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International Orthopaedics

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01-06-2016 | Original Paper

Long-term effects of placing one or two cages in instrumented posterior lumbar interbody fusion

Authors: Mingzheng Zhang, Fang Pu, Liqiang Xu, Linlin Zhang, Jie Yao, Deyu Li, Yu Wang, Yubo Fan

Published in: International Orthopaedics | Issue 6/2016

Abstract

Purpose

Posterior lumbar interbody fusion (PLIF) is an established surgical procedure for spine stabilization after the removal of an intervertebral disc. Researches have shown that inserting a single oblique cage has a similar immediate effect to coupled cages, and it has been proposed that single-cage PLIF is a useful alternative to traditional two-cage PLIF. However, it is not clear whether placing one or two cages represents the best choice for long-term fusion. The aim of this study is to examine how cage placement affects bone remodeling after PLIF surgery, and how this consequently impacts the long-term fusion process.

Methods

A finite element model of a L3-L4 lumbar spine with PLIF was developed. The spinal segment was modeled with a partial laminectomy and a discectomy with partial facetectomy, and implanted with posterior pedicle screws. Two models were analyzed, one with coupled parallel cages and one with a single oblique cage. Adaptive bone remodeling was simulated according to Huiskes’ criterion.

Results

The results showed that in the initial state prior to any bone remodeling, cage stress, cage subsidence and cage dislodgement in the single cage model were all greater than in the coupled cage model. In the final state after significant bone remodeling had taken place, these parameters had decreased in both models and the differences between the two models were reduced. Also, the single cage model demonstrated superior bone development in the bone graft when placed under a constant 400 N axial compressive load.

Conclusion

Based on the long-term results, instrumented PLIF with a single cage could also be encouraged in clinical practice.

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Title: Long-term effects of placing one or two cages in instrumented posterior lumbar interbody fusion
Authors: Mingzheng Zhang
Fang Pu
Liqiang Xu
Linlin Zhang
Jie Yao
Deyu Li
Yu Wang
Yubo Fan
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 6/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3173-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-term effects of placing one or two cages in instrumented posterior lumbar interbody fusion

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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