Anterior Lumbar Interbody Fusion With Cage Retrieval for the Treatment of Pseudarthrosis After Transforaminal Lumbar Interbody Fusion: A Single-Institution Case Series

2020 ◽  
Author(s):  
Michael M Safaee ◽  
Alexander Tenorio ◽  
Alexander F Haddad ◽  
Bian Wu ◽  
Serena S Hu ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Medical Center ◽  
Perioperative Complications ◽  
Academic Medical Center ◽  
Case Series ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Additional Surgery ◽  
Tract Infections

Abstract BACKGROUND The treatment of pseudarthrosis after transforaminal lumbar interbody fusion (TLIF) can be challenging, particularly when anterior column reconstruction is required. There are limited data on TLIF cage removal through an anterior approach. OBJECTIVE To assess the safety and efficacy of anterior lumbar interbody fusion (ALIF) as a treatment for pseudarthrosis after TLIF. METHODS ALIFs performed at a single academic medical center were reviewed to identify cases performed for the treatment of pseudarthrosis after TLIF. Patient demographics, surgical characteristics, perioperative complications, and 1-yr radiographic data were collected. RESULTS A total of 84 patients were identified with mean age of 59 yr and 37 women (44.0%). A total of 16 patients (19.0%) underwent removal of 2 interbody cages for a total of 99 implants removed with distribution as follows: 1 L2/3 (0.9%), 6 L3/4 (5.7%), 37 L4/5 (41.5%), and 55 L5/S1 (51.9%). There were 2 intraoperative venous injuries (2.4%) and postoperative complications were as follows: 7 ileus (8.3%), 5 wound-related (6.0%), 1 rectus hematoma (1.1%), and 12 medical complications (14.3%), including 6 pulmonary (7.1%), 3 cardiac (3.6%), and 6 urinary tract infections (7.1%). Among 58 patients with at least 1-yr follow-up, 56 (96.6%) had solid fusion. There were 5 cases of subsidence (6.0%), none of which required surgical revision. Two patients (2.4%) required additional surgery at the level of ALIF for pseudarthrosis. CONCLUSION ALIF is a safe and effective technique for the treatment of TLIF cage pseudarthrosis with a favorable risk profile.

scholarly journals Robotic-Assisted Trajectory Into Kambin's Triangle During Percutaneous Transforaminal Lumbar Interbody Fusion—Initial Case Series Investigating Safety and Efficacy

2021 ◽  
Author(s):  
Tara Dalton ◽  
David Sykes ◽  
Timothy Y Wang ◽  
Dustin Donnelly ◽  
Khoi D Than ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Average Length ◽  
Perioperative Complications ◽  
Anatomical Variation ◽  
Case Series ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Average Length Of Stay ◽  
Creative Solutions ◽  
Minimally Invasive Spine

Abstract BACKGROUND Minimally invasive spine surgery (MISS) has the potential to further advance with the use of robot-assisted (RA) techniques. While RA pedicle screw placement has been extensively investigated, there is a lack of literature on the use of the robot for other tasks, such as accessing Kambin's triangle in percutaneous lumbar interbody fusion (percLIF). OBJECTIVE To characterize the surgical feasibility and preliminary outcomes of an initial case series of 10 patients receiving percLIF with RA cage placement via Kambin's triangle. METHODS We performed a single-center, retrospective review of patients undergoing RA percLIF using robot-guided trajectory to access Kambin's triangle for cage placement. Patients undergoing RA percLIF were eligible for enrollment. Baseline health and demographic information in addition to peri- and postoperative data was collected. The dimensions of each patient's Kambin's triangle were measured. RESULTS Ten patients and 11 levels with spondylolisthesis were retrospectively reviewed. All patients successfully underwent the planned procedure without perioperative complications. Four patients underwent their procedure with awake anesthesia. The average dimension of Kambin's triangle was 66.3 m2. With the exception of 1 patient who stayed in the hospital for 7 d, the average length of stay was 1.2 d, with 2 patients discharged the day of surgery. No patients suffered postoperative motor or sensory deficits. Spinopelvic parameters and anterior and posterior disc heights were improved with surgery. CONCLUSION As MISS continues to evolve, further exploration of robot-guided surgical practice, such as our technique, will lead to creative solutions to challenging anatomical variation and overall improved patient care.

scholarly journals Computerized tomography evaluation of a resorbable implant after transforaminal lumbar interbody fusion

2004 ◽  
Vol 16 (3) ◽  
pp. 1-6 ◽  
Author(s):  
Timothy R. Kuklo ◽  
Michael K. Rosner ◽  
David W. Polly
Keyword(s):  
Computerized Tomography ◽  
Interbody Fusion ◽  
Case Series ◽  
Ct Scanning ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Delayed Union ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Screw Breakage

Object Synthetic bioabsorbable implants have recently been introduced in spinal surgery; consequently, the indications, applications, and results are still evolving. The authors used absorbable interbody spacers (Medtronic Sofamor Danek, Memphis, TN) packed with recombinant bone morphogenetic protein (Infuse; Medtronic Sofamor Danek) for single- and multiple-level transforaminal lumbar interbody fusion (TLIF) procedures over a period of 18 months. This is a consecutive case series in which postoperative computerized tomography (CT) scanning was used to assess fusion status. Methods There were 22 patients (17 men, five women; 39 fusion levels) whose mean age was 41.6 years (range 23–70 years) and in whom the mean follow-up duration was 12.4 months (range 6–18 months). Bridging bone was noted as early as the 3-month postoperative CT scan when obtained; solid arthrodesis was routinely noted between 6 and 12 months in 38 (97.4%) of 39 fusion levels. In patients who underwent repeated CT scanning, the fusion mass appeared to increase with time, whereas the disc space height remained stable. Although the results are early (mean 12-month follow-up duration), there was only one noted asymptomatic delayed union/nonunion at L5–S1 in a two-level TLIF with associated screw breakage. There were no infections or complications related to the cages. Conclusions The bioabsorbable cages appear to be a viable alternative to metal interbody spacers, and may be ideally suited to spinal interbody applications because of their progressive load-bearing properties.

scholarly journals Comparison of Incidence of Adjacent Segment Pathology between Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion Treatments for Lumbosacral Junction

Tomography ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 855-865
Author(s):  
Po-Kuan Wu ◽  
Meng-Huang Wu ◽  
Cheng-Min Shih ◽  
Yen-Kuang Lin ◽  
Kun-Hui Chen ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Medical Center ◽  
Lumbar Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Lumbosacral Junction ◽  
The Mean ◽  
Anterior Interbody Lumbar Fusion

This research compared the incidence of adjacent segment pathology (ASP) between anterior interbody lumbar fusion (ALIF) treatment and transforaminal lumbar interbody fusion (TLIF) treatment. Seventy patients were included in this retrospective study: 30 patients received ALIF treatment, and 40 patients received TLIF treatment at a single medical center between 2011 and 2020 with a follow-up of at least 12 months. The outcomes were radiographic adjacent segment pathology (RASP) and clinical adjacent segment pathology (CASP). The mean follow-up period was 42.10 ± 22.61 months in the ALIF group and 56.20 ± 29.91 months in the TLIF group. Following single-level lumbosacral fusion, ALIF is superior to TLIF in maintaining lumbar lordosis, whereas the risk of adjacent instability in the ALIF group is significantly higher. Regarding ASP, the incidence of overall RASP and CASP did not differ significantly between ALIF and TLIF groups.

A Case Series of Retroperitoneal Lymphocele Following Anterior Lumbar Interbody Fusion

2020 ◽  
Vol 140 ◽  
pp. 114-118
Author(s):  
Sidney Roberts ◽  
Ram Alluri ◽  
Hannah Hageman Licari ◽  
Jihoon T. Choi ◽  
Jeffrey C. Wang ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Case Series ◽  
Anterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion
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