Article
Lumbar interbody fusion with metal implants ("cages"): indications, results, outlooks
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Authors
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G. von Salis-Soglio
- Orthopädische Universitätsklinik Leipzig, Orthopädie, Leipzig
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R. Scholz
- Leipzig
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K. Seller
- Leipzig
| Published: | June 13, 2005 |
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Outline
Text
Introduction
In recent years a hugh variety of cages for lumbar interbody fusion came up with at the moment about 150 different implants on the market. The basic principle of interbody fusion is the high primary stability with maintenance of the intervertebral heigth of the instrumented levels, thus enabling constant bony fusion. However instead of the rising use of cages, there is an unsatisfactory lack of scientific evaluation of this subject.
Material and methods
Comparing data from literature and showing own cases (n=200) indications, results and complications are discussed.
Results
Beside other different materials more and more titanium is used for cages, and they can be implanted with nearly all fusion-techniques. The anyalysis of definitive bony fusion is unsactisfactory untill now
with different evaluation criteria. Our results show a fusion rate through and around the implant of over 90%, cage subsidence at the lumbar spine can be seen in 4%, revisions are necessary in 8%.
Discussion
Disadvantages of the cages are revision-problems, the costs and the fact of a durable metal implant, advantages are the high primary stability, the ongoing distraction effect and the reduced need for autologuos bone. Further development targets optimized surface structures, the use of biodegradable materials and the combination with osteoinductive substances.
