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Stand-alone anterior interbody fusion for substitution of iliac fixation in lengthy spinal fixation constructs.

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Stand-alone anterior interbody fusion for substitution of iliac fixation in lengthy spinal fixation constructs.

Arch Orthop Trauma Surg. 2018 Apr;138(four):479-486

Authors: Khashan M, Camisa W, Berven S, Leasure J

Summary
INTRODUCTION: Using distal sacral anchorage solely, in lengthy spinal fusions, might result in substantial issues. Extending the fixation all the way down to the ilium and the addition of anterior column help are each used to facilitate assemble stability and enhance fusion charges. Within the present research, we aimed to find out whether or not supplementation of lengthy thoracolumbar fixation constructs with stand-alone anterior interbody fusion (ALIF) cage with embedded screws can eradicate the biomechanical want for iliac screws fixation biomechanically.
METHODS: Seven lumbopelvic human cadavers (L1-full pelvis) had been used. All specimens had been examined with the next fixation constructs: bilateral L1-S1, bilateral L1-S1 with unilateral iliac screw, and bilateral L1-S1 with bilateral iliac screw. The three constructs had been examined with and with out the addition of stand-alone ALIF cage. We evaluated the multidirectional rigidity and the axial S1 screw pressure.
RESULTS: The addition of an ALIF cage solely didn’t have an effect on rigidity and resulted in combined S1 screw pressure outcomes. One iliac screw was superior to ALIF in rigidity and inferior in S1 screws pressure. Bilateral iliac fixation produced related rigidity and decrease S1 screws pressure than unilateral iliac fixation. When ALIF was mixed with bilateral iliac screws, it resulted in equal rigidity and decrease S1 screws pressure.
CONCLUSION: Our outcomes don’t help stand-alone ALIF cage as an alternative choice to iliac fixation in in lengthy posterior lumbosacral fusion. They do help the usage of stand-alone ALIF for the supplementation of bilateral iliac fixation in lengthy lumbosacral fusions.

PMID: 29288274 [PubMed – indexed for MEDLINE]

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