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Anterior lumbar interbody fusion with integrated fixation and adjunctive posterior stabilization: A comparative biomechanical analysis
Journal article   Peer reviewed

Anterior lumbar interbody fusion with integrated fixation and adjunctive posterior stabilization: A comparative biomechanical analysis

Matthew S. Yeager, Derrick A. Dupre, Daniel J. Cook, Michael Y. Oh, Daniel T. Altman and Boyle C. Cheng
Clinical biomechanics (Bristol), v 30(8), pp 769-774
Oct 2015
DOI: https://doi.org/10.1016/j.clinbiomech.2015.06.015
PMID: 26169603
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Anterior lumbar interbody fusion Circumferential fusion Integrated fixation Interspinous process clamp Lumbar spine
Interbody fusion cages with integrated fixation components have become of interest due to their ability to provide enhanced post-operative stability and mitigate device migration. A recently approved anterior lumbar interbody fusion cage with integrated fixation anchors has yet to be compared in vitro to a standard polyetheretherketone cage when used in combination with an interspinous process clamp. Twelve human cadaveric lumbar segments were implanted at L4–L5 with a Solus interbody cage (n=6) or standard polyetheretherketone cage (n=6) following Intact testing and discectomy. Each cage was subsequently evaluated in all primary modes of loading after supplementation with the following posterior constructs: interspinous process clamp, bilateral transfacet screws, unilateral transfacet screw with contralateral pedicle screws, and bilateral pedicle screws. Range of motion results were normalized to Intact, and a two-way mixed analysis of variance was utilized to detect statistical differences. The Solus cage in combination with all posterior constructs provided significant fixation compared to Intact in all loading conditions. The polyetheretherketone cage also provided significant fixation when combined with all screw based treatments, however when used with the interspinous process clamp a significant reduction was not observed in lateral bending or axial torsion. Interbody cages with integrated fixation components enhance post-operative stability within the intervertebral space, thus affording clinicians the potential to utilize less invasive methods of posterior stabilization when seeking circumferential fusion. Interspinous process clamps, in particular, may reduce peri-operative and post-operative comorbidities compared to screw based constructs. Further study is necessary to corroborate their effectiveness in vivo. •PEEK ALIF cages traditionally lack stability in torsion and lateral bending.•ALIF cages with integrated supplemental fixation enhance immediate stability.•IPCs adjunct to ALIF cages may provide a stable fusion environment.

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10 citations in Web of Science
15 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Engineering, Biomedical
Orthopedics
Sport Sciences
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