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Treatment of Symptomatic Lumbar Disc Degeneration with the VariLift-L Interbody Fusion System: Retrospective Review of 470 Cases

Warren F. Neely, Frank Fichtel, Diana Cardenas del Monaco and Jon E. Block
International Journal of Spine Surgery January 2016, 10 15; DOI: https://doi.org/10.14444/3015

Article Figures & Data

Figures

  • Fig. 1
    Fig. 1

    VariLift-L expandable stand-alone lumbar interbody fusion device.

  • Fig. 2
    Fig. 2

    Expansion of the VariLift-L device providing maintenance of segmental lordosis due to the wedge shape of the deployed implant. The large hollow inner chamber and wide fenestrations allow easy placement of bone graft and improved radiographic visualization to assess fusion status.

  • Fig. 3
    Fig. 3

    Fluoroscopic evaluation of intraoperative surgical technique; A) disc distraction with temporary interbody spacer, B) sizing of the VariLift-L, C) device insertion, D) intermediate device expansion, E) full device expansion, F) final fluoroscopic image of expanded bilateral devices.

  • Fig. 4
    Fig. 4

    Twelve month postoperative lateral radiographic image of bilaterally implanted devices, maintaining excellent anatomical position at L4-5 and purchase to the endplates. The large fenestrations allow exquisite radiographic visualization of progression of bony fusion within the cage chamber.

  • Fig. 5
    Fig. 5

    Composite back pain severity scores preoperatively (n=470) as well as at 6 months (n=419, 89%) and 12 months (n=352, 75%).

Tables

  • Table 1

    Patient Baseline Characteristics.

    CharacteristicValue (N = 470)
    Sex, n (%)
    Female261 (55.5)
    Demographic Information, n (%)
    History Of Smoking*
    Employed†
    Spine Surgical History‡    		119 (25.5)
    352 (77.7)
    134 (29.8)
    Pre-Existing Conditions, n (%)
    Diabetes
    Osteoporosis
    Obesity
    HTN
    Cardio HX
    Hypercholestermia
    Cancer HX
    Thyroid Disorders    		51 (10.9)
    21 (4.5)
    27 (5.7)
    132 (28.1)
    49 (10.4)
    60 (12.8)
    34 (7.2)
    33 (7.0)
    Pre-surgical Symptoms, n (%)
    Back Pain§
    Radicular Pain§
    Bowel/Bladder Dysfunction*    		467 (99.6)
    434 (92.6)
    9 (2.0)
    Diagnosis, n (%)
    Spondylosis
    Spondylolisthesis (Grade 1 or less)
    Herniated Nucleus Pulposis#
    Facet Joint Degeneration**
    Instability††
    Osteophyte Formation**
    Decreased Disc Height#    		335 (71.9)
    78 (16.6)
    412 (89.0)
    397 (87.1)
    462 (98.7)
    376 (82.5)
    452 (97.6)

    • ↵* N = 460

    • ↵† N = 453

    • ↵‡ N = 450

    • ↵§ N = 469

    • N = 466

    • ↵# N = 463

    • ↵** N = 456

    • ↵†† N = 468.

  • Table 2

    Operative Levels.

    Variable
    Number of Levels Implanted Per Patient Value (N = 470)
    1 Level
    2 Level    		298 (63.4)
    172 (36.6)
    Total Levels Implanted Value (N = 642)
    L1-2
    L2-3
    L3-4
    L4-5
    L5-S1    		1 (0.2)
    27 (4.1)
    114 (17.5)
    319 (48.9)
    181 (27.7)
  • Table 3

    Intra-operative and Post-operative Complications.

    ComplicationValue (N = 470)
    Excessive Blood Loss (>750cc)42 (8.9)
    Dural Laceration2 (<1.0)
    Superficial Wound Infection12 (2.6)
    CSF Leak11 (2.4)
    Post-Operative Radiculopathy18 (3.9)
    Sensory Deficit22 (4.7)
    Motor Deficit31 (6.7)
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Treatment of Symptomatic Lumbar Disc Degeneration with the VariLift-L Interbody Fusion System: Retrospective Review of 470 Cases
Warren F. Neely, Frank Fichtel, Diana Cardenas del Monaco, Jon E. Block
International Journal of Spine Surgery Jan 2016, 10 15; DOI: 10.14444/3015
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