Radiological evaluation of fusion patterns after Lateral Lumbar Interbody fusion with 3D-printed porous titanium cages vs. conventional titanium cages.

IF 1.6 4区 医学 Q2 SURGERY
Frontiers in Surgery Pub Date : 2024-10-15 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1446792
Calogero Velluto, Gregory Mundis, Laura Scaramuzzo, Andrea Perna, Giacomo Capece, Andrea Cruciani, Michele Inverso, Maria Ilaria Borruto, Luca Proietti
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引用次数: 0

Abstract

Introduction: The assessment of segmental fusion after Lateral Lumbar Interbody fusion (LLIF) using 3D-printed porous titanium cage is still not well studied. Various criteria, such as the presence of bone bridges (BB) between adjacent vertebrae, serve as indicators for anterior fusion. However, limited radiological studies have investigated zygapophyseal joints (ZJ) status following LLIF with porous titanium cages vs. conventional titanium threaded cages. The porous design of the latest titanium intervertebral cages is thought to enhance the bone-to-implant fusion rate. This radiological study aimed to compare the fusion patterns post-LLIF using 3D-printed porous titanium cages against those using threaded titanium cages. This radiological study aimed to compare the fusion patterns after LLIF using 3D-printed porous titanium cages against those using threaded titanium cages.

Material and methods: This retrospective, single-center radiological study involved 135 patients who underwent LLIF and posterior percutaneous screw fixation for degenerative spondylolisthesis. The study included 51 patients (Group A) with the novel porous titanium cages and 84 patients (Group B) with conventional threaded titanium cages. Inclusion criteria mandated complete radiological data and a minimum follow-up period of 24 months. The study evaluated intervertebral bone bridges (BB) for anterior fusion and zygapophyseal joints (ZJ) ankylotic degeneration, based on Pathria et al., as evidence of posterior fusion and segmental immobilization.

Results: Two years after surgery, intervertebral BB were identified in 83 segments (94.31%) in Group A and in 87 segments (88.77%) in Group B. ZJ Pathria grade I was observed in 2 segments (2.27%) of Group A and in 4 segments (4.08%) of Group B. Grade II was seen in 5 segments (5.68%) of Group A and in 6 segments (6.12%) of Group B. Posterior fusion, classified as grade III, was found in 81 segments (92.04%) of Group A and 88 segments (89.79%) of Group B. Subsidence incidence was 5.88% (3 segments) for the novel cage and 9.88% (8 segments) for the conventional cage.

Conclusions: The architecture of porous titanium cages offers a promising solution for increasing bone ingrowth and bridging space, supporting successful spinal fusion while minimizing the risk of subsidence.

使用 3D 打印多孔钛笼与传统钛笼进行侧腰椎椎间融合术后融合模式的放射学评估。
导言:使用三维打印多孔钛笼进行侧腰椎椎体间融合术(LLIF)后节段融合的评估仍未得到充分研究。相邻椎体之间是否存在骨桥(BB)等各种标准可作为前路融合的指标。然而,对使用多孔钛笼与传统钛螺纹笼进行 LLIF 后颧骨关节(ZJ)状态的放射学研究还很有限。最新钛椎间笼的多孔设计被认为可提高骨与植入物的融合率。这项放射学研究旨在比较使用三维打印多孔钛笼与使用螺纹钛笼的 LLIF 术后融合模式。这项放射学研究旨在比较使用三维打印多孔钛笼与使用螺纹钛笼的 LLIF 术后融合模式:这项回顾性、单中心放射学研究涉及 135 名接受 LLIF 和后路经皮螺钉固定治疗的退行性脊柱滑脱症患者。其中 51 名患者(A 组)使用新型多孔钛笼,84 名患者(B 组)使用传统螺纹钛笼。纳入标准为完整的放射学数据和至少 24 个月的随访期。研究根据 Pathria 等人的研究结果,评估了用于前路融合的椎间骨桥(BB)和作为后路融合和节段固定证据的颧骨关节(ZJ)强直性变性:术后两年,A 组 83 个节段(94.31%)和 B 组 87 个节段(88.77%)发现椎间 BB。A组81个节段(92.04%)和B组88个节段(89.79%)发现后方融合,被归类为III级。新型保持架的下沉发生率为5.88%(3个节段),传统保持架为9.88%(8个节段):结论:多孔钛笼的结构为增加骨的生长和桥接空间提供了一种很有前景的解决方案,在支持脊柱融合成功的同时最大限度地降低了下沉的风险。
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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
期刊介绍: Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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