Article Figures & Data
Figures
- Figure 1
Degenerative Lumbar Scoliosis and Spinal Stenosis: This 59-year-old male presented with degenerative lumbar scoliosis and spinal stenosis (A, B). He underwent posterior decompression from L3-L5 with unilateral interbody PEEK cage and transpedicular screw and rod fixation using the spinal rod system. Intervertebral height and segmental alignment at the L3-L4 and L4-L5 levels were restored following reconstruction (C, D).
- Figure 2
Bar chart demonstrating patient stratification based on number of operative levels and the use of interbody cages. A total of 167 operative levels were treated in 100 patients (51 single-level, 39 two-level and 10 three-level cases). Eleven cases (11%) were revisions and 67% patients received PEEK interbody cage implants.
- Figure 3
Changes in intervertebral disc height between preoperative, immediate postoperative and 12-month postoperative plain film radiographs were calculated for those intervertebral levels reconstructed with interbody PEEK cages. Intervertebral disc height (millimeters) was measured at the operative level(s) using the vertebral endplates as margins (A, B).
- Figure 4
Intervertebral disc height, as measured from the center of the operative level, increased from an average of 7.5 ± 2.3 mm preoperatively to 9.0 ± 2.1 mm postoperatively for the spinal rod ystem with interbody PEEK cages. This 20% increase in disc space height decreased on average by 0.9 ± 1.77 mm at 1-year follow-up. These values closely approximate those that were reported by Brantigan et al.8 (Brantigan IDE) and McAfee et al.17 (carbon-fiber-reinforced cage and BAK)
- Figure 5
This 74-year-old male presented with an L4-5 Grade I isthmic spondylolisthesis and spinal stenosis (A, B). He underwent reconstruction at the L4-5 level, which included posterior decompression, discectomy with unilateral interbody PEEK cage implantation, and posterior rod instrumentation using the spinal rod system (C, D). As evidenced in the lateral plain films, interbody and posterior reconstruction restored intervertebral and neuroforaminal heights.
Tables
Brantigan Cage IDE Carbon-fiber-reinforced Cage BAK Spinal Rod System P value Mean Length Follow-Up (Months) 24 Months 35.1 Months 22.8±4 Months Surgical Time (Minutes) 297±82 (175-633)* 151.71±40 (70-225)# 137.44±53 (72-228) 125.2±29.2 (70-203) P = 0.000a,b EBL (ml) 1577±1246 (100-8200)a 695.5 ±423 (100-1700) 812.14±504 (200-2500) 942.1±504 (300-2600) P = 0.000a Dural Tears 41 / 221 (18.6%)** 7 / 100 (7%) 8 / 100 (8%) 3/100 (3.0%) P = 0.000c Disc Space Height (mm) Preoperative 7.9 5.7 5.6 7.55 Intitial Postop 12.3 9 10.3 9 Lost at Healing 0.6 0.2 1.4 0.94 Reoperation Rate 102 / 221 (46.1%)c 5 / 100 (5%) 3 / 100 (3%) 4/100 4.0%) P = 0.000c Revision of Pedicle Screws or cages 5 / 221 (2.2%) 1 / 100 (1%) 0 / 100 (0%) 0/102 (0%) NS Fusion Success 176 / 178 (98.9%) 98 / 100 (98%) 100 / 100 (100%) 100/100 (100%) NS Reference Brantigan et al8 McAfee et al17 McAfee et al17 The average overall surgical time, estimated blood loss and incidence of intraoperative durotomies was significantly higher for the clinical IDE Brantigan series versus all other treatments (P < .05). For each treatment modality, the intervertebral disc space height and foraminal height were restored as part of the surgical procedure. However, it's interesting to note that the disc height lost at healing was greatest for the cylindrical BAK (1.4 mm) vs the carbon-fiber-reinforced cage (0.2 to 0.6 mm) and PEEK cage (0.9 mm).
↵a Indicates difference from all other treatments
↵b Significantly greater than spinal rod system (ANOVA,P < .05).
↵c Versus all (χ2 Comparison of Contingency Tables). NS = Not significant at P < .05
Count % Male 107 47.6% Female 118 52.4% Total 225 100.0% Count Average Charge Male 107 $69,250 Female 118 $63,502 Mean 225 $66,201 Count % Male 2,378 41.7% Female 3,318 58.3% Total 5,696 100.0% Count Average Charge Male 2,378 $99,601 Female 3,318 $102,082 Mean 5,696 $101,042 - Table 5
Lumbar Total Disc Replacement Patients Subsequently Undergoing Lumbar Fusion (Cumulative)
Gender Count >= 6 months >= 12 months >= 18 months >= 24 months Male 107 0 2 2 2 % of patients 0.0% 1.9% 1.9% 1.9% Female 118 4 6 7 7 % of patients 3.4% 5.1% 5.9% 5.9% Total 225 4 8 9 9 % of patients 1.8% 3.6% 4.0% 4.0% Gender Count >= 6 months >= 12 months >= 18 months >= 24 months Males 2,378 9 17 25 28 % of patients 0.4% 0.7% 1.1% 1.2% Females 3,318 16 26 38 43 % of patients 0.5% 0.8% 1.1% 1.3% Total 5,696 22 43 63 71 % of patients 0.4% 0.8% 1.1% 1.2% - Table 7
AnteriorLumbar Fusion Patients Subsequently Undergoing Another Fusion, Including Refusions (Cumulative)
Gender Count >= 6 months >= 12 months >= 18 months >= 24 months Males 2,378 26 46 58 66 % of patients 1.1% 1.9% 2.4% 2.8% Females 3,318 46 61 76 83 % of patients 1.4% 1.8% 2.3% 2.5% Total 5,696 72 107 134 149 % of patients 1.3% 1.9% 2.4% 2.6% - Table 8
Aggregate Accumulated Orthopedic-related Charges Before Anterior Lumbar Fusion by Time Interval
14 days prior 30 days prior 90 days prior 6 months 1 year 2 years $1,897 $3,000 $7,499 $11,426 $16,467 $20,562 - Table 9
Aggregate Accumulated Orthopedic-related Charges Before Lumbar Total Disc Replacment by Time Interval
14 days prior 30 days prior 90 days prior 6 months 1 year 2 years $1,021 $1,517 $3,442 $5,349 $11,695 $14,818
In this issue
Jump to section
Related Articles
Cited By...
- No citing articles found.