Two-year follow-up results after treatment of lumbar instability with titanium-coated fusion system.

Objective:   The purpose of this prospective clinical trial, with a minimum two-year follow-up, was to evaluate the clinical effects of a titanium-coated lumbar interbody fusion system in the treatment of lumbar instability.

Methods:   The study cohort consisted of 94 patients with lumbar instability who accepted posterior lumbar interbody fusion with a titanium-coated fusion system. The patients were examined at the sixth, 12th and 24th month postoperatively. The clinical outcomes of all patients were evaluated according to the Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI). Radiological studies, which included assessment of loss of disc space height, intervertebral angle and isodense bone bridging, were used to evaluate the fusion.

Results:   The overall fusion rate was 95.75% at the 24th month after surgery. Ninety-two (97.87%) patients were able to work while 53 patients (56.38%) were capable of performing heavy manual labor. Neurological assessment showed 77 patients (81.92%) had no sensory or motor deficit. The mean JOA score had increased from 15.34 to 28.92 and ODI had decreased from 45 to 15 at the 24th month after surgery. No implant fracture or displacement was found.

Conclusion:   The titanium-coated intervertebral fusion cage is effective and safe for treatment of lumbar instability.