Background: Bidirectional expandable designs for lumbar interbody fusion cages are the latest iteration of expandable spacers employed to address some of the common problems inherent to static interbody fusion cages.
Objective: To describe the rationales for contemporary bidirectional, multimaterial expandable lumbar interbody fusion cage designs to achieve in situ expansion for maximum anterior column support while decreasing insertion size during minimal-access surgeries.
Methods: The authors summarize the current concepts behind expandable spinal fusion open architecture cage designs focusing on advanced minimally invasive spinal surgery techniques, such as endoscopy. A cage capable of bidirectional expansion in both height and width to address constrained surgical access problems was of particular interest to the authors while they analyzed the relationship between implant material stiffness and geometric design regarding the risk of subsidence and reduced graft loading.
Conclusions: Biomechanical advantages of new bidirectional, multimaterial expandable interbody fusion cages allow insertion through minimal surgical access and combine the advantages of proven device configurations and advanced material selection. The final construct stiffness is sufficient to provide immediate anterior column support while accommodating reduced sizes required for minimally invasive surgery applications.
Level Of Evidence: 7.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735463 | PMC |
http://dx.doi.org/10.14444/7128 | DOI Listing |
Study Design: Retrospective cohort study.
Objective: Frailty is defined as a state of minimal "physiologic reserve." The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality.
World Neurosurg
January 2025
Department of Orthopedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai city, Osaka 5918025, Japan.
Backgrounds: Postoperative inflammatory parameters are important markers of surgical site infection. Some authors have reported that spine surgery with instrumentation elevates CRP levels more than that without instrumentation does. However, those studies compared early postoperative inflammatory markers with or without instrumentation in different patients, although CRP levels vary widely among patients.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Purpose: This study aimed to compare the incidence of radiological adjacent segment disease (R-ASD) at L3/4 between patients with L4/5 degenerative spondylolisthesis (DS) who underwent L4/5 posterior lumbar interbody fusion (PLIF) and those who underwent microscopic bilateral decompression via a unilateral approach (MBDU) at L4/5. Our ultimate goal was to distinguish the course of natural lumbar degeneration from fusion-related degeneration while eliminating L4/5 decompression as a confounder.
Methods: Ninety patients with L4/5 DS who underwent L4/5 PLIF (n = 53) or MBDU (n = 37) and were followed for at least 5 years were retrospectively analyzed.
Orthop Surg
January 2025
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Objectives: The advent of O-arm navigation optimized the oblique lumbar interbody fusion (OLIF) procedure, allowing the operator to simultaneously perform OLIF and percutaneous posterior pedicle screw implantation without patient position change, thus improving the fluency and accuracy of the OLIF procedure (called as OLIF360). Nevertheless, a consensus regarding its suitability for patients with severe spinal stenosis remains elusive. This study aims to investigate the clinical efficacy of OLIF360 and its imaging changes in severe lumbar spinal stenosis cases.
View Article and Find Full Text PDFFront Bioeng Biotechnol
January 2025
Department of Orthopedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Background: Currently, some novel rods with lower elastic modulus have the potential as alternatives to traditional titanium alloy rods in lumbar fusion. However, how the elastic modulus of the rod (rod-E) influences the biomechanical performance of lumbar interbody fusion remains unclear. This study aimed to explore the quantitative relationships between rod-E and the biomechanical performance of transforaminal lumbar interbody fusion (TLIF).
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