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Low fusion rate after L5-S1 laparoscopic anterior lumbar interbody fusion using twin stand-alone carbon fiber cages.

Abstract：

STUDY DESIGN:Prospective study of a cohort of patients who underwent L5-S1 laparoscopic anterior lumbar interbody fusion. OBJECTIVES:To assess the fusion rate and the clinical outcome more than 2 years after L5-S1 laparoscopic anterior lumbar interbody fusion using twin stand-alone carbon-fiber cages. SUMMARY OF BACKGROUND DATA:The first reports on laparoscopic anterior lumbar interbody fusion using stand-alone cages appeared in 1995. Since then several articles have reported contradictory data regarding fusion rate. There are no publications describing the fusion rate of stand-alone lumbar carbon-fiber cages. METHODS:The authors evaluated 12 patients (mean age 36.5 years) in whom endoscopic L5-S1 anterior lumbar interbody fusion was performed using twin stand-alone laparoscopic carbon-fiber cages. Clinical evaluation was carried out prospectively by the use of three self-evaluation scales. Radiologic evaluation was performed by an independent radiologist using dynamic flexion-extension films and CT scans at 6 and 12 months after surgery and subsequently every year until fusion was demonstrated. RESULTS:After a mean follow-up of 36.6 months (range 24-63 months) the clinical condition of the patients was significantly better than their preoperative status: visual analog scale (P < 0.01), Prolo score (P < 0.05), and Waddell Disability Index (P < 0.01). L5-S1 mobility did not exceed 5 degrees in any dynamic study. However, the overall CT scan fusion rate at 2 years of follow-up was 16.6%. Three years after surgery, CT demonstrated fusion in one of five patients. CONCLUSION:Two years after endoscopic L5-S1 anterior lumbar interbody fusion using twin stand-alone laparoscopic carbon-fiber cages, the fusion rate was unacceptably low. However, the clinical outcomes of these patients were significantly improved compared with their preoperative status.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Pellisé F,Puig O,Rivas A,Bagó J,Villanueva C

doi

10.1097/00007632-200208010-00015

keywords:

subject

Has Abstract

pub_date

2002-08-01 00:00:00

pages

1665-9

issue

15

eissn

0362-2436

issn

1528-1159

pii

00007632-200208010-00015

journal_volume

27

pub_type

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