | anterior lumbar interbody fusion bone morphogenetic protein-2 integral fixation polyetheretherketone supercritical co2 allograft titanium |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=42;epage=47;aulast=Mobbs |
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